Endoscopic Sinus Surgery Abroad

What is Endoscopic Sinus surgery?
Endoscopic Sinus Surgery is a surgical procedure to remove unhealthy sinus tissue from the drainage channels, which helps in making way for the drainage of infected material from the sinus cavities. The surgery is mostly performed using endoscopic methods for improved and accurate view. Endoscopic nasal sinus surgery is done without external incisions and therefore there is very little bleeding, swelling and discomfort, which enables a fast recovery. Endoscopic sinus surgery does not damage healthy tissues, requires less time and yields good results. Nasal sinus surgery requires post-operative care, therefore follow-up and aftercare should be given essential attention.

How is Endoscopic Sinus Surgery performed?

• A nasal endoscope is inserted through the nostrils into the nasal cavity. This allows the doctor to view the inside of the nose and sinuses.
• The middle turbinate is located to identify and remove the uncinate process.
• The ethmoid air cells are opened to improve ventilation, leaving the bone with the covering of mucous membrane.
• Any blockage in the ostium, situated close to the jaw is removed with a meatal antrostomy.
• The surgery helps to improve the ventilation of the sinuses by making the osteomeatal complex function better.

How to prepare for the Endoscopic Sinus surgery?

• The patient’s medical history is reviewed by the doctor.
• An ENT specialist will conduct diagnostic examination on the patient, which may involve fiberoptic endoscopy and CT scan.
• The patient needs to avoid taking certain medication that may worsen bleeding. This includes herbs and vitamins.
• The patient may be required to take antibiotics and steroids to reduce swelling.
• Patients who smoke are advised to stop or reduce smoking to help in recovery.
• The doctor should be informed if the patient has fever or any illness before the surgery.

Duration of procedure/surgery:
60 to 90 minutes

Days admitted:
Nasal sinus surgery is usually done as an outpatient procedure.

Anesthesia:
Local anesthesia with intravenous sedation

Recovery:
- The patient is taken to the recovery room where the patient’s vital signs are monitored.
- Moderate bleeding from the nose after the surgery is normal.
- The patient may vomit once or twice after the surgery.
- Swelling of the nose, around the eyes, and upper lip is noticed for several days.
- Complete recovery may take three to five days.

Risks:
- Injury to the optic nerve, resulting in blindness
- Leakage of cerebrospinal fluid
- Orbital Hematoma
- Nasolacrimal duct stenosis
- Intracranial injury
- Smell and taste impairment
- Numbness
- Voice change
- Pain
- Nasal blockage

After care:
- The patient will not be able to drive after the surgery due to drowsiness and disorientation.
- The nose dressing should be changed regularly as it becomes wet.
- The patient may need to wear a nose pack for a few days
- The patient should avoid blowing the nose for about a week from the surgery.
- The patient should sleep with the head at an elevation.
- Pain medication should be taken only after consulting the doctor.
- The patient may need to use a saline spray for six to eight times a day to keep the nose moist.
- The patient should restrain from strenuous activities and physical recreational activities for a few weeks.
- Alcoholic beverages, caffeine, and spicy food should be avoided.
- Decongestant nasal sprays should not be used without consulting a doctor.
- Dairy products may cause excessive mucous formation and should therefore be avoided.
- The patient should avoid smoking and should drink a lot of water.
- The patient should take all medication prescribed by the doctor.
- A follow up appointment is scheduled a week after the surgery.