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Endoscopic polypectomy or sinusotomy or FESS

Why is it done:

In people with a diagnosis of polypous rhinosinusitis, choanal polyp, maxillary sinus cyst, foreign body, filling material or mycetoma, removal of these formations is often prescribed due to frequent problems with nasal breathing, frequent sinusitis, and unpleasant smell, inability to breathe without drops, problems with smell snoring, headaches, fatigue, sleepiness, problems with the throat caused by dryness of mucous membranes of the oropharynx.

Diagnostics:

Often, in addition to examining by the otolaryngologist, imaging is needed (computed tomogram of the paranasal sinuses)

Surgical Methods:

Depending on which sinus of the nose (maxillary, ethmoid, frontal or sphenoid) there is a problem, the location of intervention is chosen accordingly. Interventions can be one-sided or two-sided. During surgical interventions on the paranasal sinuses, to minimise postoperative discomfort, swelling and pain, we use an endoscopic technique that allows performing manipulations in the sinuses without any incisions in the mouth and face. All sinus surgery using an endoscope is called “Functional Endoscopic Sinus Surgery” or FESS. During surgery, we use endoscopes with an angle of 0 °, 30 °, 45 °, 70 °. For a more gentle removal of polyps and preservation of the nasal mucosa, a shaver is used, which allows to almost bloodlessly remove only those areas that need to be eliminated.

Preoperative preparation:

If you are recommended to perform this operation, for hospitalization in hospital and anaesthesia, you must undergo a standard set of laboratory tests. The minimum set of tests: a complete blood count, blood biochemistry, glucose, coagulation test, a general urinalysis, blood type and Rh factor, chest X-ray, electrocardiography, given that all people are different and their health statuses are not the same, other additional tests may be necessary, as well as consultations of a pulmonologist or cardiologist. The operation takes place under general anaesthesia, so it is necessary to exclude alcohol intake, minimise smoking, and not overeat on the night before the operation. You need to take convenient things with you to the hospital: a tracksuit, several T-shirts, underwear, shoes to change into or slippers, personal hygiene products, leisure facilities (books, laptop), based on the fact that you will need to stay for 2-3 days. It is best to give valuables on the day of surgery to relatives or to warn medical personnel about them.

Operation Day:

If the operation is scheduled for the first half of the day, then you cannot eat or drink that day, since the operation and anaesthesia are performed on an empty stomach. If the operation is scheduled for lunch or after lunch, then the last meal (without meat) should be 6 hours before the operation, the last intake of plain water, in the amount of 100 ml should take place 4 hours before the operation. In the ward, you will need to change clothes and wait to be called upon. The most unpleasant thing for you will be 1 injection into a vein. There will be no more discomfort and pain. You will be put on a table and bounded, but not so that you do not run away, but so that you do not fall off the table when you are under anaesthesia. A mask will be put on your face and you will fall asleep.

Immediately after surgery:

After the operation, tampons will be inside your nose. Tampons can be different (with and without tubes, laminated and with added hemostatic), but you do not need to count on nasal breathing on the first day. Under the nose, there may be a bandage that performs exclusively hygienic function. Until complete awakening, you will be under the control of doctors and only after that, you will be transferred to the ward, so if you were told that the operation lasts for about an hour and a half, this does not mean that you will be in the ward immediately after its completion. This may take another 1-2 hours. After you arrive at the ward, you will be allowed to drink in 1.5-2 hours.

Postoperative period in the clinic:

Usually, the day after surgery, nasal tampons are removed. This procedure is not painful, as we use Merocel nasal tampons for tamponades, which are 8-10 cm long and not the usual 2 meters of gauze. These tampons resemble foam rubber. After removing the tampons, you will go to the ward, where you will need to lie on your side for an hour. After that, you can get up and walk. After 6-8 hours or the next day, a nose toilet is done. Only after the first toilet of the nose is it possible to assess the condition of the mucous membrane, the severity of oedema, the presence of discharge in the nose and decide when you can go home.

Postoperative period at home and recommendations:

When you have crossed the threshold of your home, you must adhere to and follow the doctor’s recommendations, since the greatest number of complications occurs at home. You are at the stage of recovery, but this does not mean that you are already healthy. Therefore, you need to behave appropriately in accordance to undergone surgery. You will have to visit a doctor for dressings and nose toilets. The necessary medication therapy is usually prescribed individually for each patient at discharge.

After surgery: Rinse nose with saline 2-3 times per day (Pshyk, Humer, Aqua Maris); Use Aecol solution drops for the nose 3 times a day.

You can: Take a slightly warm shower, go for a walk, breathe air, eat warm food.

You can not: Take baths, play sports for 14 days after surgery, consume hot food and drinks, carbonated drinks.