Our Summary

This research paper looks at a surgical procedure that combines two types of nasal surgery at the same time: endoscopic sinus surgery (ESS), which treats sinus problems, and rhinoplasty, which reshapes the nose. The study found that conditions like chronic rhinosinusitis (long-term inflammation of the sinuses) and septal deviation (a crooked wall between the nostrils) can seriously affect a patient’s quality of life.

The guidelines suggest that surgeons should use endoscopy (a procedure using a flexible tube with a light and camera attached to it) to accurately assess the patient’s symptoms. The study found that the risk of complications from this combined surgery is not higher than when the two surgeries are performed separately. However, the combined surgery does take longer to perform.

Despite this, patient satisfaction rates are high. The authors conclude that doing rhinoplasty and ESS together in one operation is safe. They also suggest that more studies are needed, especially ones that ask patients about their experiences and outcomes after the surgery.

FAQs

  1. What conditions can be treated with concurrent endoscopic sinus surgery (ESS) and rhinoplasty?
  2. Are there any increased risks or complications associated with having ESS and rhinoplasty performed at the same time?
  3. What has been the reported patient satisfaction rate following concurrent ESS and rhinoplasty surgeries?

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 surgeon, such as avoiding certain medications or fasting before the procedure. It is also important to discuss any concerns or questions with the surgeon before the surgery to ensure a successful outcome. After the surgery, following post-operative care instructions, such as taking prescribed medications and attending follow-up appointments, is crucial for a smooth recovery.

Suitable For

Patients who may be recommended for sinus surgery typically have chronic rhinosinusitis, septal deviation, and inferior turbinate hypertrophy. These conditions can impair quality of life and may be best treated through endoscopic sinus surgery. Patients who are also seeking cosmetic improvement of their nasal appearance may benefit from concurrent rhinoplasty. It is important for surgeons to accurately evaluate patient symptoms using endoscopy and consider the potential benefits of combining these procedures. Complication rates for concurrent surgeries are similar to those for individual surgeries, and patient satisfaction rates are generally high. Additional studies are needed to further assess patient outcomes and satisfaction with concurrent ESS and rhinoplasty.

Timeline

Before sinus surgery:

  1. Patient experiences chronic symptoms of sinusitis such as facial pain, pressure, congestion, and difficulty breathing through the nose.
  2. Patient may have tried various non-surgical treatments such as medications, nasal sprays, and sinus rinses without relief.
  3. Patient undergoes consultation with an ENT specialist who recommends endoscopic sinus surgery to improve sinus drainage and alleviate symptoms.
  4. Preoperative evaluations such as CT scans and allergy testing may be conducted to assess the severity of sinus disease and identify any potential risk factors.

After sinus surgery:

  1. Patient undergoes endoscopic sinus surgery, which involves the removal of blocked sinus tissue and opening up the sinus passages to promote better drainage.
  2. Patient may experience some postoperative discomfort, swelling, and mild bleeding in the days following surgery.
  3. Patient is prescribed pain medication and nasal sprays to help with healing and reduce inflammation.
  4. Follow-up appointments with the surgeon are scheduled to monitor the healing process and assess any potential complications.
  5. Over time, the patient should experience a significant improvement in sinus symptoms, with better breathing, reduced congestion, and decreased facial pain and pressure.

What to Ask Your Doctor

  1. What specific symptoms or conditions indicate that I may benefit from sinus surgery?
  2. Are there any alternative treatments or procedures that I should consider before opting for sinus surgery?
  3. Will the surgery be performed using endoscopic techniques?
  4. What can I expect during the recovery period after sinus surgery?
  5. What are the potential risks or complications associated with sinus surgery?
  6. How long will the surgery take, and what is the expected outcome in terms of improved sinus function?
  7. Will I need to follow any specific post-operative care instructions or take any medications after the surgery?
  8. How soon after sinus surgery can I expect to see improvement in my symptoms?
  9. Will I need to have any follow-up appointments or additional treatments after the surgery?
  10. What are the success rates and patient satisfaction rates for patients who have undergone concurrent sinus surgery and rhinoplasty procedures?

Reference

Authors: Steele TO, Gill A, Tollefson TT. Journal: Curr Opin Otolaryngol Head Neck Surg. 2018 Aug;26(4):209-213. doi: 10.1097/MOO.0000000000000469. PMID: 29894317