What is endoscopic nasosinusal surgery?
Endoscopic nasosinusal surgery encompasses all those interventions inside the nose, visualizing or manipulating the structures through optical instruments. Its objective is to treat lesions or anomalies that alter the normal functions of the nose or its surrounding structures. The surgery is performed under general anesthesia.
Why is it performed?
This surgery is performed when there is a permanent nasal and sinus inflammation, especially in chronic sinusitis, in the case of nasal polyps or repeated acute sinusitis that have not responded well to medical treatment. The goal is to restore normal sinus function through minimally invasive surgical invasion. This surgery is also used for septoplasty and turbinate surgery, closure of cerebrospinal fluid fistulas, orbital decompression, etc.
This surgery is performed when there is a permanent nasal and sinus inflammation.
What does it consist of?
The first thing is to apply nasal decongestant and then start the dissection of the wall. For this, a rigid and thin optical fiber is introduced into the nostril obtaining a direct view of the place where the sinuses are opened. With the appropriate tools, the abnormal or obstructive tissue is resected. At the end of the surgery a control of the bleeding points is performed and depending on the case, a nasal packing will be placed to prevent bleeding or silicone sheets to prevent sticking from one wall to another and abnormal scars are formed.
The surgery lasts between 1 and 3 hours depending on the complexity of the case. The nostrils are usually plugged with coagulating foam and specific self-removing sponges or plugs that can be easily removed.
Preparation for endoscopic nasosinusal surgery
For the preparation a CT-sinus study is performed and from this test the surgery is planned. Preoperative tests are also performed since the surgery is performed under general anesthesia. Admission is usually a short stay, maximum one night, and the patient has to remain fasting for 6 to 8 hours before surgery.
Care after surgery
The nose is usually blocked, so the patient cannot breathe through the nose. Bleeding can also occur and therefore a gauze is placed under the nose, although sometimes it is not necessary. During the first 3-4 days the patient cannot smoke, drink alcohol or make physical efforts. In addition, rest at home is recommended, avoiding blowing the nose, preferably in a seated or semi-sitting position to reduce blood pressure in the head, head congestion and bleeding. It is recommended to follow a diet of soft foods and drink plenty of fluids, due to the dryness of the throat that causes nasal packing.
It is not a painful procedure but may cause discomfort, so anti-inflammatory drugs are prescribed according to individual pain tolerance. Antibiotics may be prescribed to prevent superinfection of the retained mucosa.
Alternatives to this treatment
Endoscopic nasosinusal surgery is a very safe procedure since nowadays there are therapeutic means that facilitate both the procedure and recovery. This surgery encompasses interventions inside the nose, visualizing or manipulating the structures through optical instruments, such as septoplasty. For more information, consult a specialist in Otolaryngology.