Our Summary

This research paper is a review of how to make a type of sinus surgery safer. The surgery is called functional endoscopic sinus surgery (FESS), which is often used to treat sinus problems caused by inflammation or infection.

To gather information, the researchers used various databases and search engines, and looked for articles published between 2000 and 2024. They found that there are four common methods of performing FESS, and the complication rates range from 0% to 1.5% for major issues and 1.12% to 20.8% for minor issues.

The researchers highlighted that preparation before the operation can improve the results and reduce the risk of complications. They cautioned that using powered tools might increase the seriousness of complications, although not the frequency of them. If there is a leak of cerebrospinal fluid during the operation, it is important to find and fix the leak straight away. If this is not done, the risk of infection increases and the patient may need to stay in the hospital longer.

The researchers also mentioned a technique called image-guided surgery. This involves using images from before the operation to help the surgeon see exactly where their tools are in relation to the surrounding structures in real time. This technique, which was first developed for brain surgery, has become very popular in sinus surgery.

In conclusion, the researchers believe that safer FESS can be achieved with accurate CT scans, good patient preparation, surgical knowledge and training, and the use of image guidance.

FAQs

  1. What are the most common methods for functional endoscopic sinus surgery (FESS)?
  2. What is the rate of complications for FESS and how can they be avoided?
  3. How is image-guided technology used in endoscopic sinus surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sinus surgery is to ensure they receive accurate CT scans before the procedure. This will help the surgeon pinpoint the exact location of the sinus issues and surrounding structures, leading to a safer surgery. Additionally, good patient preparation, surgical knowledge and training, and the use of image guidance can also contribute to a successful and safer outcome.

Suitable For

Patients who are typically recommended for sinus surgery include those with chronic sinusitis, recurrent acute sinusitis, nasal polyps, sinus tumors, deviated septum, and other structural abnormalities of the sinuses. These patients may have symptoms such as facial pain, pressure, congestion, difficulty breathing through the nose, and decreased sense of smell. Sinus surgery may also be recommended for patients who have not responded to conservative treatments such as medications and nasal sprays.

Timeline

  • Before sinus surgery:
  1. Patient experiences symptoms such as chronic sinusitis, nasal polyps, or other sinus-related issues that do not respond to other treatments.
  2. Patient undergoes consultation with an ENT specialist, who may recommend functional endoscopic sinus surgery (FESS) as a treatment option.
  3. Preoperative preparation includes CT scans to assess the extent of the sinus disease and to help the surgeon plan the procedure.
  4. Patient may undergo allergy testing or other tests to identify any underlying causes of the sinus issues.
  5. Patient receives instructions on preoperative care, such as avoiding certain medications or foods before surgery.
  • After sinus surgery:
  1. Patient undergoes FESS procedure, which may involve endoscopic uncinectomy, maxillary antral ostomy/ethmoidectomy, anterior ethmoidectomy, and posterior ethmoidectomy.
  2. Patient may experience some pain, swelling, and nasal congestion immediately after surgery.
  3. Patient is usually able to go home the same day or after a short hospital stay.
  4. Patient follows postoperative care instructions, which may include taking medications, using nasal sprays, and avoiding strenuous activities.
  5. Patient has follow-up appointments with the surgeon to monitor healing and address any concerns.
  6. Patient experiences improved sinus symptoms and quality of life in the weeks and months following surgery.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with sinus surgery?
  2. How long is the recovery process and what can I expect during the healing period?
  3. Will I need any follow-up appointments or additional treatments after the surgery?
  4. Are there any alternative treatments or procedures that could be considered before opting for sinus surgery?
  5. How experienced are you in performing functional endoscopic sinus surgery?
  6. Will I need to undergo any imaging tests before the surgery to plan the procedure?
  7. Will I need to stop taking any medications or make any lifestyle changes before the surgery?
  8. How will the surgery be performed and what can I expect during the procedure?
  9. What are the success rates for this type of surgery in treating my specific condition?
  10. What can I do to minimize the risks of complications and ensure a successful outcome from the surgery?

Reference

Authors: Kar M, Bayar Muluk N, Alqunaee M, Manole F, Cingi C. Journal: Ear Nose Throat J. 2024 Nov;103(3_suppl):5S-14S. doi: 10.1177/01455613241287280. Epub 2024 Sep 27. PMID: 39331753