Minimally invasive surgery for sinusitis
Oct 31, 2022
Source: Cainiu Health
Dr. Xu Gang
Introduction
General anesthesia is administered by an anesthesiologist, and nasal vasoconstriction is achieved using cottonoids soaked in normal saline with epinephrine. The nasal endoscope is inserted into the nasal cavity to examine the ostia of the paranasal sinuses and assess the presence of nasal polyps within the nasal cavity. The anterior portion of the uncinate process is removed to expose the ethmoid bulla; the ethmoid bulla is then opened to access and unblock the affected sinus ostia, thereby establishing adequate drainage from all paranasal sinuses.
Minimally invasive surgery for sinusitis is performed via endoscopic sinus surgery, which promotes resolution of local mucosal inflammation by restoring ventilation and drainage of the nasal cavity and sinuses. This procedure is suitable for cases unresponsive to conservative treatment, as well as for sinusitis accompanied by nasal polyps. The specific steps are as follows:
1. Prior to surgery, patients must undergo a paranasal sinus CT scan to comprehensively evaluate the extent of sinus lesions. Patients should fast from food and water for six hours before the procedure.
2. In the operating room, the patient lies in a supine position. After general anesthesia is administered by an anesthesiologist, cottonoids soaked in normal saline with epinephrine are applied to constrict nasal blood vessels.
3. Once the endoscopic surgical equipment is adjusted, the surgeon inserts the nasal endoscope into the nasal cavity to examine the ostia of each sinus and check for the presence of nasal polyps.
4. The anterior ethmoid bulla (uncinate process) is removed to expose the underlying ethmoid air cells. The affected sinus ostia are then opened and enlarged to ensure adequate drainage from all sinuses.
5. Thorough hemostasis is achieved in the surgical cavity. After confirming no residual lesions remain in the sinuses, nasal packing with gelatin sponge, expandable sponge, or Vaseline-impregnated gauze is performed based on the patient's bleeding status.
6. After recovery from anesthesia, the patient is transferred back to the ward.
