What is endoscopic nasosinusal surgery?
ENT specialists explain that nasosinusal endoscopic surgery (NENS) consists of operating on the nostrils, paranasal sinuses and sometimes nearby areas, such as the anterior skull base, the pituitary gland, the orbit or the tear ducts; the intervention is performed through the nostrils with the help of special rigid optics (endoscopes) and specifically designed surgical instruments.
These optics are usually connected to a camera that provides an excellent image of the region to be intervened with adequate illumination and magnification.
Applications of endoscopy of the nose
Endoscopic nasosinual surgery is performed in chronic rhinosinusitis with and without polyps, chronic rhinitis with turbinate hypertrophy, complications of sinusitis, deviated septum and chronic dacryocystitis (“rhinitis” with lacrimation and tearing).
In addition, it is also used less frequently in the coagulation of uncontrolled nosebleeds, in surgery for pituitary and skull base tumors, in some cerebrospinal fluid fistulas, in biopsies and resection of benign and malignant tumors of the nose, in the sinuses, etc.
Technique of endoscopy of the nose
The technique of nasosinusal endoscopy varies according to the pathology to be treated. In the most frequent case of chronic rhinosinusitis, surgery removes polyps and damaged mucosa and widens the natural openings of the sinuses to ensure their lavage and ventilation, avoiding their blockage by inflammatory tissue.
Each case is different, but this operation is usually performed under general anesthesia, varying the usual admission between a few hours and a day of hospitalization. Normally, it does not involve any incision or external scar. On the other hand, it is common to place a clotting substance or a small nasal packing.
Outcome of nasosinusal endoscopic surgery
The outcome of nasosinusal endoscopic surgery (NES) varies according to the pathology. In infectious sinusitis, septal deviations, skull base defects, tumors and dacryocystitis, for example, the surgery aims to be definitive and usually achieves this.
On the other hand, in the case of chronic rhinosinusitis with severe polyps, there is a possibility that significant polyps may appear and the procedure may have to be repeated years later. This case is more frequent in patients who combine nasal polyps with asthma and/or aspirin allergy, since the intrinsic airway disease remains -although usually with significant improvement-, and the need for maintenance medical treatment persists.