Endoscopic Sinus Surgery

Endoscopic Sinus Surgery

Functional Endoscopic Sinus Surgery (FESS) - Indications for Endoscopic Sinus Surgery - Contraindications for Endoscopic Sinus Surgery - Technique of Endoscopic Sinus Surgery - Caldwell Luc Operation - Risks and Complications of Endoscopic Sinus Surgery - Postoperative Patient Care for Endoscopic Sinus Surgery - Post-operative Instructions for endoscopic sinus surgery
Endoscopic Sinus Surgery

Functional endoscopic sinus surgery (FESS) is the primary safe approach used currently for the surgical treatment of chronic sinusitis.

This procedure is a minimally invasive, safe and it can be performed entirely through the nostrils, leaving no external scars. There is little swelling and only mild discomfort. It can be combined with other nasal operations (septoplasty, turbinate radiofrequency etc.).

A recently developed alternative to functional endoscopic sinus surgery is balloon sinuplasty. This technique uses balloon catheters to dilate the maxillary, frontal, and sphenoid natural ostia without bone or soft-tissue removal. Reports show persistent patient symptom improvement and sinus ostia patency.

Indications for Endoscopic Sinus Surgery

Functional Endoscopic Sinus Surgery (FESS) - Indications for Endoscopic Sinus Surgery - Contraindications for Endoscopic Sinus Surgery - Technique of Endoscopic Sinus Surgery - Caldwell Luc Operation - Risks and Complications of Endoscopic Sinus Surgery - Postoperative Patient Care for Endoscopic Sinus Surgery - Post-operative Instructions for endoscopic sinus surgery
Indications for Endoscopic Sinus Surgery

The most common indication for endoscopic sinus surgery is “chronic rhinosinusitis”.

The most common indications for endoscopic sinus surgery are as follows:

• Chronic sinusitis refractory to medical treatment
• Recurrent sinusitis
• Nasal polyposis
• Antrochoanal polyps
• Sinus mucoceles
• Excision of selected tumors
• Cerebrospinal fluid (CSF) leak closure
• Orbital decompression (eg, Graves ophthalmopathy)
• Optic nerve decompression
• Dacryocystorhinostomy (DCR)
• Choanal atresia repair
• Foreign body removal
• Epistaxis control

Contraindications for Endoscopic Sinus Surgery 

Functional Endoscopic Sinus Surgery (FESS) - Indications for Endoscopic Sinus Surgery - Contraindications for Endoscopic Sinus Surgery - Technique of Endoscopic Sinus Surgery - Caldwell Luc Operation - Risks and Complications of Endoscopic Sinus Surgery - Postoperative Patient Care for Endoscopic Sinus Surgery - Post-operative Instructions for endoscopic sinus surgery
Contraindications for Endoscopic Sinus Surgery 

There are probably no absolute contraindications to endoscopic sinus surgery.

The most common relative contraindications for endoscopic sinus surgery are as follows:

• Absence of specific osteomeatal complex abnormalities.
• Oesteomyelitis involving the sinuses.
• Frontal sinus disease with stenosed internal ostium.
• Threatened intracranial and / or intracerebral complications.
• Inaccessible lateral frontal sinus disease.

Smoking is also consider as a relative contraindication to endoscopic sinus surgery.

Technique of Endoscopic Sinus Surgery

Functional Endoscopic Sinus Surgery (FESS) - Indications for Endoscopic Sinus Surgery - Contraindications for Endoscopic Sinus Surgery - Technique of Endoscopic Sinus Surgery - Caldwell Luc Operation - Risks and Complications of Endoscopic Sinus Surgery - Postoperative Patient Care for Endoscopic Sinus Surgery - Post-operative Instructions for endoscopic sinus surgery
Technique of Endoscopic Sinus Surgery

Endoscopes with different diameters of 4mm (adult use) and 2.7mm (pediatric use) and with a variety of viewing angles (0 degrees to 30, 45, 70, 90, and 120 degrees) provide good illumination of the inside of the nasal cavity and sinuses. High definition cameras, monitors and different tiny articulating instruments aid in identifying and restoring the proper drainage and ventilation relationships between the nose and sinus cavities.

Paranasal Sinus CT scanning can also be used to identify the diseased areas, a process that is required for planning the surgical procedure.

Endoscopic Sinus Surgery - Maxillary Drainage Video



On the video above: Right maxillary sinus retention cysts discharging into the nasal cavity.

Inner wall of right maxillary sinus pushed toward the nasal cavity by retention cyst, endoscopic evacuation of cyst is showing on video.

Endoscopic Concha Bullosa Operation Video



 Endoscopic Sinus Surgery - Injection of Local Anesthetic Video



Caldwell Luc Operation: An Alternative Method For Surgical Traetment of Chronic Maxillary Sinusitis

Caldwell Luc Operation: An Alternative Method For Surgical Traetment of Chronic Maxillary Sinusitis
Caldwell Luc Operation: An Alternative Method For Surgical Traetment of Chronic Maxillary Sinusitis

Caldwell-Luc operation is defined before the endoscopic sinus surgery to relieve chronic sinusitis by improving the drainage of the maxillary sinus, one of the cavities beneath the eye. The maxillary sinus is entered through the upper jaw above one of the second molar teeth. A window is created to connect the maxillary sinus with the nose, thus improving drainage.

Risks and Complications of Endoscopic Sinus Surgery

Functional Endoscopic Sinus Surgery (FESS) - Indications for Endoscopic Sinus Surgery - Contraindications for Endoscopic Sinus Surgery - Technique of Endoscopic Sinus Surgery - Caldwell Luc Operation - Risks and Complications of Endoscopic Sinus Surgery - Postoperative Patient Care for Endoscopic Sinus Surgery - Post-operative Instructions for endoscopic sinus surgery
Risks and Complications of Endoscopic Sinus Surgery

The risks and complications of endoscopic sinus surgery are as follows:

• Blindness : The most serious risk associated with FESS. It is resulting from damage to the optic nerve. The chances of this complication occurring, however, are extremely low.
• Hemorrhage
• Cerebrospinal fluid leak: It represents the most common major complication of FESS. The leak is usually recognized at the time of surgery and can easily be repaired.
• Orbital hematoma
• Nasolacrimal duct stenosis
• Changes in your sense of smell and / or taste

Postoperative Patient Care for Endoscopic Sinus Surgery

Postoperative Patient Care for Endoscopic Sinus Surgery

For the post-operative first week patients should not blow his / her nose. For firts few days, minor nasal or post nasal bleeding are normal. A saline spray may be used several times per day to relieve nasal irritation. In addition, exercise or any other exertional activity for at least two weeks following surgery should not be performed. This includes no bending, lifting (more than about 10 lbs.), or straining.

The amount is post-operative pain usually less and disappears within a few days.

You should plan on taking at least one week off from work to recover from surgery.

Source links about "Functional Endoscopic Sinus Surgery (FESS) - Indications for Endoscopic Sinus Surgery - Contraindications for Endoscopic Sinus Surgery - Technique of Endoscopic Sinus Surgery - Caldwell Luc Operation - Risks and Complications of Endoscopic Sinus Surgery - Postoperative Patient Care for Endoscopic Sinus Surgery - Post-operative Instructions for endoscopic sinus surgery":


  • Fonksiyonel Endoskopik Sinüs Cerrahisi (FESS) ve Diğer Sinüzit Ameliyatları

  • Functional endoscopic sinus surgery - Wikipedia

  • Endoscopic surgery for sinusitis - WebMD

  • Functional Endoscopic Sinus Surgery (FESS) - ENT UK

  • Endoscopic Sinus Surgery - Johns Hopkins Medicine

  • Endoscopic Nasal & Sinus Surgery - American Rhinologic Society

  • Fact Sheet: Sinus Surgery

  • Sinus Surgery Patient Recovery, Types, Risks - MedicineNet

  • Functional endoscopic sinus surgery (FESS)


  • Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

    Private Office:
    Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
    Appointment Phone: +90 212 561 00 52
    E-Mail: muratenoz@gmail.com
    Mobile phone: +90 533 6550199
    Fax: +90 212 542 74 47


     

     
    

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