Nasal endoscopic surgery is a technique that has developed rapidly in recent years and has now become the mainstream of treatment for sinusitis.
I. Preoperative preparation.
1.Conduct a specialist examination of ear, nose and throat, including the application of nasal endoscopy to understand the basic structure and lesions of the nasal cavity in detail, and the treatment of the local nasal cavity.
2. General examination and understanding of the basic conditions of the body.
3.Pre-operative antibiotic application, and application of hormone therapy to promote secretion discharge, and if necessary, application of anti-allergy treatment.
4.Ophthalmic clinical examination is routinely performed, including visual acuity, visual field, intraocular pressure, eye movement, pupil, fundus, etc.
5.Coronal CT examination of the sinuses, detailed understanding of the sinus lesions, as the basis for surgery.
II. Surgical procedures.
1.Position: supine position.
2.Anesthesia: general anesthesia by transoral tracheal intubation and nasal surface anesthesia.
3. Surgical principle: The surgical principle of functional nasal endoscopic surgery is to remove the lesion, preserve the function, minimize the scope of surgery and reduce unnecessary damage in the nose. The scope of surgical resection depends on the specific situation.
3.Surgical complications.
The sinuses are surrounded by many important anatomical structures, such as the anterior skull base, dura mater, orbital optic nerve, internal carotid artery, cavernous sinus, etc. Once complications occur, they often cause very serious consequences. For example, rhinorrhea, intraorbital hematoma, optic nerve injury, cerebrospinal fluid nasal leakage, etc. Therefore, prevention is important.
IV. Postoperative treatment.
1.General treatment: take a semi-recumbent position, pay attention to bleeding, application of systemic antibiotics, promotion of secretion discharge and hormone therapy, symptomatic treatment and body temperature detection.
2. Routine eye examination
3.Operative cavity treatment.
Phase I: 2 weeks postoperatively.
After 48 hours of routine postoperative extraction of the nasal cavity filled with sand strips, use ephedrine to shrink the nasal cavity, and then daily or every other day under the guidance of nasal endoscope with suction of blood clots and nasal secretions, so that each sinus cavity drainage, in addition, daily saline rinse nasal cavity once for 5-7 days. Generally, the scabs can be gradually reduced until they disappear completely within 2 weeks.
Phase 2: Within 3 months after surgery.
In principle, come to the hospital every week or two weeks for a review and a detailed examination of the operated cavity with nasal endoscopy. All new granulation and scabs are thoroughly removed and adhesions are separated. This stage is the most important stage to ensure the effectiveness of the surgery and should be given sufficient attention.
Phase 3: The maintenance phase of the treatment effect, up to more than six months after surgery.
It is important to review every month or two months and to come to the hospital as instructed by the doctor.
Therefore, the follow-up review after surgery is very important. Especially the initial stage is an important period for controlling recurrence.