Endoscopic Sinus Surgery

Endoscopic Sinus Surgery

Endoscopic sinus surgery is a surgery which allows the sinuses to be normal again. Blockage of the sinus gates causes the patient to have sinusitis. Duration of the disease defines the need for this surgery. Post nasal drainage, facial pain, facial swelling, coughing, dizziness and nausea can be the symptoms of sinusitis. Diagnosis can be done by physical examination which endoscopes are used.

Why to do Endoscopy?

Endoscopy is the minimally invasive method to let us see the gates of the sinuses. Nasal cavity, inferior chonchas and nasophayrnx also assessed during the endoscopy. It is more comfortable if flexible fiber optic endoscopes are used.

Why to have Endoscopic Sinus Surgery?

Some of the diseases need to be solved by sinus surgery. Such as:

• Chronic Sinusitis
• Nasal Polyps
• Nasal Tumors
• Paranasal sinus tumors
• Dacriostenosis
• Exophtalmus (Endoscopic orbital decompression)

Aims of Endoscopic Sinus Surgery

Endoscopic sinus surgery allows us to open the gates of the paranasal sinuses. If less invasive method is planned Bloon Sinuplasty can be applicable.

• Reduces the frequency and the severity of sinus infections
• Reliefs the symptoms of Sinusitis
• Opens the nasal airflow
• Improves the sense of smell
• Allows us resecting the nasal and paranasal sinus tumors

What is waiting us before and after the Sinus Surgery?

This procedure can be done under general anesthesia. Blood tests and preoperative anesthesiology examination will be scheduled for you. We only work with a specific anesthesist who knows our procedures best. Only endoscopes will be used during your operation. There will be no skin incisions. After the operations you will not have any bruise or swelling of your face. But in some cases we might need to leave nasal packs to control the nose bleeding after surgery. These packs are soft sponges which can be taken out without any pain. You will experience facial pressure after the operation. Just after taking the packs out of your nose you will get rid of the facial pressure immediately.

Septum corrections and choncha reductions can be done by Diode Laser which lets us not to pack the nose after the surgery. Recovery after Laser is much better and faster than the conventional methods. Diode Laser is available in Endoscopic Sinus Surgery in Cyprus. All surgery can be done through nostrils. Most of our patients can go home at the same day of the surgery.

Recovery is possible in a week. After 2-3 days our patient will be able to light work at home. After the 5^th day the patient will be able to go back to normal life. Rinsing the nose is the most effective method to heal the operation field. As soon as the follow up examinations reveals no wound inside rinsing frequency can be decreased.

Before the sinus surgery

Your doctor might prescribe you some medications prior to the surgery to reduce the inflammation in your nose and paranasal sinuses.   Please quit smoking if you are a smoker at least 2 weeks prior to the surgery.

You will be asked to have some blood test prior to the surgery. These tests can be done at the same day with the surgery too. Assessment of the results will be made by your doctor.

To reduce the risk of nose bleeding during and after the surgery you should;

• Stop taking ASPIRIN if you were taking 10 days prior to the surgery.
• Ginseng, ginko biloba, vitamin E and garlic tablets are prolonging the bleeding time. So please do not take any 10 days prior to the surgery.
• Blood thinner drugs should be stopped until the nose and the paranasal sinus mucosa healed totally. You should ask stopping suggestions to your doctor who started blood thinners.

After the sinus surgery

You will be prescribed some medication to continue for a while after the sinus surgery. The most important active treatment will be done by you. You should rinse your nose as you need it to. Humidification for the nasal cavity is very important for the healing process. Do not blow your nose with high pressure.

Diet

You will be able to eat and drink 3-4 hour after sinus surgery. You should start with small amounts of fluids then you can eat light food. Too salty too spicy food will increase your blood pressure that can cause nose bleeding. Rather than that you can eat or drink any think you used to before the operation.

What are the complications of the sinus surgery?

As every surgery sinus surgery also have some complications list. With very delicate surgery skills none of these can be seen.

• Bleeding: During the surgery small amounts of mucosal bleeding is usual. In some cases arterial bleeding can be seen which may require vessel ligations. In very rare occasions bleeding can be seen after the sinus surgery. You should call and visit your doctor in such situation. Surgeon will take the bleeding under control. Sometimes repacking for the nose can be applicable to control excessive bleeding.
• Infection: Antibiotics are usually prescribed by your doctor after the surgery as a precaution for the infections. In case of a sinus infection after the surgery requires stronger antibiotic therapy. Your doctor will cover the situation.
• Cerebrospinal Fluid Leak: Brain and Eyes are separated by thin bony walls from the nasal structures. During the sinus surgery it is extremely rare to cause a leak but it is in the list of complications. If this is visible during the surgery it can be repaired. If the leak happened after the surgery there will be some precautions such as sleeping with elevated head and decreasing the physical activity.
• Vision changes: Eyes are separated from the sinuses with a very tiny bone called Lamina Paperecia. Injury of this bone will not make any vision changes unless you touch nor tear the orbital muscles. This is a very rare complication. If such a thing happens rest without any treatment will resolve the vision blurring complaint.
• Loss of Smell: As a very rare complication some of the patients can lose their sense of smell.