Functional Endoscopic Sinus Surgery (FESS)
FESS procedures that are performed in conjunction with navigation solutions offered by Medtronic are highly effective treatment strategies for complicated acute sinusitis and chronic sinusitis.
The primary advantages to using our navigation solutions for FESS include:
- Procedures are much less invasive than open surgical operations that were once standard
- Precision is greater, resulting in lower risk to the patient
- Patient discomfort is minimal
- Procedure recovery time is shorter
In the late 1980’s and early 1990’s, a minimally-invasive approach to surgery for sinusitis called functional endoscopic sinus surgery (FESS) evolved. FESS represents a significant advance compared to the open sinus procedures performed prior to the development of FESS. The goal of FESS is to reestablish physiologically normal sinus drainage pathways by removing or correcting diseased pieces of tissues in key areas of sinus obstruction. Small rigid telescopes, also called endoscopes, are inserted into the nose and the surgery is performed using fine instruments to open the sinuses.
There are several advantages to FESS over the open sinus procedures that preceded it. To begin with, the ability to see within the nose and sinuses is much improved. Open sinus procedures often required facial incisions with resulting visible scars and lots of nasal packing. With FESS, there are usually no visible signs that surgery has been performed since the surgery is almost always done completely through the nostrils. Recovery is usually faster and there is usually less postoperative pain and bleeding. Nasal packing is used infrequently in FESS.
When patients with sinusitis do not improve after repeated courses of antibiotics and reasonable trials of the other medications used to treat sinusitis, the otolaryngologist may recommend undergoing FESS. The recommendation will also be based upon the physical examination, nasal endoscopy and CT scan findings. The decision to perform surgery should be made only after carefully considering the risks and benefits.
Patient preferences also play a role in the decision. The decision to have sinus surgery is usually made by the patient when the impact of the sinusitis on their quality-of-life is so significant that a successful surgery can improve their ability to function in daily life.
Northwest ENT and Allergy Center offers an array of new surgical technologies for the treatment of sinusitis. One of the most recent advances is the development of computer-guided sinus surgery. Via a computer workstation in the operating room, surgeons can now access 3-dimensional CT scan images of a patient’s sinuses during surgery. This interactive surgical device allows identification of critical anatomic structures and treatment of diseased areas for the patient with complex sinus disease.
The Northwest ENT and Allergy Center surgeons are using this new “STEALTH” technology that guides surgical instruments for potentially more accurate and effective sinus surgery. Because the new procedure is done through an endoscope inserted into the nose, an open incision is rarely necessary.
The new technology, image-guided surgery, is used during surgery for severe forms of chronic sinusitis, in cases when previous sinus surgery has altered anatomical landmarks, or where a patient’s sinus anatomy is very unusual, making typical surgery difficult. Tumors and cerebrospinal fluid leaks involving the nose and sinuses may also be approached using this technology.
While complications of sinus surgery are very low, unusual nasal structures may put a patient at increased risk for complication. The image guided surgery system may help to minimize such risks.
What is a CT Scan?
Sometimes referred to as a CAT scan, a CT (computerized tomography) scan is a test that helps ENT physicians diagnose and develop a treatment plan for ear, nose and throat conditions. Using a combination of specialized x-ray equipment and computer imaging technology, this diagnostic technique can generate cross-sectional images of the body. Compared to a typical x-ray, a CT scan is able to show bones, blood vessels, and soft tissue in greater detail, allowing the physician to better pinpoint the root of the medical condition.
The skilled physicians of Northwest ENT and Allergy Center use an upright CT scanning system designed for high-resolution imaging of the sinuses and temporal bones (ear bones). The scan itself takes less than a minute. The tool provides the patient and physician with immediate access to the images resulting in faster diagnosis and treatment.
Who Requires a Sinus or Ear CT Scan?
- Suffer from chronic or recurrent sinusitis.
- Experience nasal congestion or symptoms of nasal polyps or a deviated septum.
- Suffer from persistent or recurring ear infections, drainage, ear pain, or certain types of hearing loss.
Contact Northwest ENT and Allergy Center
Patients who think they might be candidates for a diagnostic CT scan should call Northwest ENT and Allergy Center at (770) 427-0368 to learn more.
Advanced Skull Base Surgery
The endonasal, endoscopic approach to the anterior skull base provides a minimally invasive way to remove tumors that would otherwise require either a large cranial opening and brain retraction or disfiguring facial scars. Instead, an endoscope is advanced through the natural opening in the face, namely the nasal cavity. A variety of tumors can be removed in this fashion, in various locations, since the normal sinus cavities of the face are used to maneuver the endoscope to the desired location. This approach was first developed by endoscopic sinus surgeons but is no way being used in our specialized Institute for Minimally Invasive Skull Base Surgery to treat brain tumors as well.
Since the anterior skull base comprises a number of important structures such as the pituitary gland, the optic nerves and the carotid arteries, we emphasize a multidisciplinary approach to the management of diseases in this area.
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