Functional Endoscopic Sinus Surgery (FESS) | फंक्शनल एंडोस्कोपिक साइनस सर्जरी | Dr. Rajesh Bhardwaj скачать в хорошем качестве

Functional Endoscopic Sinus Surgery (FESS) | फंक्शनल एंडोस्कोपिक साइनस सर्जरी | Dr. Rajesh Bhardwaj

FESS – Functional Endoscopic Sinus Surgery is routinely performed to treat various types of diseases of the sinuses. FESS versus ESS – What is the difference? FESS relates to improving the Function of the sinuses. In earlier times radical sinus obliteration surgeries were performed to treat sinus disease. However, Professor Messerklinger demonstrated that chronic sinus disease arose out of poor drainage from the sinus cavity. He postulated and proved that the way to treat chronic sinus disease was by improving the FUNCTION of the sinus – this was done by opening up natural drainage passages. So the surgery came to be called Functional Endoscopic Sinus Surgery (FESS). ESS on the other hand is any endoscopic-assisted surgery done on the sinus – this may be for polyps, tumours etc. INDICATIONS OF FESS/ESS 1. Chronic sinusitis not responding to routine medication 2. Nasal Polyposis 3. For repair of CSF Rhinorrhoea 4. For Orbital decompression 5. Biopsy of suspicious lesions/ Removal of Tumours from the nose and sinuses 6. As an approach to the skull base for tumour removal or decompression 7. Other nasal and sinus lesions amenable to endoscopic removal/ management ANAESTHESIA The surgery can be performed under the following Anaesthesia - 1. Local Anaesthesia – after discussing with the patient – only Local Anaesthetic is used along with some sedation. 2. MAC- Monitored Anaesthesia Care- the anaesthetist gives pain-relieving drugs intravenously, along with sedation. 3. General Anaesthesia – Full General Anaesthesia where the patient is completely unconscious. An oral pack is also kept in the throat. The decision regarding the type of anaesthesia to be used is taken following a discussion between the ENT surgeon and the patient. SURGICAL PROCEDURE The patient lies supine on the OT table and part is prepared and draped with surgical drapes. Cotton patties or Merocel pledgets soaked in 4 % Xylocaine with adrenaline or Saline with adrenaline are placed for decongestion. Sometimes 2 % Xylocaine with adrenaline is infiltrated locally into the parts to be operated. The steps in Functional Endoscopic Sinus Surgery (FESS) depend on the condition being treated. In routine cases of chronic sinusitis, key steps include: Incising the uncinate process to access the maxillary sinus. Widening the maxillary sinus opening and clearing disease. Clearing ethmoid air cells, including the bulla ethmoidalis. Opening the frontal sinus with angled endoscopes. Clearing and widening the sphenoid sinus. After disease removal, a nasal pack is applied. POSTOPERATIVE PERIOD There is usually a nasal pack which remains in the nose for 1-2 days After pack removal, the patient is called for follow-up visits in which nasal crusts, blood clots etc are removed and cleaned. Post-op visits are very important and must be adhered to. Normal simple home food is to be eaten. You cannot blow your nose since delicate nasal tissues are healing inside. Saline irrigations/ nasal douching is started a few days after the surgery. You can work from home but travelling outside, especially into dusty or polluted places is to be avoided. Once the tissue report (Biopsy/ Histopathology) is available you must discuss that with your ENT Surgeon. The recovery period is usually for about a week. COMPLICATIONS Though fairly safe in experienced hands there are complications related to the procedure. Bleeding Infection Recurrence of disease/ Polyps CSF Rhinorrhoea Blindness Synechaie formation Nasal Crusting FESS is a commonly performed nasal surgery and offers long-standing benefits in properly indicated cases. About The Doctor! Our centre is run by Dr. (Major) Rajesh Bhardwaj, who brings over 15 years of Army service into his civilian practice, ensuring that every patient is treated with discipline, care, and precision. He has an MBBS from AFMC in addition to an MS, DNB, DLO, and DHA, making him one of the most qualified and experienced ENT specialists in the region. Follow us : 🌐 Website: https://entdelhi.com/ 📘 Facebook:   / medfirstentcentre   📸 Instagram:   / drbhardwajent   🐦 Twitter: https://x.com/entdelhi 📝 Blog: https://medfirstentcentre.blogspot.com/ ⚕️ Contact Form: https://bit.ly/fill_medical_form Contact Us: 📍 Location: MedFirst ENT Centre, South Delhi 📞 Phone: +91 98711 50032, +91 92055 85295 https://entdelhi.com/book-an-appointm... 📧 Email: [email protected] 🕒 Timings: Monday - Saturday 🕒 9:30 AM - 12:30 PM 🕓 4:00 PM - 6:30 PM Disclaimer: Dr. Bhardwaj’s decades of experience ensure that the information provided is medically accurate, comprehensive, and easy to understand. However, this content is intended for educational purposes and should not be considered a substitute for professional medical advice. Always consult a qualified healthcare provider for any medical concerns.