Endoscopic Sinus Surgery

Endoscopic Sinus Surgery (ESC)

Endoscopic sinus surgery (ESC) is a minimally invasive surgical method for the treatment of problems such as congestion, chronic sinusitis and polyps in the nose and sinuses.
Sinuses are air-filled cavities in the skull located around the nasal cavity.
Inflammation or blockage of these sinuses causes breathing difficulties, headaches and a decrease in overall quality of life.
Endoscopic sinus surgery allows the sinuses to be opened and their normal function restored through incisions made through the nose.

Why is Endoscopic Sinus Surgery Performed?

Endoscopic sinus surgery is one of the first choices in the surgical treatment of sinus and nasal problems.
Among the reasons for the application of this surgical method are the following:

• Chronic Sinusitis: If the sinuses become inflamed and blocked, surgical intervention may be necessary in cases where antibiotic and drug treatments are inadequate.
• Sinus Polyps Polyps in the nose and sinuses block the airways and cause breathing difficulties.
  ESC is an effective method for removing polyps.
• Nasal Congestion: It is used to relieve nasal congestion caused by structural problems or cysts and tumors in the sinuses.
• Sinus Infections: In the treatment of recurrent sinus infections, surgical intervention may be performed to open the sinuses and provide drainage.
• Structural Disorders of the Sinuses: Congenital or post-traumatic structural disorders of the sinuses can be corrected with endoscopic surgery.

Preparation Before Endoscopic Sinus Surgery

In the preoperative period, the patient’s condition is evaluated in detail and surgical planning is performed.
Things to consider before ESC surgery:

• Clinical Examination and Imaging: The condition of the patient’s sinuses is examined by intranasal endoscopy and computed tomography (CT).
  In this way, the location, cause and extent of the obstruction are determined.
• Medication Use: The use of blood thinners should be stopped before surgery.
  In addition, antibiotics and anti-inflammatory drugs recommended by the doctor can be used.
• Smoking and Alcohol: Smoking and alcohol can negatively affect the healing process after surgery.
  Therefore, it is recommended to stop smoking and drinking alcohol in the preoperative period.

How is Endoscopic Sinus Surgery Performed?

Endoscopic sinus surgery is usually performed under general anesthesia and may take 1-2 hours.
During the operation, an endoscope is inserted into the nasal cavity, allowing the surgeon to examine the internal structure of the sinuses in detail.
The basic stages of the procedure are as follows:

1. Placement of the Endoscope: The endoscope inserted into the nose allows the surgeon to see and intervene in the sinus cavities with the help of a camera.
2. Opening of the sinuses The polyp, inflamed tissues or bone structure causing the blockage is removed with the help of special surgical instruments.
   This ensures normal air and mucus drainage of the sinuses.
3. Tissue Correction: If necessary, the internal structure of the sinuses is corrected to create openings through which mucus can drain freely.
   This prevents the sinuses from becoming blocked again.
4. Completion of the Procedure: After the opening and cleaning of the sinuses is completed, the endoscope is removed and the inside of the nose is checked.
   After the surgery, tampons or special absorbent sponges can be placed inside the nose.

Postoperative Recovery Process

The recovery period after endoscopic sinus surgery is usually comfortable and patients can return to their daily activities in a short time.
Points to be considered:

• Swelling and Congestion: There may be mild swelling and congestion in the nose after surgery.
  This condition decreases within a few days and nasal breathing returns to normal.
• Nasal Cleaning: In the first weeks, the nose should be kept clean by washing it with special solutions.
  This helps to remove mucus and blood clots from the nose.
• Medication Use: Antibiotics, painkillers and nasal sprays recommended by the doctor should be used regularly to prevent postoperative infection and reduce swelling.
• Activities: After surgery, physical activities, heavy lifting and straining that can damage the nose and sinus area should be avoided.

Risks and Side Effects

Although endoscopic sinus surgery is a minimally invasive procedure, it may have some risks and side effects:

• Bleeding Postoperative intranasal bleeding may occur in rare cases.
  In this case, nasal tampons help to stop the bleeding.
• Infection There is a risk of infection in the nose and sinuses.
  To prevent infection, the medication and cleaning instructions recommended by the doctor should be followed.
• Crusting in the nose: Crusting and dryness in the nose may occur after surgery.
  Nasal wash solutions are used to alleviate this condition.
• Injury Due to the close anatomical relationship of the sinuses with the eye, brain and large vessels, there is a rare risk of injury to the surrounding tissues.
  Therefore, it is important that the surgery is performed by an experienced surgeon.