Operations for treating sinusitis have developed impressively in recent years. Previously, sinus surgery was carried out through external incisions on the face and through the mouth. They required extended nasal packing, causing pain and discomfort for the patient, with a long recovery period. The progress of technology with nasal endoscopes made the surgery exclusively through the nose simpler.
The rigid nasal endoscope permits the surgeon to see inside the nose and the sinuses via a special video camera adapted to the endoscope.
Today, endoscopic surgery is done painlessly with minimum nasal packing and brief recovery time.
Indications for Surgery
The most frequent cause that will lead us to an endoscopic surgery is chronic rhinosinusitis – chronic sinusitis. It is an edema inside the nose and the sinuses which does not improve with medication.
Chronicity is determined by the persistence of the inflammation for over three months.
Persistent inflammation, nasal polyps (benign protrusions from a mucous edema), allergies.
But less frequent causes for a surgical intervention are: recurrent inflammations (many sinusitis incidents), inflammation of the sinuses moving towards the eye, the face or the brain.
Before the Operation
The medication the patient has taken so far is analyzed.
An allergy check is carried out.
Paranasal sinuses CT.
Medication depending on the case, antibiotics, antihistamines, cortisone spray and cortisone by mouth in order to prepare the mucous before surgery.
How is the Endoscopic Paranasal Surgery carried out?
Usually under general anesthesia. The special endoscope in inserted into the nose and the aim is to identify the narrow channels connecting the nose to all the paranasal sinuses and to widen them. In this way the drainage of mucus from the sinuses to the nose is improved, but also air enters freely. The sinuses are in the cheekbones, the ethmoids between the eyes, frontal sinuses in the forehead and sphenoid sinuses at the center of the head. Sinusitis may have affected some or all sinuses. From the CT the surgeon will determine which sinuses he must widen. During endoscopic surgery the nasal septum will also be aligned. The nasal conches which have the role of humidifying and filtering the nose may have to be surgically reduced.
Light nasal packing is usually required for one day after surgery. Depending on the extent of the operation the corresponding instructions will be provided. There is post-operative nasal blocking from the secretions during the first days. The post-operative treatment and frequent cleaning complete the work of the operation and are equally important. Besides washes with normal saline, cortisone spray and antibiotics may be required.