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Chronic rhino-sinusitis is an inflammation of the nose and sinuses (lasting usually for at least 3 months) that does not improve sufficiently with pharmaceutical treatment. Symptoms of chronic rhino-sinusitis include a blocked and/or running nose, facial pain, headache, recurrent lower respiratory tract infections, and bronchial asthma.
Nasal polyps are non-cancerous, painless, teardrop or grape shaped swollen outgrowths on the lining of the nose or sinuses. They develop as a result of chronic or recurring rhino-sinusitis due to asthma, allergies, drug sensitivity or certain immune disorders.
While small nasal polyps may not cause any symptoms, larger growths or groups of nasal polyps can block the nose and lead to breathing problems, lost sense of smell, infections and chronic sinusitis. Large nasal polyps can also change the shape of the nose itself. Nasal polyps can be easily removed with surgery.
Most common reasons for endoscopic sinus surgery are chronic rhino-sinusitis and nasal polyps, while less common reasons include recurrent infections, impaired sense of smell, maxillary cyst, sinus infections that spread to the eye, face or brain, tumors (cancerous or non-cancerous growths) of the nasal and sinus cavities leaking brain fluid into the nose, and tear duct blockage.
Endoscopic sinus surgery may be performed under local or general anesthesia based on the extent and duration of the intervention, and takes around 30 to 80 minutes.
During the procedure our ENT surgeon inserts an endoscope (a small tube) with a tiny camera through the nostrils to view the nose and the sinuses. Afterwards small instruments are used to remove polyps and other obstructions, enlarge the narrow openings that connect the sinuses to the nose, which in turn improves the drainage from the sinuses into the nose.
The main goal of sinus surgery is to improve the drainage pathway of the sinuses. By widening the natural drainage pathway, sinus infections should be reduced, and by removing nasal polyps, nasal congestion and breathing improves significantly. As a secondary benefit, medications (sprays, rinses, nebulized drugs) delivered directly to the lining of the sinuses may become more efficacious.
Potential risks of sinus surgery are rare but include bleeding, damage to the eye or vision, and intracranial complications (brain injury, brain fluid leakage, infection of the brain). However, it is important to note that the sinuses are found next to the orbits (eye sockets) and directly beneath the bottom of the brain. Failure to treat chronic rhino-sinusitis in itself may lead to severe problems, such as infection of the eye or brain.
You will get a patient information sheet and informed consent form for detailed information about FESS, risks of the operation, and perioperative tasks. By all means, you will discuss with your doctor the possible risks of surgery before you make a treatment decision.
There are certain risks associated with general anaesthesia, for which we will provide a separate information sheet and an informed consent form. The tests that you will have before your surgery will ensure that these risks are reduced to minimum.
It is important to call your surgeon immediately in case of fever, permanent nasal bleeding, vomiting or serious headache.
Your ENT (ear, nose and throat) surgeon will advise surgery as necessary.
You will be asked to undergo some tests (nasal endoscopy, blood and allergy work, nose and paranasal sinus CT, ECG), and to see your anaesthesiologist and internist before your operation to ensure that your overall health condition is good enough to safely allow a FESS in general anaesthesia.
All of our patients are asked to complete a detailed medical history form that is necessary for our surgeon and physicians so that they can decide if you are suitable for surgery.
In case of nasal packing you can expect to have mild to moderate pain during the first postoperative days. This can be well controlled with oral pain killers. Nasal packing removal may cause some discomfort depending on individual sensitivity. You may expect nasal stuffiness, discomfort, and drainage for 3 to 10 days. The day after the surgery swelling around the nose is normal.
You should only take medications approved at our clinic, and check with your ENT surgeon about any post-operative care you will need to perform to allow your nose to recover properly.
It is normal if you feel slowed down and disorganized for about a day after the surgery due to general anaesthesia.
If there is no bleeding, you will be discharged on the first postoperative day. You will usually be advised to rest for around two weeks after surgery. Your surgeon will be able to give you more detailed information and advice.
For 2-3 weeks after surgery you will be advised to avoid intensive physical activities that may lead to nose bleeding.
You need to be careful when blowing your nose. In the first few days you are advised to wipe your nose and avoid blowing. Afterwards you may gradually start blowing your nose.
You may be asked to use nasal oil/ointment and nasal irrigation sets after your surgery up to 3-4 weeks.
The first control examination is due after a week, when a nasal cleaning treatment is needed to prevent nasal infections and formation of adhesions. The second control is usually due within 2 weeks. Afterwards regular check-up is needed to recognize any polyp reappearance.