Endoscopic sinus surgery, especially, Functional Endoscopic Sinus Surgery or FESS is a minimally invasive surgical procedure, performed to restore the normal function and ventilation of the sinus. It is one of the most common procedures done the specialist physician.
Suitability of the Candidate
The candidates, who have recurrent chronic or acute infective sinusitis and when the symptoms are improved for 90 percent are eligible for this procedure. FESS is useful for the patients, who experience chronic or acute infective sinusitis. Candidates, who have nasal blockage and facial pain usually well respond to this treatment. When the candidate finds no help from the medical treatment or any other treatments, then the surgery is proposed to be done.
So, patient selection is done on the basis preoperative test results, physical examination, medical treatment trial and patient medical history.
Advantages
- The surgical procedure is safe enough as it uses minimally invasive technique.
- The healthy tissues are not disturbed.
- The surgery is performed for better results and takes less time.
- Quick recovery
- Quick return to the regular and normal lifestyle
- Signs of the surgery are not visible
- Sense of smell is improved after the treatment
Before the Procedure
CT scan is necessary to be done to identify the ethmoid anatomy and the skull base relationshipof the patient. The same scan helps to identify the extent of the disease and any anatomic abnormalities that may be underlying.
Procedure
The FESS is the surgical procedure that is performed with minimum invasive procedure. During the surgery, the sinus ostia and sinus air cells are opened up with the anendoscope. It is considered to be a surgical modality for paranasal, nose sinuses, nasal polyposis. The procedure can be conducted on an outpatient basis, as the procedure gives minimal discomfort experience to the patient. The rate of complication is very less, when compared to the conventional sinus surgery.
Initially the patient is given either local anesthesia or general anesthesia. The procedure starts with fiberoptic telescope. Then tomography is computed for identifying the diseased area and assessing the anatomy.
Adequate vasoconstriction is induced with ephedrine or cocaine. Then the middle turbinate is located by the surgeon. Middle turbinate is the most significant site to conduct the FESS procedure. The back ethmoid air cells are opened by the surgeon so that better ventilation is allowed. The bone will be left covered by mucus membrane. The next step will be locating ostium just near the jaw and checking for any existing obstructions. If it is needed, the obstruction is opened using a middle meatal antrostomy. The recent advancements in the FESS surgical procedure involves endoscope usage and video attachment. So, it allows the surgeons to have a clear view of internal structure and obstructions through the video monitor.
After the Procedure
The FESS procedure improves the osteomeatal complex function to a great extent and thereby providing better ventilation to the sinuses. There are many refinements done by the surgeon during the surgery.
Complications
Since there is proximity of the sinuses to the optic nerves, eyes, internal carotid arteries and brain, extreme care must be taken during and after the surgery. However, the complications are rare with these procedures and there are many benefits from the endoscopic sinus surgery. The surgeon should possess adequate training along with experience to perform and manage this procedure.
Cost of Endoscopic Sinus Surgery
The above Package Cost is a tentative Approximate Package Estimate, which includes initial investigations & specialists screening, stay in a Private Room wherein patient’s assistant or relative can also stay with patient, doctor / surgeon fee, nursing care, medicines & consumables, Airport Pick-Up & Drop.
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