Endoscopic sphenoidotomy is the surgical opening of the sphenoid sinus using an endoscope (a thin and flexible tube with a camera at one end). This procedure improves the airflow through the nose. Endoscopic sphenoidotomy can be a part of
- Functional endoscopic sinus surgery (for sinus disease).
- Endoscopic endonasal transsphenoidal surgery (for surgical removal of a skull base tumor).
Endoscopic sphenoidotomy may have three approaches:
- Through the nasal cavity using an optical telescope for visualization of the sphenoid sinus
- Through the nasal septum (the partition that divides your nose into left and right nostrils) that directs the surgeon to the midline of the sphenoid sinus
- Through the ethmoid sinus (the sinus present between your nose and eyes)
The sphenoid sinus is a hollow space in the bones around the nose. There are two large sphenoid sinuses in the sphenoid bone present behind the nose between the eyes. The
What are the indications of endoscopic sphenoidotomy?
The indications of endoscopic sphenoidotomy include:
- Acute and chronic sphenoid rhinosinusitis (inflammation of the sinuses and nasal cavity)
- Tumor in the sphenoid sinus
- Endonasal skull base or pituitary surgery
- Cerebrospinal fluid (CSF) leak
- Traumatic injury to the optic canal
- Endonasal vidian neurectomy (a surgical procedure to cut the vidian nerve for curing excessive nasal secretions, increased tear production, or inflammation)
How to prepare for an endoscopic procedure?
Before the surgery, you must prepare yourself by following these instructions:
- Undergo blood tests, electrocardiography (EKG), computed tomography (CT), and chest X-ray around 1 month before the surgery.
- Schedule a visit to the surgeon before the actual procedure.
- Start oral steroids and/or antibiotic therapy during the pre-surgical period.
- Do not take aspirin or salicylate for at least 10 weeks before the surgery because it increases the risk of bleeding.
- Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) for at least 5 days before the surgery.
- Avoid smoking for at least 3 weeks before the surgery because smoking exacerbates the sinus symptoms and increases the risk of complications.
- Do not eat or drink anything for at least 8-12 hours before the surgery.
- Buy Afrin nasal spray and spray into the nose 1-2 hours before the surgery.
QUESTION
What percentage of the human body is water? See AnswerWhat to expect during endoscopic sphenoidotomy?
Usually, under general anesthesia, a surgeon will use an endoscope to visualize the sinus tissues.
There are three approaches used to locate the sphenoid sinus:
- Through the nasal cavity using an optical telescope for visualization of the sphenoid sinus
- Through the nasal septum that directs the surgeon to the midline of the sphenoid sinus
- Through ethmoidectomy (it requires partial removal of the front wall of the maxillary sinus to visualize the ethmoid and maxillary sinus)
After identifying the sphenoid sinus, the physician enlarges the opening.
What to expect after endoscopic sphenoidotomy?
You can expect the following after the surgery:
- Bleeding
- Pain
- Fatigue
- Nasal congestion and discharge
You should avoid doing the following after the surgery:
- Straining or nose blowing
- Heavy lifting
- Taking aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) for 2 weeks after the surgery
- Taking steroid nasal sprays unless prescribed by your surgeon
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References
https://emedicine.medscape.com/article/2051621-technique#c7
https://my.clevelandclinic.org/health/treatments/17478-sinus-surgery
https://my.clevelandclinic.org/health/treatments/17478-sinus-surgery
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