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Endoscopic Sinus Surgery


Any inflammation or swelling of the tissue lining the sinuses is called sinusitis. Sinuses are filled with air but if they are blocked and filled with fluid then germs can grow and cause infection. Acute sinusitis, sub-acute sinus, chronic inflammation, recurrent sinusitis is different types of sinus and some of the conditions that can cause sinus blockage may include:

·        Common cold

·        Allergic rhinitis

·        Nasal polyps

·        Deviated septum

Sinus can cause pain and discomfort and in rare cases, untreated sinusitis can cause meningitis, a brain abscess or an infection of the bone.  Surgery is required to remove severely blocked and infected sinus and when used along with medicine and home treatment shows better results to prevent future sinusitis. Antibiotics can prevent recurrence of infection and future surgery can be avoided.  

Endoscopic surgery is more preferred over traditional surgery for most cases of chronic sinus which allow better and more precise visualization without the need for external incisions resulting in less swelling, bleeding, and discomfort, and a faster recovery from sinus surgery. The most important advantage of this surgery is the ability to deliver medications to the lining of the sinus after their opening.

During the consultation, doctor will advise the patient to avoid taking medicines or blood thinners that may cause bleeding and may suggest some antibiotics or steroids prior to sinus surgery depending on the patient.

 

Patient will be given either local anesthesia (for numbing the nasal/sinus cavity but patient remains awake) or general anesthesia (patient goes to sleep during the surgery). Small telescope called nasal endoscope is inserted through the nostril to see inside the nose and sinuses. Through endoscopic surgery, doctor can easily identify the channels that connect sinuses to the nose, enlarge these openings and drain the sinuses out through the nose. Surgeon will decide whether a patient needs nasal packing during the surgery or not. After removing the packing, patient can breathe through nose but should not blow or sneeze at least for 7 to 10 days to reduce the chances of bleeding

The recovery will depend on patient to patient and the type of surgery performed. It may take up to 3 to 5 days to feel completely normal. Patient should avoid strenuous activities that may increase heart rate, blood pressure such as exercising, running, weight lifting etc.  Doctor will prescribe some medicines for relieving pain, saline rinses, nasal steroid sprays and some antibiotics to prevent infection post surgery.  Patient may experience some mild symptoms for several weeks after the surgery but discomfort, congestion and drainage will be improved after first few days.

There is another technology that can be used along with traditional endoscopic sinus surgery. The surgery uses balloons to widen the sinus channels is called sinuplasty or balloon dilation. In this procedure, balloons are placed into the channels or openings of a patient’s sinuses. Then balloon is expanded in the narrowed sinus channel to wider the opening of sinus. But balloon sinuplasty may not prove beneficial for everyone.

There are some potential complications and risks involved with endoscopic sinus surgery that may include:

·        Bleeding

·        Vision damage

·        Reaction to anesthesia

·        Brain injury

·        Brain fluid leakage

·        Infection in the brain

 

Doctor should be immediately informed in case patient experience sudden increased amount of bleeding that cannot be relieved by pressure, ice or head elevation, high fever, sharp or continuous headache, increased swelling or redness etc.
it is always better to take some preventive measures to avoid any further problem caused by sinus such as:

·        Moistening – moist sinuses makes mucus thinner which allows the better drainage of the sinuses. This will also prevent infection

·        Should use plenty of saline irrigation

·        should avoid smoking as it can dry out sinus linings

·        avoid allergens and wear mask

 

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