Tiếng Việt
Assoc. Prof. Dr. Vo Thanh Quang, ENT Specialist at Hanoi French Hospital and former President of the Southeast Asia Rhinology Society, stated:
“Not all cases of chronic rhinosinusitis require surgery. Treatment should be individualized, and determining the right time to transition from medical therapy to surgery is crucial for effective disease control and complication prevention.”
Surgery is typically considered when appropriate and adequate medical treatment has failed. Common indications include:
- Chronic rhinosinusitis with nasal polyps: Polyps causing obstruction of the nasal cavity and sinus openings, persistent loss of smell, and poor response to corticosteroids (topical or systemic)
- Significant obstruction of sinus drainage on CT imaging, with persistent mucus retention and risk of secondary infection
- Recurrent sinusitis: ≥ 4 acute episodes per year despite appropriate treatment, significantly affecting daily life and work
- Presence or risk of complications such as orbital complications (eye swelling, pain, reduced vision), intracranial complications, or sinus abscess
- Anatomical abnormalities impairing drainage: severe septal deviation, turbinate hypertrophy, or structural variations causing obstruction
The current standard surgical approach is Functional Endoscopic Sinus Surgery (FESS), with the following objectives:
- Widening the natural sinus openings
- Removing polyps and inflamed tissue
- Restoring sinus ventilation and drainage
- Facilitating the effectiveness of postoperative medical therapy
Recently, ENT specialists at Hanoi French Hospital successfully performed endoscopic sinus surgery on a patient with nearly 25 years of chronic rhinosinusitis.
The 40-year-old male patient had been managed with long-term medical therapy. However, the disease progressed, leading to persistent and worsening nasal obstruction, to the point where he could barely breathe through his nose. Detailed examination and CT imaging revealed severe bilateral chronic rhinosinusitis (Grade IV), with extensive nasal polyps completely obstructing the sinus openings.
At this stage, medical therapy was no longer effective, as medications could not reach the completely obstructed sinuses. The patient was indicated for endoscopic sinus surgery by Assoc. Prof. Dr. Vo Thanh Quang, involving complex bilateral ethmoid-maxillary sinus opening and complete polyp removal.
The surgery was successfully performed, removing the polyps, restoring sinus ventilation, and preserving critical adjacent structures such as the orbit, optic nerve, and skull base. Postoperatively, the patient recovered well, regained nasal breathing, and experienced a significant improvement in quality of life.
This case highlights the important role of endoscopic sinus surgery in the treatment and long-term management of chronic rhinosinusitis. The specialists at Hanoi French Hospital helped the patient overcome the fear of surgery, achieve effective treatment outcomes, and improve long-term quality of life.
For consultation or appointments with our ENT specialists, please contact our HOTLINE at 024.35771100 or message our Fanpage “Hanoi French Hospital” or Zalo OA: zalo.me/2008009049335817955.
