Endoscopic Sinus Surgery

Endoscopic Sinus Surgery is a procedure designed to widen the natural drainage pathways of the sinuses to restore their function and health. As a result, nasal secretions can get stuck in the sinuses and become chronically infected. The goal of surgery is to carefully remove the bone and the thin, delicate mucous membranes that block the sinus drainage pathways. The term "endoscopic" refers to the use of small fiber-optic telescopes that allow surgery to be performed through the nostrils, without the need for external skin incisions.

Endoscopic sinus surgery / Nasal Surgery are performed in the hospital, usually under a general anesthetic. Using endoscopes and high-definition cameras it is possible to obtain an excellent vision. The area that that needs to be treated most frequently is called the ostiomeatal unit. It is an area on the sidewall of the nose where many sinuses drain. By removing a small bone in this area, usually allows for better ventilation and drainage can usually be achieved. It is not uncommon for there to be anatomical variations in this area that make people prone to sinus disease. These can be easily corrected in surgery. In case of more extensive sinus disease, it may be necessary to operate on other sinuses such as the sphenoid and frontal sinuses. It is common for this surgery will be performed in conjunction with Septoplasty or Turbinate Surgery. A Ice pack may be placed in the nose at the end of the surgery to help with bleeding.

Preoperative prescriptions: before surgery, your doctor will most likely prescribe several medications that help in reducing inflammation. It is important to follow your doctor's instructions and start medication at the appropriate time before and after surgery.

• Preoperative physical: Your surgeon will seek medical autorization from an anesthetist before surgery. This will require basic lab tests (CBC, LFT, KFT, Chest X-ray, ECG, coagulation profile, Serology test) and studies (CT scan PNS), and anesthetists may require additional tests. This ensures that you have medical clearance for safe surgery.
• • Smoking:Smoking causes increased scar tissue and poor healing that leads to failure of endoscopic sinus surgery. If you do smoke your surgeon will usually require you to stop smoking 3-4 weeks before surgery and avoid smoking for an additional month after surgery. What to avoid before surgery: Certain drugs increase your risk of bleeding during and after sinus surgery. These include aspirin and NSAIDs. These should be stopped at least 2 weeks before surgery. Vitamins E and herbal medicines such as Ginkgo Biloba, ginseng, and garlic tablets can also provoke your risk of bleeding and should be stopped before surgery. Anti-coagulation medicines are used for blood-thinning that must also be temporarily stopped before and after surgery.
• • What to avoid before surgery: Certain drugs increase your risk of bleeding during and after sinus surgery. These include aspirin and NSAIDs. These should be stopped at least 2 weeks before surgery. Vitamins E and herbal medicines such as Ginkgo Biloba, ginseng, and garlic tablets can also provoke your risk of bleeding and should be stopped before surgery. Anti-coagulation medicines are used for blood-thinning that must also be temporarily stopped before and after surgery.
• • Recommended over-the-counter medications: We recommend that you purchase two over-the-counter drugs before your surgery. Nasal saline mist (Ayr, Ocean, Simple Saline) can be used every 3-4 hours after surgery to keep your nose moist and humidified. Afrin should be used after surgery if you have steady bleeding that doesn’t stop with a gentle head tilt. Both of these medications can be purchased at any pharmacy without a prescription and are good to have after your surgery.