| ENDOSCOPIC SINUS SURGERY IN INDIA What Is Endoscopic Sinus Surgery ? Endoscopic sinus surgery – also called endoscopy or sinoscopy – is a procedure used to remove blockages in the sinuses (the spaces filled with air in some of the bones of the skull). These blockages cause sinusitis, a condition in which the sinuses swell and become clogged, causing pain and impaired breathing.A thin, lighted instrument called an endoscope is inserted into the nose, and the doctor looks inside through an eyepiece. Much like a telescope with a wide-angle camera lens, the endoscope beams light into different parts of the nose and sinuses, allowing the doctor to see what is causing blockages. Surgical instruments can then be used along with the endoscope to remove the blockages and improve breathing. This surgery does not involve cutting through the skin, as it is performed entirely through the nostrils. Therefore, most people can go home the same day. Endoscopic sinus surgery is a relatively new procedure designed to increase the amount of air flowing through the sinuses and allow mucus to drain properly out of the nose. The procedure can : – Relieve nasal blockages Relieve facial pain Improve breathing Improve the sense of smell and taste Endoscopic sinus surgery is an effective procedure to correct : – Sinusitis Deviated septum, in which the partition separating the left and right sides of the nose is crooked Polyps, a noncancerous water-filled swelling Tumors, a swelling caused by an uncontrolled growth of cells However, it seems to be less effective for those with post-nasal drip or allergies that are caused by airborne particles which cannot be avoided, such as dust and ragweed. Facts about endoscopic sinus surgery : – 80% to 90% of people report a considerable reduction in symptoms after endoscopic sinus surgery. Endoscopic sinus surgery was introduced in the 1960s but did not become widely used in the U.S. until the 1980s. The endoscope, which utilizes fiberoptic technology, allows doctors to see inside the sinuses without cutting the face, and makes it possible to see parts of the sinuses that were formerly difficult to reach. 35 million Americans – about 14% of the population – experience symptoms of sinusitis every year. It is estimated that 1% to 2% of adults in the U.S. have lost their sense of smell and taste to a significant degree. What Conditions Are Treated With This Surgery ? Endoscopic sinus surgery is used to treat : – Sinusitis : – Sinusitis is a common condition that usually is easy to treat with medication. It feels much like a head cold, with a blocked, stuffy, or runny nose. Sinusitis is actually a swelling of the inner lining of the sinuses. This swelling causes the openings of the nose to be blocked so that the mucus inside can no longer drain out. When the mucus cannot drain, the pressure of the blocked fluid creates pain in the face and impairs breathing. For most people, sinusitis is a temporary condition that goes away with simple treatment. If the symptoms continue for a significant period of time without responding to medication, or if the symptoms are especially severe, surgery may bring about permanent relief. However, surgery for sinusitis is considered a last resort and will not be recommended unless all other courses of treatment have been exhausted over a period of time with little or no results. Sinusitis can be the result of : – A cold that lingers A bacterial or viral infection Swelling due to allergies Having small sinus openings Deviated Septum : – The partition separating the left and right sides of the nose, called the septum, is sometimes crooked. This crooked condition is called a deviated septum. Some people are born with this abnormality, but sometimes it is the result of an injury. Very few people have a perfectly straight septum, but endoscopic sinus surgery is only recommended for those whose septum is crooked enough to cause significant sinus blockage. The surgery can then straighten the septum and improve breathing. Polyps : – A polyp, also called a cyst, is a benign (noncancerous) water-filled swelling about the size of a grape, which develops in the sinuses and causes blockage. They most frequently occur in people who have asthma. Polyps can sometimes be reduced in size with medication. However, endoscopic sinus surgery has proven to be an excellent method with which to remove polyps and restore normal breathing. Tumors : – A tumor is a swelling caused by an uncontrolled growth of cells that creates new tissue. It is not water-filled like a polyp. A tumor can be noncancerous or cancerous. Tumors in the sinuses are quite uncommon but can sometimes be removed with endoscopic sinus surgery. However, more extensive surgery is often necessary. About The Sinuses The sinuses are spaces filled with air in some of the bones of the skull. Air passes in and out of these spaces, and mucus drains through them and out of the nose. They also reduce the weight of the skull and give our voices a nicer sound. There are four main pairs of sinus openings, sometimes called sinus cavities, in the face : – Maxillary – in the cheekbones Read More.. Ethmoid – between the eye sockets Frontal – in the forehead and above the eyebrows Sphenoid – deep in the head at the back of the nose Each of these pairs of sinus openings has a channel that leads to the nose. These channels are quite narrow, and when the lining of the channels becomes swollen, blockage results. This lining is called the mucous membrane. This same mucous membrane forms the inner lining of the nose. The mucous membrane in the nose and sinuses is our personal air conditioner. It warms, moistens, and cleans the air. The mucous membrane creates a clear, wet, slightly sticky mucus that gathers any dust, smoke, bacteria, or virus particles that may have been in the air. Tiny hairs along the membrane called cilia act as tiny oars, moving the mucus along much like a conveyor belt through the sinuses and out the nose. When the mucus containing the unwanted particles reaches the nose and throat, the body prompts us to swallow, spit, sneeze, or cough it out of the body. When a cold or allergy prevents the cilia from moving the mucus through, the nose becomes blocked. The mucous membrane is also one of the body’s front-line defense systems. It releases chemicals that help to destroy bacteria and viruses before they can attack. If a virus, bacteria, allergen or other irritant is strong enough to prevent the mucous membrane and cilia from doing their job, blockages can occur in any of the pairs of sinus openings. Endoscopic sinus surgery can correct chronic or severe blockages in one or more of the maxillary, ethmoid, frontal, or sphenoid sinuses. What Causes Sinusitis ? The potential causes of sinusitis include : – Virus Bacteria Fungus Allergies Asthma Poor air quality Extremes of temperature and humidity Dehydration Excessive nose blowing Foreign objects placed in the nose Stress Diseased teeth Hormonal imbalances Medication side effects Low immune system Deviated septum Small sinus openings Polyps Tumors Most cases of sinusitis can be easily treated by a family doctor. However, in those cases where the sufferer has chronic sinusitis or repeated attacks of acute sinusitis that have not responded to medication, endoscopic sinus surgery may be the answer. This is especially true in the case of nasal obstructions such as polyps. There are two types of sinusitis : – Acute sinusitis means that the symptoms of the condition are temporary, usually lasting no more than 30 days. However, the symptoms of acute sinusitis are more severe and painful than the symptoms of chronic sinusitis. Chronic sinusitis means that the symptoms of sinusitis occur frequently or for long periods of time. The symptoms are usually more annoying than painful. However, those with chronic sinusitis are more likely to have recurring attacks of acute sinusitis, which can be quite painful. What Are The Symptoms Of Sinusitis ? Symptoms of sinusitis vary from person to person. The most common symptoms are : – Stuffy or runny nose Clear, thin discharge from the nose (as in chronic sinusitis), or thick yellow or green discharge from the nose, sometimes tinged with blood (as in acute sinusitis) Sneezing and/or coughing Pain over the bridge of the nose Headache that is worse in the morning, when bending forward, or when riding an elevator Post-nasal drip from the nose into the throat Frequent throat clearing Itchy eyes and/or nose Impaired sense of smell and/or taste Bad breath Fever and chills Pain in the roof of the mouth or teeth Face and eye pain Less common symptoms, which may or may not be accompanied by a stuffy nose, are : – Earache, feeling of fullness in the ear, swelling, and tenderness behind the ear, and/or ear popping due to mucus in the eustachian tube of the ear Sore throat and hoarse voice caused by infected post-nasal drip Swelling of the eye area due to spread of infection from the sinuses to the eye Severe headache with vomiting, a very rare symptom, indicates the possibility of meningitis or the spread of infection into the brain. How Does A Doctor Determine If Surgery Is Necessary ? The first thing a doctor will do is take a detailed medical history and make note of all symptoms, as well as how long the symptoms have been present. The doctor will need to know any medications being taken, as well as any other conditions such as high blood pressure, eye diseases or bleeding disorders. If there is another course of treatment besides surgery that has not yet been tried, the doctor may prescribe new medications. If surgery appears to be the best course of action, a CT scan, which is a special type of x-ray, is usually taken so that the doctor can see all of the sinuses prior to using the endoscope. The CT scan serves as a kind of road map for the endoscopic examination. Before the endoscopic examination, a nasal spray is used to shrink and anesthetize sinus tissues. The doctor will then insert the endoscope into the nostrils to determine what is causing the sinusitis symptoms, such as thick mucus, swelling, small openings, deviated septum, or polyps. The doctor will only perform surgery if the examination shows problems that can be surgically corrected.Preparing For Surgery Prior to endoscopic sinus surgery, your doctor may recommend that you do the following : – Discontinue taking any pain relievers that contain aspirin for at least two weeks prior to surgery, as aspirin thins the blood and promotes bleeding. Make an appointment for lab tests two days before surgery (depending upon the doctor’s request). Discontinue taking any other medications the day of surgery. Do not drink or eat anything after midnight the night before surgery. What Happens During The Procedure ? The surgery itself lasts 60 to 90 minutes, after which the patient spends an hour or two in a recovery room. After the doctor has determined the nature of the problem and where it is located, a surgical plan will be made. A simple clearing of the intersection between the two sides of the nose is often all that is needed to relieve symptoms. In this case, a local anesthetic, where the patient remains awake during the procedure, is enough. Some crunching sounds may be heard and a sensation of tightness may be felt during the surgery, but there is no pain. If there are several blockages deeper in the sinuses or polyps to be removed, a general anesthetic, where the patient is fully asleep, is recommended. The doctor typically begins by clearing the ethmoid sinuses, followed by the sphenoid sinuses, the frontal sinuses, and finally the maxillary sinuses, if necessary. The doctor will clear any blockages, create larger openings where needed, correct a deviated septum if necessary, and remove any growths such as polyps. What Happens After Surgery ? Someone will need to drive the patient home, since both local and general anesthesia can cause drowsiness and disorientation for a short period of time after surgery. The nose is usually covered with a gauze dressing that will need to be changed whenever it becomes dirty or wet. A packing is placed in the nose after surgery, which requires breathing through the mouth for a short time during the healing process. The packing usually has to be worn for only a few days, and the doctor will advise when it can be removed. It may have a bad odor, however, or cause bad breath. Nose blowing should be avoided entirely for at least a week after surgery. Sleep on at least two pillows to keep the head elevated. It is not uncommon to experience discomfort in the nose and face for a short time after surgery. Mild headaches are also normal. Do not take pain relievers containing aspirin without consulting a doctor. Aspirin can promote bleeding and cause problems after surgery. Keep the nose as free from dry crusting as possible. A saline spray may be used six to eight times per day to keep the nose moist. Sometimes, the doctor will want to take care of cleaning the area in the office two to three times a week. Generally, however, the patient can make a nasal rinse from 1/4 teaspoon salt, 1/4 teaspoon baking soda, and eight ounces of warm water. A bulb syringe can then be used to squirt the solution into the nostrils whenever necessary. Keep activities to a minimum for a couple of weeks, as too much activity can increase the chances of bleeding. Do not lift heavy objects, swim, scuba dive, or fly for a few weeks following surgery. Avoid caffeine, alcoholic beverages, spicy foods, and antihistamine medications, which can cause drying of the sinus passages. Do not use decongestant nasal sprays unless prescribed by a doctor, as these sprays can become addictive after a few days of continuous use. Avoid eating dairy products, which can promote excess mucus production. Avoid anything that causes allergic reactions. Do not smoke, and avoid secondhand smoke. Drink plenty of fluids, especially water. Use a humidifier, if necessary, to moisten dry air. Finish all prescribed antibiotic medication. Within a week after surgery, the doctor will set an appointment to check the progress of healing. What Are The Most Common Complications ? It is important to note that no surgery is successful in 100% of cases. All surgeries have the potential for complications. With endoscopic sinus surgery, as with most surgeries, serious complications are uncommon. Most complications are not serious and are easily treated with antibiotics or other simple measures. Any complications from endoscopic sinus surgery are the same as with any type of sinus surgery. While complications are infrequent with all sinus surgeries, there are fewer incidents with endoscopic sinus surgery than the more invasive traditional surgeries. The most common serious complication, which occurs in approximately 2% of cases, is leakage of the body’s spinal fluid. This is usually discovered during the surgery itself and repaired at that time so that no adverse effects will occur. The worst and most rare complication is blindness, which is caused by damage to the optic nerve in the eye. रवि ईएनटी और एलर्जी निकट विराट अस्पताल धारूहेड़ा चुंगी रेवाड़ी सुबह 10 बजे से दोपहर 2 बजे तक. अपेक्स अस्पताल प्लॉट नंबर 5 सेकंड 6 धारूहेड़ा रेवाड़ी समय सुबह 8 बजे से 10 बजे तक, दोपहर 2 बजे से शाम 7 बजे तक 9899334307 8607274999 www.rksingh.in |
