Endoscopic Sinus Surgery

The field of endoscopic sinus surgery has seen a lot of innovations and development in the past few decades. Initially, sinus surgery used to be performed by making a skin incision directly over the sinuses on the face, or through a very limited view of the sinuses that was available by looking into the nostrils externally (transnasal). Occasionally, surgery was also performed from under the lip into the sinuses of the cheek (Caldwell-Luc procedure).

The first major advancement in development of endoscopic sinus surgery came with development of the Endoscopic Sinus Surgery. Rigid scopes that could easily be inserted into the nasal passages allowed visualization of the inside of the nose to a degree that could never be achieved from an external point of view. At the same time, development of microscopic instruments facilitated achieving better results with proper surgery and development of better drainage pathways.

Balloon Sinuplasty

The most significant advancement in sinus surgery that has come in the past few years is that of development of Balloon Sinuplasty. This method is classified as a minimally-invasive technique that is becoming the standard of care in many medical fields. Similar to the balloons used for vascular surgery, the sinus balloons could be threaded through the natural opening of the sinuses, and then inflated to achieve dilation of the natural drainage pathways. By dilating the natural opening of the sinuses rather than resecting pieces of mucosal membranes and bone, there is less postoperative pain and discomfort. There is also less postoperative bleeding and potential for infection. Generally, patients can expect a quicker recovery and a faster return to work.

At the present time, there are two companies that produce balloon equipment for endoscopic surgery. Acclarent and Entellus are both FDA approved for use in the United States. There are other companies on the horizon that might soon provide similar balloon equipment. The selection of which equipment to use in the appropriate setting is left to the individual surgeon. Dr. Namdar is equally comfortable with the use of either system, and can tailor each patient’s individual needs to the best technology for each case.

With advances in techniques for balloon sinus surgery, more patients are becoming eligible for having Office-based Sinuplasty. In the appropriate setting, the same procedure can done in an office setting using local anesthetic only. This would obviate the need for general anesthesia, and would cut down the recovery time dramatically. Again, a consultation with an Ear, Nose, and Throat surgeon is the best method of determining if a minimally invasive technique as this one is appropriate in your individual setting.

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