I. Why surgical treatment?
If chronic sinusitis is long-standing and the symptoms do not improve significantly after standard outpatient medication, then this is the time for surgery. Of course, if the patient has clear nasal polyps and anatomical abnormalities that affect the drainage of the sinuses, then surgery can be performed directly without conservative drug treatment.
What exactly is nasal endoscopy?
Nasal endoscopic surgery is a technique to perform surgery in the nasal cavity, sinuses, orbit and skull base area through nasal approach with the support of a complete optical system and surveillance system, using nasal endoscope and other special surgical instruments. The procedure is based on the principles of clearing blockages caused by anatomical abnormalities of the nasal cavity and sinuses (e.g., correction of deviated septum), ventilation and drainage of the sinuses (opening and enlargement of the sinus openings), and preservation of the mucosa. The surgery is a minimally invasive procedure, there is no incision in the head because we all have 2 natural orifices and the inside of the nasal cavity is not as small as we think. Our department has introduced sinus balloon dilation technology in addition to nasal endoscopy, which can make the surgery more minimally invasive.
What are the main advantages of nasal endoscopic surgery compared with traditional surgery?
1.Nasal endoscopic surgery is performed with multi-angle nasal endoscope, good optical illumination and high-definition video surveillance, so a clear and all-rounded operative field can be obtained.
2.Surgery is less traumatic, shorter, more precise operation, less painful for patients and faster postoperative recovery.
3.For certain skull base and orbital area diseases, craniotomy or facial incision is dispensed with, and the efficacy is better than that of the surgery with traditional approach.
4.Do I need to prepare anything before surgery?
Our rhinology surgery is different from other surgeries, and it is not possible to operate as soon as the patient comes in. Adequate medication should be used before surgery to achieve good surgical results. After admission, we continue to use nasal linctus to constrict blood vessels, nasal hormone anti-inflammatory treatment, and hypertonic saline to clear the nasal cavity. Preoperative hormone drips are required as well as necessary antibiotic therapy.
Hanging the head upside down, three drops of nasal ling in each nostril and then lying flat for one minute before rising, and ten minutes later hypertonic seawater nasal (Sinonin, sitting position), two sprays on each side, three times a day; nasal ling is usually used for no more than one week, and hypertonic seawater nasal (preoperative and postoperative) for at least three to six months.
Nasal hormones.
Every morning and evening, after hypertonic seawater nasal, nasal hormone (Nesuna or Reynocort) two sprays per nostril, two times a day. The person remains upright and sprays the right nostril with the left hand and the left nostril with the right hand. Inhale slightly backward while spraying the medication.
Why pre-operative medication.
Some people often ask why pre-operative medication is needed. Because pre-surgical medication can reduce the size of nasal polyps and reduce the dilatation and congestion of the blood vessels. Reduce nasal obstruction and promote drainage of the nasal sinuses. Adequate preoperative medication can greatly reduce intraoperative bleeding, and less intraoperative bleeding will inevitably lead to more precise operation and faster postoperative recovery. The pursuit of sinus surgery is minimally invasive.
V. Do I still need to use medication after surgery?
The answer is yes. It is necessary to continue to use medication. Because the function of functional nasal endoscopy is to completely remove the diseased tissues, especially those that block the drainage, but not to remove the inflammation of the mucosa and restore the function of the mucosa. Therefore, medication is necessary and long-term for patients with chronic sinusitis.
During hospitalization, one should continue to use nasal sinus rinses to remove blood crusts and mucus from the nasal cavity, nasal lining to clear the nasal cavity, nasal anti-inflammatory treatment with hormones, and IV hormones and antibiotics for anti-inflammatory and anti-infective treatment (the specific use is the same as before surgery).
After discharge, nasal clearance with hypertonic seawater spray, nasal hormone anti-inflammatory treatment, and oral Medrol tablets 8mg once a day (for half a month) should be continued. Subsequently, nasal hormone and hypertonic seawater should be continued until the inflammation is completely controlled.
VI. What are the postoperative precautions?
After the surgery, patients can eat normally, but spicy and irritating food should be avoided. After surgery, there may be some headache, head swelling, nasal distension, tearing, a small amount of blood oozing from the nasal cavity, and a small amount of blood spitting out of the mouth, which are all normal phenomena so there is no need to be too nervous. After the surgery, you should avoid coughing, sneezing and blowing your nose. Also pay attention to rest and prevent repeated colds.
Do I need to review after surgery?
For sinusitis patients, surgery is only a starting point. After surgery, medication, regular review and post-operative examination and treatment of the cavity are very important, so it is necessary to follow the medical prescriptions for regular medication and regular review and change of medication on time and in the right amount, generally at the following times.
The first change of medication, 7-10 days after surgery; the second change of medication, 2 weeks after the first change of medication; the third change of medication, 2 weeks after the second change of medication; the fourth change of medication, 1 month after the third change of medication; the fifth change of medication, 1 month after the fourth change of medication. The next change of medication will be decided afterwards according to the situation.
We wish all patients a speedy recovery. The recovery of the disease not only depends on the doctor’s diagnosis and treatment, but also depends on the patients’ own efforts. Let’s work together to overcome sinusitis. If you have any further questions, please contact us.