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.