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Endoscopic Sinus Surgery

Blockages in the sinuses can lead to sinusitis, a condition in which the mucus membranes of the sinuses become inflamed and swollen, causing pain, pressure, and impaired breathing. Sinusitis that persists for three months or more is considered chronic.

The most common procedure for treatment of chronic sinusitis is endoscopic sinus surgery. This procedure is performed to unblock the sinuses when drug therapy is not effective, or when sinusitis complications exist, such as structural abnormalities, spread of infection into the eye, or fungal sinusitis.

In endoscopic sinus surgery, fiber-optic surgical techniques are utilized to open the natural drainage areas of the sinuses and to remove polyps, if any are present. Endoscopic sinus surgery unblocks obstructions, allowing ventilation and drainage. This provides relief from sinus headaches and congestion, improves nasal breathing, and often enhances the patient’s sense of smell.

Image-guided Endoscopic Sinus Surgery:

At Los Angeles Sinus Institute, Dr. Zadeh uses CT imaging and computers intra-operatively to minimize risk. Intra-operative CT guidance, or computer-aided surgery, allows Dr. Zadeh to not only view the “live images” of the procedure, but also, at the same time, to have a real time, three-dimensional CAT scan image of the area being operated on. Intra-operative image-guidance provides important anatomic information, allowing better insight into the operative field, decreasing the risks, and improving the results of surgery.

The Goals of Endoscopic Sinus Surgery:

Endoscopic sinus surgery is designed to improve the drainage of the sinuses and improve airflow through the nose. This procedure is also performed to relieve symptoms associated with sinusitis, septal deviations, turbinate hypertrophy (enlargement of the long, narrow, curled bone that protrudes into the nasal cavity), and nasal polyps. The goals of endoscopic sinus surgery include:

  • Reduction of the number and severity of sinus infections.
  • Improvement of symptoms associated with sinusitis.
  • Improvement of airflow through the nose.
  • Improvement of the patient’s sense of smell.

Endoscopic sinus surgery procedure

The following is an overview of the endoscopic sinus surgery procedure at Los Angeles Sinus Institute:

  • This surgery is performed under general anesthesia.
  • Endoscopic sinus surgery is performed entirely through the nostrils and no incisions are made on the skin.
  • A thin camera rod with a light at the end to provide visualization and magnification (endoscope) is used for direct visualization of the nasal cavity and sinuses.
  • Adjacent to the screen with the live images from the endoscope is a second screen with real time three-dimensional CAT scan images of the surgical area.
  • Working endoscopically through the nose, Dr. Zadeh uses specialized instruments to safely and effectively remove causes of sinus blockage, such as nasal polyps, diseased bone, diseased tissue, or scar tissue.
  • Under direct visualization and CT guidance, the natural drainage pathways of the sinuses are opened.
  • The patient is allowed to recover from the effects of general anesthesia, and then discharged.

What to expect after endoscopic sinus surgery

This surgery is performed under general anesthesia and you will sleep through it. Immediately after the surgery, you will spend a few hours in the recovery room while the anesthesia wears off, until you are fully awake and feeling well enough to go home.

There will be red-colored drainage from your nose after the surgery. In the first few days, you can expect the amount of drainage to decrease and the color to become lighter, although you may have blood-tinged drainage for 10 to 14 days.

You may have a feeling of congestion and fullness in your nose and sinuses because of temporary swelling of the tissues in the nasal cavity resulting from the surgery. Sleep with head your elevated higher than your heart to assist in reducing swelling.

Do not blow your nose for 14 days after the surgery. (You may gently sniff back nasal secretions.) After your first post-operative visit, you will begin saltwater nasal flushes with a solution we prescribe for you. Sneeze with your mouth open, and do not hold back a sneeze.

Avoid all strenuous activity for 2 weeks after the surgery. Do not bend over, lift objects weighing more than 20 lbs, or perform jogging, aerobics, swimming, exercising, or contact sports. Walking for moderate exercise is acceptable. Do not smoke, and avoid secondhand smoke or any other irritating fumes.

Benefits of endoscopic sinus surgery

For individuals suffering from chronic sinusitis, image-guided endoscopic sinus surgery can have a number of benefits, including:

  • Fewer sinus infection and sinus headaches
  • Widened airways for easier administration of medications
  • Less pressure and facial pain
  • Improved quality of life

If you are suffering from chronic sinusitis, schedule an initial consultation at Los Angeles Sinus Institute. Taking all medical therapies and surgical techniques into consideration, Dr. Zadeh can determine if endoscopic sinus surgery is the most effective and appropriate treatment option for you.