Our Summary

This research paper discusses the risks associated with functional endoscopic sinus surgery, a procedure often used to treat patients with recurring and hard to treat sinusitis. The authors suggest that one way to mitigate these risks is to use preoperative computed tomography (CT) scans. This tool could help doctors identify specific anatomical features that might make a patient more likely to experience serious complications from the surgery. However, the authors note that these features are not always evaluated or documented in pre-surgery image reports.

The paper’s goal is to highlight these important anatomical features and landmarks that could lead to surgical complications. They suggest a mnemonic, “CLOSE”, to help remember these features: Cribriform plate, Lamina papyracea, Onodi cell, Sphenoid sinus pneumatization, and (anterior) Ethmoidal artery.

The authors believe that using this mnemonic could improve the usefulness of pre-surgery imaging reports and help doctors reduce the risk of surgical complications.

FAQs

  1. What is the main goal of the research paper on functional endoscopic sinus surgery?
  2. How do the authors propose to mitigate the risks associated with functional endoscopic sinus surgery?
  3. What is the “CLOSE” mnemonic suggested in the research paper and how can it be useful in reducing surgical complications?

Doctor’s Tip

A doctor might advise a patient undergoing sinus surgery to discuss the results of their preoperative CT scan with their surgeon to ensure that any potential anatomical features that could increase the risk of complications are identified and accounted for during the procedure. By being proactive and informed about their individual anatomy, patients can help their surgeon tailor the surgery to their specific needs and reduce the likelihood of adverse events.

Suitable For

Patients who may be recommended sinus surgery include those with:

  1. Chronic sinusitis: Patients who have frequent or long-lasting sinus infections that do not respond to other treatment options may benefit from sinus surgery to improve drainage and reduce inflammation.

  2. Nasal polyps: Patients with nasal polyps, which are noncancerous growths in the lining of the nose or sinuses, may require surgery to remove them and improve breathing.

  3. Deviated septum: A deviated septum, which is a shift in the nasal septum that can block airflow and lead to sinus issues, may be corrected through surgery.

  4. Sinus tumors: Patients with tumors in the sinuses may require surgery to remove the growth and prevent further complications.

  5. Structural abnormalities: Patients with structural abnormalities in the sinuses, such as narrow drainage pathways or enlarged sinus cavities, may benefit from surgery to correct these issues.

Overall, sinus surgery may be recommended for patients who have not found relief from other treatments, have recurring sinus infections, or have anatomical issues that are causing sinus problems. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if sinus surgery is the best course of action for their individual situation.

Timeline

Before sinus surgery:

  1. Patient experiences symptoms of chronic sinusitis, such as facial pain, congestion, and difficulty breathing.
  2. Patient undergoes consultation with an ENT specialist who recommends functional endoscopic sinus surgery.
  3. Preoperative CT scan is performed to assess the patient’s sinus anatomy and identify any potential risk factors for complications.

After sinus surgery:

  1. Patient undergoes functional endoscopic sinus surgery to remove blockages and improve sinus drainage.
  2. Patient may experience temporary swelling, discomfort, and congestion in the days following surgery.
  3. Follow-up appointments are scheduled to monitor the patient’s recovery and ensure proper healing.
  4. Patient experiences improved sinus symptoms and overall quality of life following successful surgery.

What to Ask Your Doctor

  1. What specific risks are associated with functional endoscopic sinus surgery?
  2. How often do these risks occur, and what is the likelihood of experiencing complications?
  3. How will my specific anatomical features be evaluated before surgery?
  4. Will a preoperative CT scan be conducted, and what information will it provide about my sinus anatomy?
  5. How will the mnemonic “CLOSE” be used to assess my risk for surgical complications?
  6. Are there any alternative treatment options that may be less invasive or pose fewer risks?
  7. What is the recovery process like after sinus surgery, and what can I expect in terms of pain and discomfort?
  8. How long will it take for me to fully recover and resume normal activities?
  9. Are there any specific post-operative care instructions I should follow to ensure a successful recovery?
  10. How often will I need to follow up with you after the surgery, and what signs or symptoms should I watch for that may indicate a complication?

Reference

Authors: O’Brien WT Sr, Hamelin S, Weitzel EK. Journal: Radiology. 2016 Oct;281(1):10-21. doi: 10.1148/radiol.2016152230. PMID: 27643765