Our Summary

This research paper discusses techniques to minimize bleeding during nose surgeries. The bleeding can make the surgery more difficult and risky for the patient. The paper discusses recent international guidelines and best practices for reducing bleeding during these surgeries. It mentions that pre-surgery corticosteroid therapy (using steroid drugs) and the use of total intravenous anesthetic techniques (using drugs to make the patient unconscious) are increasingly being validated as effective methods. It also mentions that a surgical position called reverse Trendelenburg is safe for managing inflammatory disease. The paper ends by saying that there is still ambiguity about the effectiveness of some interventions to manage bleeding during surgery.

FAQs

  1. What techniques are discussed in the research paper to minimize bleeding during nose surgeries?
  2. What is the role of pre-surgery corticosteroid therapy and total intravenous anesthetic techniques in reducing bleeding during sinus surgeries?
  3. What is the reverse Trendelenburg position and how is it effective in managing inflammatory disease during surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sinus surgery is to follow all pre-operative instructions provided by the surgical team. This may include stopping certain medications, avoiding food and drink before surgery, and taking any prescribed medications as directed. Following these instructions can help reduce the risk of complications during and after the surgery.

Suitable For

Patients who are typically recommended sinus surgery include those who have chronic sinusitis that does not improve with medication, recurrent acute sinusitis, nasal polyps, deviated septum, or other structural issues in the nasal passages. These patients may experience symptoms such as facial pain, pressure, congestion, and difficulty breathing through the nose. Sinus surgery may be recommended to improve drainage and airflow in the sinuses, reduce inflammation, and alleviate symptoms.

Timeline

Before sinus surgery:

  1. Consultation with an ENT specialist to discuss symptoms and determine the need for surgery.
  2. Pre-operative testing such as CT scans and blood work to assess the extent of the sinus issues.
  3. Pre-operative instructions from the surgeon, including medications to stop taking before surgery and fasting guidelines.
  4. Anesthesia consultation to discuss the type of anesthesia that will be used during the surgery.

After sinus surgery:

  1. Recovery in the post-anesthesia care unit (PACU) immediately after surgery.
  2. Monitoring of vital signs and pain management by medical staff.
  3. Discharge instructions from the surgeon, including how to care for the surgical site and when to follow up for a post-operative appointment.
  4. Follow-up appointments with the surgeon to monitor healing and address any concerns or complications.
  5. Gradual return to normal activities and possibly post-operative care such as nasal irrigation or medication management to prevent infection.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with sinus surgery?
  2. What is the success rate of sinus surgery for my specific condition?
  3. How long is the recovery period after sinus surgery?
  4. Will I need to follow any specific post-operative care instructions?
  5. Are there any alternative treatment options to sinus surgery that I should consider?
  6. How frequently do patients experience post-operative bleeding after sinus surgery?
  7. Will I need to take any medications before or after the surgery to minimize bleeding?
  8. What is the experience of the surgical team in performing sinus surgeries?
  9. How long does the surgery typically take?
  10. What should I expect in terms of pain management after the surgery?

Reference

Authors: Vuncannon JR, Wise SK. Journal: Curr Opin Otolaryngol Head Neck Surg. 2023 Feb 1;31(1):33-38. doi: 10.1097/MOO.0000000000000855. Epub 2022 Nov 14. PMID: 36730664