Name of the Procedure:

Nasal/sinus endoscopy, surgical, with sphenoidotomy.

Summary

A nasal/sinus endoscopy with sphenoidotomy is a minimally invasive surgical procedure where doctors use an endoscope to view and operate on the sphenoid sinus, located near the base of the skull. This involves creating an opening in the sinus to relieve blockages or remove abnormal tissue.

Purpose

The procedure is aimed at treating chronic sinus infections, tumors, and other abnormalities in the sphenoid sinus. The goal is to improve sinus drainage, reduce symptoms like congestion and headaches, and eliminate sources of infection or inflammation.

Indications

• Chronic sinusitis unresponsive to medication
• Nasal polyps
• Fungal sinus infections
• Sinus tumors
• Cerebrospinal fluid leaks into the sphenoid sinus
• Recurring sinus infections

Preparation

• Patients may need to fast for several hours before the procedure.
• Certain medications, such as blood thinners, might need to be adjusted or stopped.
• Pre-operative assessments may include CT scans or MRIs of the sinuses.

Procedure Description

1. Anesthesia: General anesthesia is commonly used.
2. Endoscope Insertion: A thin, flexible tube with a camera (endoscope) is inserted through the nostril to visualize the sphenoid sinus.
3. Sphenoidotomy: Specialized surgical instruments are used to make an opening in the sphenoid sinus.
4. Treatment: Removal of blockages, polyps, or infected tissue.
5. Conclusion: The area is cleaned, and the instruments are removed.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Otolaryngologist (ENT surgeon)
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Bleeding
• Infection
• Damage to surrounding tissues, including nerves and blood vessels
• Complications from anesthesia
• Recurrence of the original problem

Benefits

• Relief from chronic sinusitis symptoms
• Improved sinus drainage and function
• Reduction in the frequency of infections
• Removal of problematic tissues or polyps Benefits can often be noticed within weeks after the procedure.

Recovery

• Patients may experience nasal congestion and mild discomfort, which can be managed with pain medication.
• Nasal saline rinses and decongestants are often recommended.
• Avoid strenuous activities for at least a week.
• Follow-up appointments are usually scheduled within a few weeks to monitor healing.

Alternatives

• Medications (e.g., antibiotics, steroids)
• Balloon sinuplasty for less severe cases
• Traditional sinus surgery which is more invasive
• Each alternative has its pros and cons in terms of efficacy, recovery time, and invasiveness.

Patient Experience

During the procedure, patients are under general anesthesia and will not feel anything. Post-procedure, there may be some discomfort, congestion, and a need for nasal care. Pain management includes prescribed painkillers and saline rinses. Most patients can return to normal activities within a week but should follow all post-operative care instructions to ensure proper healing.