Endoscopic sinus surgery This procedure is used to treat chronic sinusitis and to remove benign nasal tumors. It is also performed with the aim of expanding the nasal drainage pathways for the sinuses and to improve ventilation. Learn more about this procedure in Turkey, and how to prepare for it.
Why is sinus surgery performed?
Chronic sinus infections are usually treated with medication rather than surgery. However, sinus surgery may be necessary when these infections are frequent or persistent. Therefore, sinus surgery is commonly used to treat chronic sinus infections, but may be necessary for other sinus problems. The endoscopic sinus operation includes widening the openings between the sinuses and inside the nose to improve sinus ventilation and help mucus exit into the nose. It also enables the removal of sinus tissue, bone or polyps. Endoscopic sinus surgery is a newer technology that reduces postoperative bleeding, is less invasive than traditional sinus surgery and requires less recovery time.
What are the types of sinus surgery?
- Functional endoscopic sinus surgery (FESS): This is the most common type of sinus surgery. It can be performed on an outpatient basis. This is done using a special endoscope that is inserted into the nose through the nostril (a telescope) to see the inside of the nose and the entrances to the sinuses. Then other instruments are used through the same nostril to perform the procedure.
- Image-guided sinus surgery: In this procedure, sinus surgery is often performed with an image-guided system that uses computerized tomography (CT) scans to help the surgeon identify anatomical structures and remove as little nasal tissue as possible. This system helps the ENT doctor know when to approach the edge of the sinuses and thus ensures the integrity of the sinuses.
What is fess endoscopic sinus surgery?
Functional endoscopic sinus surgery (fess) differs from traditional sinus surgery, using an endoscope inserted into the nose to view the nasal cavity and sinuses. This eliminates the need for the external incision used in traditional sinus surgery. The rhinoscope allows better visualization of the diseased structures and helps the surgeon to remove them. This endoscopy, along with detailed X-ray studies, may reveal a problem that wasn't clear before. Another difference is that functional endoscopic sinus surgery focuses on treating the underlying cause of the problem. During which the ethmoid regions are opened, allowing the maxillary, forehead, and sphenoid sinuses to be seen. The sinuses can then be viewed directly, and diseased or obstructive tissues removed if necessary. So there is often less normal tissue removal, and endoscopic sinus surgery can often be performed on an outpatient basis.
When is endoscopic sinus surgery fess used?
Endoscopic functional sinus surgery is generally performed for people with chronic sinusitis who do not respond to medical treatment. The diagnosis of chronic sinusitis should be based on an ear, nose, and throat doctor evaluation, as other problems can cause symptoms similar to those of chronic sinusitis. Most people with sinusitis do not need surgery. Sinusitis symptoms can be treated pharmacologically with antibiotics, other medications, and allergy treatment. Therefore, the type of drug treatment used depends on the evaluation of an otolaryngologist. However, surgical intervention is sometimes required as a treatment for the sinuses. This may be because the infection is not adequately treated with antibiotics or other medications, symptoms continue to return when the antibiotics are stopped, or for other reasons. You should discuss the need for sinus surgery with your doctor. The decision to have sinus surgery depends on your health history and physical examination. At the initial consultation, it is important to bring your records from your doctor including your health history and sinus treatment used up to this time. If a CT or MRI scan is available, they should also be brought on your first visit to the hospital. It is also required to do a CT scan to accurately assess the areas involved. If you have not done so before your visit, you will need to do so at a later time. The otolaryngologist suggests starting with drug treatments, to see how you will respond to the maximum drug therapy before deciding on a surgical procedure. If endoscopic sinus surgery is an option for you, your consent will be obtained and an appointment for the procedure will be arranged.
How do I prepare for endoscopic sinus surgery?
- Before having endoscopic sinus surgery, you will need to have some blood tests and possibly other studies such as an EKG and a chest X-ray, which are ordered if your age or medical history indicates the need.
- Sometimes starting oral decongestants (or increasing the dose if you are already taking them) and/or antibiotics in the period before endoscopic sinus surgery. Take these medications as directed by your doctor. If you have a significant increase in sinusitis in the week(s) before surgery, let your doctor know. Because you may need to postpone sinus surgery.
- Do not take aspirin or other analgesic salicylates for at least 10 days prior to endoscopic sinus surgery. Aspirin, even in small amounts, can significantly increase bleeding during and after endoscopic sinus surgery.
- Do not take non-steroidal anti-inflammatory drugs (ibuprofen, Advil, Motrin, Aleve) for at least five days before endoscopic sinus surgery. These medications will also increase bleeding, although their effect on the blood is shorter.
- Do not smoke for at least three weeks before endoscopic sinus surgery. Because smoking not only aggravates sinus symptoms, but smoking in the weeks before or after the operation leads to hypertrophic scars, and may lead to the failure of the operation.
- Do not eat or drink anything after midnight the night before endoscopic sinus surgery.
You should get a nasal spray from a pharmacy, and spray it into your nose 1-2 hours before endoscopic sinus surgery.
What will happen during the functional endoscopic sinus surgery in Turkey?
Endoscopic sinus surgery is performed under general or local anesthesia, under the supervision of a specialist doctor. If you choose to have an endoscopic sinus procedure under local anaesthesia, you will be given medications to make you sleepy and relaxed, and you will be given some music with a headset. You will usually hear some annoying noises when the bones are removed, which may sound loud to you. You may also feel some mucus or blood in the back of your throat that you must swallow. You'll be able to talk to your doctor during endoscopic sinus surgery, so let us know if there's anything bothering you. If the patient feels uncomfortable during the operation, he will be given general anesthesia. In some cases, it may be necessary to repair the nasal septum (septum) during endoscopic sinus surgery.
What are the risks of endoscopic sinus surgery?
Complications of functional endoscopic sinus surgery are not uncommon, but your otolaryngologist and anesthesiologist will talk about them with you. So be sure to ask any questions you have. Complications may include:
Although the risk of bleeding appears to be reduced with the endoscopic sinus surgery technique, sometimes severe bleeding may require termination of the procedure and placement of nasal tampons. Bleeding after endoscopic sinus surgery may require nasal filling and hospitalization. But a blood transfusion is rarely necessary.
In the rare cases when a blood transfusion is necessary, there is a risk of an adverse reaction or transmission of an infection with the blood.
cerebrospinal fluid (CSF) leak
All operations on the ethmoid sinuses carry a rare chance of causing a leak of cerebrospinal fluid (the fluid that surrounds the brain). The risk of cerebrospinal fluid leakage is generally higher when ethmoid sinus surgery is performed through the nose rather than through an external incision. However, because the endoscope used allows for improved vision, the risk of this complication is likely to be reduced. If this rare complication occurs, it creates a potential pathway for infection, potentially leading to meningitis (inflammation of the brain). A cerebrospinal fluid leak may prolong your stay in the hospital and may require more surgery to repair.
Although extremely rare, there have been reports of vision loss after endoscopic sinus surgery. In addition, temporary or prolonged double vision has been reported after endoscopic sinus treatment in some patients.
General anesthesia risks
Because endoscopic sinus surgery is usually performed under local anesthesia, adverse reactions are uncommon. But if general anesthesia is required, you'll run into occasional, and potentially serious, risks. You can discuss adverse reactions to general anesthesia with a specialist.
Risks of reconstruction (correction) of the nasal septum
During septal repair, the patient may experience numbness in the front teeth, bleeding and inflammation of the nasal septum or a perforation of the nasal septum. Perforation of the nasal septum may cause difficulty breathing. Since the cartilage in the septum contains a "memory", it may move after the rebuilding process and result in a regenerative deviation. There is also a small risk of a change in the shape of the nose.
Decreased sense of smell after endoscopic sinus surgery
Permanent loss or decreased sense of smell can occur after endoscopic sinus surgery. However, it has actually decreased in a number of patients before surgery, and usually improves with surgical intervention.
Endoscopic sinus surgery can result in chronic sinusitis not improving, and the patient may feel numbness or discomfort in the upper front teeth for a period of time. Temporary swelling, bruising or numbness of the lip may occur, as well as swelling or bruising around the eye. It is common for any slight changes in the voice.
What after endoscopic sinus surgery?
Some bloody discharge may occur in the nose for about two weeks after the operation, this is normal and gets better slowly. The patient should not blow their nose for at least four to seven days after endoscopic sinus surgery. As normal sinus drainage returns, you may secrete some thick bloody mucus. This is also normal. Review visits are usually arranged around one and six days after endoscopic sinus surgery to clear the nasal crusts and remove any inflammation or scar tissue under local anaesthesia. Although the chances of complications from these procedures are rare, the potential risks are the same as with the surgery itself. Careful post-operative care is essential to the success of this surgery. You will be provided with a brochure on post-operative care instructions. It is very important that you follow these instructions, as well as any additional instructions we give you, to promote healing and reduce the chance of complications. The patient should be able to return to his daily routine several days after the sinus operation. He may experience crusting or stuffy nose for several weeks after the procedure. In the first few days, the gauze placed under the nose may need to be changed. Among the recommendations, sleep with the head elevated and drink plenty of fluids. If necessary, he or she may prescribe pain medication or antibiotics. The patient will also be asked to schedule follow-up visits with an ear, nose, and throat doctor to make sure the sinuses are healing properly, and to clear out any excess blood or mucus. It is important that the patient does not blow their nose when recovering from sinus surgery. This can cause excessive bleeding.
Will endoscopic sinus surgery treat sinus diseases?
As with all sinus surgeries, the disease may not be cured by the operation, or the disease may recur at a later time. If this happens, subsequent surgical treatment may be needed. Be aware that some medications must be continued after surgical treatment, especially if allergies or polyps play a role in the sinus disease. This is necessary to prevent recurrence of the disease. In general, the majority of patients had significant improvement with the combination of surgery and continuous drug therapy. We will certainly work with you to achieve this goal.
Recovery from endoscopic sinus surgery:
Endoscopic sinus surgery is an effective treatment for those with sinus problems but is only performed on patients who have not responded to drug therapy. Some people notice an immediate improvement in their symptoms after an endoscopic sinus procedure, while for others it may take a few weeks or months. Some patients may require continuous care even after they recover from endoscopic sinus surgery. Bimaristan Medical Center remains your first choice for treatment in Turkey. We direct you to the best specialized doctors who are experts in all fields, we break the language barrier, Arab specialist doctors will help you to communicate with your doctor, we help you book an appointment in the most important and modern hospitals in Turkey, we offer our services to secure hotel reservations for you and your companions, in addition to transportation, we help you secure a travel visa for you for free. We provide our services throughout Turkey, the best place for you is our destination. We accompany you step by step towards recovery. Free Consultation all the time. Do not hesitate to contact us, the best doctors in Turkey, Bimaristan your family center in Turkey. You can also read on our website about Eustachian tube obstruction and treatment in Turkey.
Frequently asked questions and answers about endoscopic sinus surgery in Turkey
The cost for endoscopic sinus surgery varies according to the case (with correction of frequency deviation, the goal is to remove tumors, remove adenoids, etc.) ranging from 4500-7500 US dollars.
This is rare, sometimes the shape of the nose changes slightly after the procedure due to swelling and returns to its normal shape afterwards.
The doctor may recommend sleeping with the head elevated and drinking plenty of fluids. If necessary, he or she may prescribe pain medication or antibiotics.
Recent studies show that the success rate of endoscopic sinus surgery is as high as 91%.