Endoscopic Sinus Surgery
The most common procedure for treatment of chronic sinusitis is endoscopic
sinus surgery. Endoscopic sinus surgery is used to unblock the sinuses
when drug therapy is not effective or if there are complications of sinusitis
such as structural abnormalities, spread of infection into the eye or
fungal sinusitis.
In endoscopic sinus surgery, fiber-optic surgical techniques are utilized
to open the natural drainage areas of the sinuses and remove polyps, if
present. Endoscopic sinus surgery unblocks obstructions, allowing ventilation
and drainage, thus relieving sinus headaches and congestion, improving
nasal breathing and often enhancing the sense of smell.
CT imaging and computers are used intra-operatively to minimize risk. Intra-operative
CT guidance, or computer-aided surgery, allows the doctor to not only
view the “live images” of the procedure, but at the same time
have a real time 3-dimensional CAT scan image of the area being operated
on. Intra-operative CT guidance provides important anatomic information,
thus allowing better insight into the operative field, and as a result
decreasing the risks of surgery and improving the results of surgery.
Goals
Endoscopic sinus surgery is designed to improve the drainage of the sinuses
as well as to improve airflow through the nose. Endoscopic sinus surgery
also relieves symptoms associated with sinusitis, septal deviations, turbinate
hypertrophy and nasal polyps.
The goals of surgery include
- Reduction of the number and severity of sinus infections.
- Improvement of symptoms associated with sinusitis.
- Improvement of airflow through the nose.
- Improvement of a patient’s sense of smell.
Surgical treatment
- Endoscopic sinus surgery is performed under general anesthesia.
- Endoscopic sinus surgery is performed entirely through the nostrils; thus
there are no incisions made on the skin.
- An endoscope, a thin camera rod with a light at the end to provide visualization
and magnification, is used for direct visualization of the nasal cavity
and sinuses.
- Adjacent to the screen with the live images from the endoscope is a second
screen with real time 3-dimensional CAT scan images of the area being
operated on.
- Working endoscopically through the nose, specialized instruments are used
to safely and effectively remove causes of sinus blockage such as nasal
polyps, diseased bone, diseased tissue or scar tissue.
- Under direct visualization as well as CT guidance, the natural drainage
pathways of the sinuses are opened.
- After the surgery, once the effects of the anesthesia have worn off, the
patient is discharged home.
During the initial consultation, the doctor will examine you, study your
CT Scan, if one is available, and discuss your medical history to determine
whether you are a good candidate for endoscopic sinus surgery. the doctor
will explain the surgery and what you can expect and will answer any questions
and/or concerns that you have.