Our Summary

This research paper discusses the rarely used external approaches to surgery on the paranasal sinuses, which includes the areas around your nose and eyes. These techniques, which involve making incisions on the face or neck, have been largely replaced by endoscopic surgeries, where a small camera is inserted through the nose. However, the authors argue that there are still situations where these older techniques may be necessary. The paper describes these external techniques, how they’ve evolved over time, and their potential risks. The goal is to educate current surgical trainees and practicing doctors about these less commonly used methods.

FAQs

  1. What are the external approaches to the paranasal sinuses that are described in the article?
  2. What are the potential complications of the external approaches to the maxillary, ethmoid, and frontal sinuses?
  3. How does this article aim to help residents and practitioners in the endoscopic era?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sinus surgery is to follow all pre-operative and post-operative instructions provided by the surgeon. This may include avoiding certain medications, following a specific diet, and taking care of the surgical site to prevent infection. Additionally, it is important to attend all follow-up appointments and communicate any concerns or changes in symptoms to the medical team. Proper care and adherence to instructions can help ensure a successful recovery from sinus surgery.

Suitable For

Patients who may be recommended for sinus surgery include those who have:

  • Chronic sinusitis that does not improve with medication or other non-surgical treatments
  • Nasal polyps that are causing symptoms such as nasal congestion, facial pain, or headaches
  • Structural issues in the sinuses that are causing blockages or recurrent infections
  • Tumors or growths in the sinuses that need to be removed
  • Severe sinus pain or pressure that affects daily life and does not improve with other treatments

It is important for patients to consult with an ENT specialist to determine if sinus surgery is the best option for their specific condition.

Timeline

Before sinus surgery:

  1. Patient experiences chronic sinusitis symptoms such as nasal congestion, facial pain or pressure, headaches, and loss of smell.
  2. Patient undergoes diagnostic tests such as a physical examination, nasal endoscopy, and CT scans to determine the extent of sinus disease.
  3. Patient may try conservative treatments such as nasal steroid sprays, antibiotics, and nasal irrigation before considering surgery.

After sinus surgery:

  1. Patient undergoes sinus surgery, which may include endoscopic sinus surgery or external approaches such as Caldwell-Luc approach, external ethmoidectomy, or frontal trephine.
  2. Patient may experience temporary discomfort, swelling, and congestion in the days following surgery.
  3. Patient may require post-operative care such as nasal irrigation, nasal packing removal, and follow-up appointments with their surgeon.
  4. Patient gradually experiences relief from sinus symptoms and improved quality of life as they recover from surgery.

What to Ask Your Doctor

  1. What specific type of sinus surgery will be performed and why is it necessary?
  2. What are the potential risks and complications of the surgery?
  3. What is the expected recovery time and post-operative care plan?
  4. How successful is this type of surgery in treating sinus issues?
  5. Are there any alternative treatments or less invasive procedures that could be considered?
  6. Will there be any long-term effects or changes to my sinus function after the surgery?
  7. How experienced is the surgeon in performing this type of surgery?
  8. What can I do to prepare for the surgery and optimize the outcome?
  9. Will I need any follow-up appointments or additional treatments after the surgery?
  10. Are there any lifestyle changes or precautions I should take after the surgery to prevent future sinus issues?

Reference

Authors: Schneider JS, Day A, Clavenna M, Russell PT 3rd, Duncavage J. Journal: Otolaryngol Clin North Am. 2015 Oct;48(5):839-50. doi: 10.1016/j.otc.2015.05.010. Epub 2015 Jul 2. PMID: 26143105