TRANSNASAL ENDOSCOPIC SURGERY - Dr. P. THULASI DAS
SINUSITIS
"Sinusitis cannot
be cured” and “Once a puncture always a puncture” are some of the
myths circulated among the general public. Indiscriminate
puncture(antral wash) and septal operations which have not offered
any relief for the patient are responsible for these myths.
Sinusitis means different things to different people. Headache,
nasal block, sneezing, watering from the nose are some of the
symptoms attributed to sinusitis. Sinusitis actually means an
inflammation of the mucosal lining of the sinuses with or without
collection of pus inside the same.
Click below image to enlarge view
The natural mucociliary clearance mechanism transports the mucous secreted by the glands towards the natural ostium of the sinus.
Sinuses are actually
air containing chambers in the skull bone and they are situated
around the nose.They all open into the nose and they normally
contain air. The sinuses are also lined by the same mucous membrane
which lines the nose. Now it is recognized that most of the sinus
infections spread from the nose and once the sinus is infected the
drainage is blocked owing to mucosal swelling since all these
sinuses open into the nose through narrow openings.
Click below image to enlarge view
The natural ostium of the sinus is blocked by polyps and the mucous gets collected inside the sinus
.
The problem is further
aggravated by polyps, deviated septum etc. With the Endoscopic
techniques it is possible to widen the natural opening of all the
sinuses to provide satisfactory drainage, thereby preventing further
problems. Previously, each sinus was tackled individually when
diseased, and artificial openings made for drainage never functioned
satisfactorily. Moreover, Endoscopic sinus surgery is done through
the external openings of the nose and patient morbidity and
complications are much less. Endoscopic sinus surgery provides
lasting and permanent relief from true chronic sinusitis.
This surgery is more
popularly known as Functional Endoscopic Sinus Surgery (FESS).
Functional Endoscopic Sinus Surgery has limited meaning. The radical
Endoscopic spheno - fronto - maxillo - ethmoidectomy we do for
massive polyps and fungal sinusitis would not fit into the original
description of FESS by Dr. Kennely and Prof. Stammberger. Hence we
prefer the term Endoscopic Sinus Surgery (ESS).
