Endoscopic surgery

Features of surgical intervention

Before the operation, the patient undergoes an examination, which includes blood tests (general, biochemical + for antibodies to HIV, hepatitis B and C), fluorography, ECG and examination by a therapist.

Immediately before the intervention, the doctor performs endotracheal anesthesia. It is carried out using the drug “Sevoran”. This type of anesthesia is easily tolerated and resembles normal sleep. Awakening after anesthesia goes smoothly, the patient does not feel any discomfort.

Operation types

There are 2 methods of intervention - microsinusrotomy and endoscopic maxillary sinusotomy through the nose.

The first option is carried out in the treatment of purulent and hyperplastic sinusitis. It involves making a small incision (about 5-7 mm) under the upper lip - this is required to provide access to the maxillary sinus.

Using an instrument with a sharp end (trocar) allows the doctor to penetrate the mucous and bone structure and create accurate access to the sinus. An endoscopic camera and specialized instruments are inserted through the formed channel, with which the surgeon performs the operation.

Endoscopic maxillary sinusotomy through the nose is the newest method of treating sinusitis. This operation is recommended for those who have chronic purulent or hyperplastic sinusitis, accompanied by damage to the entire sinus mucosa. The intervention is carried out through the middle or lower nasal passage. This allows you not only to examine the sinus, but also to improve its drainage.

After the operation, the patient is monitored in the hospital for some time, and then returns home and continues recovery under the supervision of a doctor. At home, he undertakes to keep the nasal cavity clean and remove any crusts that form - this is necessary for successful healing.

A likely complication of surgery on the maxillary sinuses is the risk of damage to one of the main nerve branches of the face. Against this background, severe pain appears. However, the probability of this risk with microsinlusrotomy is only 5-10%.

Preparation for surgery

Before surgery, it is necessary to take a general blood test with a leukocyte formula. You will also need to take a biochemical blood test (the important indicators are AST, ALT, bilirubin, total protein, electrolytes, iron, creatinine, urea and glycosylated hemoglobin).

Additional research:

• Coagulogram
• Tests for infectious diseases (HIV 1, 2, p24 HBs, HBsAg antigens, antibodies to hepatitis C viruses, syphilis)
• General urine analysis
• Ultrasound of the veins of the lower extremities
• ECG with interpretation
• CT (X-ray) of the chest organs

The patient also needs to obtain a conclusion from a gynecologist (relevant for women over 18 years old) about the absence of contraindications to the operation. Additionally, you should obtain advice and a physician’s opinion on your state of health and readiness for surgery.

Features of the intervention

The operation is performed under general anesthesia. The surgeon inserts instruments into the paranasal sinuses through its cavity, removes damaged areas of the mucous membrane and tumors. After this, the doctor restores natural drainage and removes pathological contents from the sinuses.

The risk of complications during and after the intervention is 35-40%. They are:

• Intraoperative. These include injuries to organs near the operated area (in particular, there is a possibility of hematomas, damage to the optic nerve and muscles)
• Early. These complications appear in the first 24 hours after the intervention. This category includes bleeding and infections that have penetrated the wound
• Late (occurs after a month or more). Scars appear that contribute to the re-development of the disease

After the operation, the patient remains in the hospital for 1 day. The next day, the doctor examines him and cleanses the nasal cavity - this helps accelerate the regeneration of the mucous membrane. After this, the person is discharged.

Recovery after endoscopic sinus surgery

For the first few days after endoscopic sinus surgery, you should remain in bed and keep your head elevated. This is necessary in order to reduce pain and inflammation. You need to sleep on 2 or 3 pillows.

For several hours after the intervention, bleeding may appear. They usually stop within 24-72 hours. In addition, slight bruising and redness around the eyes sometimes appear - these symptoms go away on their own.

Severe pain can be relieved with analgesics prescribed by your doctor. The duration of their administration usually does not exceed 3-5 days. Cold compresses will help relieve mild pain and inflammation. They should be applied to the operated area for 10-15 minutes. You need to make compresses 2-3 times a day.

In most cases, people who undergo endoscopic plastic surgery return to normal activity within 1-2 weeks. Complete recovery and disappearance of symptoms occurs within 1 to 6 months. To speed up rehabilitation and reduce the risk of complications after endoscopic interventions, it is necessary:

• Be careful. Don't blow your nose for a week after surgery. Do not clean your nose with cotton swabs or remove any tampons, splints, or tubes until your doctor allows it.
• Rinse your nose with sea water 5-6 times a day (this is necessary to restore breathing). If the doctor has prescribed antibacterial drugs and ointments, they should be used strictly according to schedule
• Avoid crowded places (this is necessary in order not to catch a new infection in the first week after discharge)
• Postpone visiting saunas and baths (high temperatures increase swelling)

If your nose starts bleeding, tilt your head back and use gentle breathing techniques. Nasal sprays should not be used without a doctor's permission. 5-7 days after the operation, you must visit a doctor for a follow-up examination.