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Thiruvananthapuram: Chronic sinusitis is a common health condition caused by persistent inflammation of the sinuses that lasts for more than 12 weeks. Things like allergies, a deviated septum, or damaged cilia (the little hairs in the sinuses) can block the natural movement of nasal secretions, causing sinusitis. This condition manifests itself as a congested nose that makes it difficult to expel mucus and blocks breathing. As a result, a stagnant environment within the sinuses favors the growth of bacteria and pathogens, ultimately leading to the development of nasal polyps—noncancerous growths in the lining of the nasal cavity and sinuses.
Nasal polyps present significant challenges, blocking the nasal passages and causing difficulty breathing, often accompanied by loss of smell. Initial treatment includes medications designed to reduce or eliminate these polyps. However, surgical intervention is often required to achieve complete resection.
“We start with medical management. First with a nasal spray and some tablets. People with allergies lose interest in treatment in due course and wait until their condition worsens before coming to us. We opt for minimally invasive sinus surgery, especially for this type of surgery Functional Endoscopic Sinus Surgery (FESS) in patients,” said Dr Gopikumar P, consultant ENT, CAM Hospital, Thrissur. He also warned that people with diabetes and other immunocompromised people are at increased risk for fungal sinus infections, a serious health condition.
Environmental factors and pollution play a large role in the prevalence of sinus-related problems. Technological advances in the medical field have resulted in minimally invasive sinus surgery, providing patients with a more comfortable and effective alternative to traditional surgical methods. In particular, FESS revolutionized sinus and nasal surgery by providing physicians with the opportunity to access the sinus area through advanced endoscopic instruments.
“The gold standard of minimally invasive technology for chronic sinusitis is functional endoscopic sinus surgery, which is widely used today. Under the endoscopic field of view, the natural sinus drainage channels are preserved, the normal sinus mucosa is preserved, and only the diseased mucosa is removed. It is completely non-invasive. Scarring, many centers are now opting for it as a day care surgery,” said Dr Vinod Felix, Consultant, ENT KIMSHEALTH Department, Thiruvananthapuram.
“With advanced bleeding control measures and the use of powered devices such as microdebriders, recovery time is reduced to 1 week on average. FESS provides extensive access to topical nasal administration of steroids and other medications in the form of nasal washes/sprays, to reach the entire nasal mucosa to prevent further recurrence of the disease in patients with nasal allergy,” he added.
Felix added that endoscopic balloon dilatation of sinus drainage channels is another option performed in selected cases.
Patients undergoing minimally invasive sinus surgery may receive local or general anesthesia. Decisions about anesthesia are usually made after a thorough evaluation by the surgical team, taking into account the patient’s overall health, the complexity of the procedure, and the surgeon’s judgment.
Doctors also emphasize the importance of follow-up treatment to obtain the maximum benefits of FESS. “Treatment of a disease that is dynamic in nature does not end with surgery. If not followed up in time, nasal polyps will definitely reappear after 2-3 years. But we can control the chances of recurrence. Nasal sprays and tablets need to be continued for a period of time,” Gopikumar said.
Advantages of Endoscopic Nasal Surgery
1 Faster recovery time: One of the main benefits of minimally invasive sinus surgery is faster recovery time. Traditional open surgery often requires longer healing times due to larger incisions and tissue destruction. In contrast, minimally invasive surgery involves smaller incisions, less trauma to surrounding tissue, and faster patient recovery.
2 Reduce pain and discomfort: Smaller incisions and less tissue destruction help reduce postoperative pain and discomfort in patients undergoing minimally invasive sinus surgery. This makes the overall experience more tolerable and promotes a quicker return to normal daily activities.
3 Protect health organizations: Endoscopic sinus surgery allows surgeons to target specific sinus problems while sparing healthy surrounding tissue. This precision is critical to minimizing the risk of complications and ensuring optimal outcomes for patients.
4 Improved visualization: The use of high-definition endoscopy provides surgeons with enhanced visualization of sinus anatomy, allowing for more accurate diagnosis and precise treatment. This increased visibility helps achieve better surgical outcomes and reduces the risk of complications.
5 Reduce scars: The small incisions of minimally invasive sinus surgery minimize scarring compared to traditional open surgery.This cosmetic advantage is especially appreciated by patients as it helps achieve more aesthetic results
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