Endoscopic Sinus Surgery has evolved over the years to be the procedure of choice for surgical management of diseases involving the sinuses. The most common reason ENT surgeons perform endoscopic sinus surgery is chronic sinusitis, but it is also an established surgical technique for acute sinusitis, and sinus & nasal polyps. More recently, we have seen applications of endoscopic techniques to involve tumours of the nose and sinuses, skull base and orbit (eye).
The goal of endoscopic sinus surgery is to remove diseased and polypoid tissue and to re-establish ventilation and drainage. Modern sinus powered instruments and video camera systems allow for targeted surgery to each sinus system. The idea is to allow maximum resolution of diseased sinus tissue without large traumatic surgery of the entire sinus chambers.
An Operating Room
Polyps are benign, localised oedematous growths of the nasal and sinus mucosa. They may enlarge while in the nose/sinuses and block the nasal cavity or sinus drainage pathways. The cause of polyps is unknown.
Polyps usually respond well to a course of steroids taken in the form tablets, and followed by a steroid nasal spray. If they don’t, or recur, then endoscopic sinus surgery may be indicated.
If mucous cannot drain properly through the natural sinus openings, the sinuses may become inflamed and infection will result. This generally results in one or more of the following symptoms: facial pain, headache, nasal discharge, impaired smell and blocked nose.
Patients with acute sinusitis should seek surgical assistance when:
- Greater than 3 episodes per year occur
- Infection is not responding to appropriate antibiotics and medicinal nasal sprays
- Associated with polyps
- Complications involving the eye, brain or other concerns
Chronic sinusitis develops when symptoms last for a long time. Treatment generally involves a combination of nasal steroids, saline nasal douches, antibiotics and avoidance of smoking and hay-fever triggers. Referral to a specialist ENT surgeon is recommended if symptoms persist.