Endoscopic Sinus Surgery
After a comprehensive evaluation of the patient’s symptoms, your surgeon will perform a fiberoptic nasendoscopy to provide direct visualization of the status of your nasal passages. After it has been determined that the patient has been adequately treated first with various antibiotics, nasal steroids, saline douches, and decongestants, the next step will often be a CT scan. At Breathe America, Dr. Gerencer will be able to have this scan performed directly in his office – sometimes, on your initial consultation depending on your specific insurance plan. Dr. Gerencer will then go over the results of your CT scan to determine if you have chronic sinusitis. If you do, Dr. Gerencer will engage in a detailed discussion regarding your treatment options. If medical measures have failed, he will discuss the potential value of Endoscopic Sinus Surgery with you.
Endoscopy is an option often used by surgeons to repair sinus bones that have been damaged. This minimally invasive technique helps reduce the risk of complications. By diminishing the likelihood of damage to nearby structures, it also enables the surgeon to maintain a functioning sinus more frequently. An endoscope is a thin, rigid, lighted tube which allows the surgeon to peer straight ahead and also around corners. When using an endoscope in a procedure, a surgeon will need to make fewer incisions, since the tools are capable of reaching the treatment site via the nostrils. The surgeon carefully inserts the endoscope probe along with some other tools in his other hand to then perform the operation.
The endoscopic sinus surgery is performed while the patient is sedated under general anesthesia. Local anesthesia is then injected by the surgeon into the operative field inside your nose. The surgeon then methodically unblocks the affected sinuses by removing any obstructing diseased tissue, such as nasal polyps, and then by enlarging the sinus openings, either with the aid a balloon catheter, or with various cutting instruments. At the completion of the procedure, Dr. Gerencer may elect to place various steroid-eluting stents into affected sinuses to reduce the risk of scar tissue formation, as well as the placement of various synthetic hemostatic compounds to minimize the risk of postoperative bleeding. Dr. Gerencer almost never places non-absorbable packing following his operations.
Risks of Endoscopic Sinus Surgery
All medical procedures carry some form of risk to patients. Possible complications associated with endoscopic sinus surgery include:
- Reactions to the anesthesia
- Scarring and potential need for revision surgery
In extremely rare cases, the procedure may result in brain injury, eye damage or seizures.
Recovery from Endoscopic Sinus Surgery
Since no external incisions are needed for endoscopic sinus surgery, the healing process is faster and more comfortable. Recovery time is less than that of “traditional” methods of surgery, since post-operative swelling, bruising and bleeding are often substantially decreased. After undergoing endoscopic sinus surgery, most patients can expect a recovery period of between 5 to 7 days before returning to work and resuming normal activities. It is common to experience some congestion and headaches as well as nasal discharge during this period.
Regular follow-up appointments with your surgeon are extremely important. The long-term success of endoscopic sinus surgery depends on prevention and minimizing the deposition of scar tissue in your sinus cavities. You will receive detailed instructions week by week in terms of what to place in your nose predicated on the status of your recovering sinuses. Dr. Gerencer and his staff follows all of our post-sinus surgical patients for a minimum of one year from surgery.