What is endoscopic sinus surgery? Important notes

What is endoscopic sinus surgery?

Endoscopic sinus surgery is a modern and minimally invasive surgical technique performed to treat sinus problems, such as chronic sinusitis, nasal polyps, or sinus blockages due to abnormal structures. This procedure uses a small endoscope equipped with a camera and light source, allowing the doctor to clearly observe the nasal cavity and sinuses without large external incisions.

Who is Endoscopic Sinus Surgery for?

Endoscopic sinus surgery is primarily designed for individuals suffering from chronic sinusitis, which affects millions of people globally. This surgical intervention becomes necessary when other treatments, such as medications and home remedies, fail to alleviate the symptoms. 

Chronic Sinusitis

Chronic sinusitis is characterized by prolonged inflammation of the sinuses, lasting more than 12 weeks despite medical treatment. Symptoms often include:

• Persistent nasal congestion
• Facial pain or pressure
• Nasal discharge
• Reduced sense of smell

Patients experiencing these symptoms consistently may be ideal candidates for endoscopic sinus surgery.

Nasal Polyps

Nasal polyps are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. They result from chronic inflammation due to asthma, recurring infection, allergies, drug sensitivity, or certain immune disorders. ESS can effectively remove these polyps, improving airflow and sinus drainage.

Deviated Septum

A deviated septum can block sinus passages, leading to recurring infections and breathing difficulties. Through ESS, surgeons can correct the deviation, enhancing sinus function and patient comfort.

Recurrent Sinus Infections

Some patients suffer from recurrent acute sinusitis, where they experience several episodes within a year, each lasting up to four weeks. If antibiotics and other treatments prove ineffective, ESS may be a recommended solution.

Cystic Fibrosis

Patients with cystic fibrosis often have thick nasal secretions and chronic sinus infections. Endoscopic sinus surgery can help clear the sinuses, enhancing breathing and reducing infection frequency.

Tumors or Growths

ESS is also used to remove benign or malignant tumors in the nasal cavity or sinuses. This procedure allows for precise removal of abnormal tissue with minimal impact on surrounding structures.

Possible Complications After Endoscopic Sinus Surgery

While endoscopic sinus surgery is generally considered safe and effective, it does carry potential risks and complications. 

Here are common complications:

• Bleeding: Some bleeding is expected after surgery, but excessive bleeding can occur. This risk is heightened if patients are on blood-thinning medications or have clotting disorders.
• Infection: Although the sinuses are cleared during surgery, there is still a risk of infection postoperatively. Symptoms of infection include fever, increased pain, and discharge from the nose.
• Scar Tissue Formation: Scar tissue can form during the healing process, potentially leading to a recurrence of sinus blockage.

There may also be some other long-term risks:

• Chronic Sinusitis Recurrence:Despite successful surgery, some patients may still experience recurring sinusitis, necessitating further treatment.
• Nasal Obstruction: Ongoing nasal obstruction can occur due to scar tissue or the regrowth of polyps.

Notes before performing endoscopic sinus surgery

Similar to endoscopic sinus surgery for children, before performing endoscopic sinus surgery, patients need to take some preparation steps to ensure the safety and effectiveness of the surgery. Here are the things to prepare:

1. Examination and testing: Patients need to consult and make an appointment to check the condition of the sinuses and assess the level of pathology
2. Perform necessary tests: Patients are often asked to do blood tests and CT or MRI scans of the sinuses so that the doctor can clearly observe the structure and level of damage of the sinuses, helping to plan a specific surgery.
3. Stop using certain medications: Patients need to inform their doctors about the medications they are using and stop using some of these medications 1-2 weeks before surgery as directed by the doctor.
4. Prepare mentally and rest: Patients need to prepare mentally and get enough sleep before the day of surgery. Getting enough rest will help your body recover faster after surgery.
5. Do not eat or drink before surgery: Usually, patients will be asked not to eat or drink for at least 6-8 hours before surgery if they have general anesthesia, to avoid respiratory complications.
6. Plan to rest after surgery: Patients should arrange their work and prepare to rest after surgery. After surgery, patients need time to recover and avoid strenuous activities so as not to affect the wound healing process.
7. Ask your doctor about issues to note: Patients should discuss their questions and concerns with their doctor before surgery. This includes information about the time of surgery, what to expect after surgery, and symptoms to monitor.

Good preparation before endoscopic sinus surgery is essential for the surgery to be safe and smooth, helping patients recover quickly and effectively.

In summary, patients need to clearly understand the concept, indications and precautions to prepare before endoscopic sinus surgery to perform the surgery in the safest way.