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Sinus Surgery at NYU Otolaryngology
Sinus surgery should be considered if medication fails to adequately relieve the symptoms associated with rhinosinusitis, and the patient's quality of life continues to suffer. The need for surgery may be due to recurrent attacks of acute bacteria rhinosinusits (ABRS) or longer term symptoms associated with chronic rhinosinusitis (CRS). Most sinus operations are now performed utilizing an endoscope placed inside the nose through the nostril, an approach known as endoscopic sinus surgery or ESS. A camera attached to the scope enables the surgeon to view the intricate anatomy of the sinuses on a monitor. Patients are generally asleep for the procedure, which takes 1-2 hours. Specialized microsurgical instruments are used during the surgery and Computer Assisted Techniques are available for more advanced cases. Most patients go home the day of the surgery.
The goal of ESS is to correct structural problems within the nose and sinuses as well as to eliminate blockage by removing thickened tissue creating wider drainage pathways. This improves nasal and sinus function, significantly reducing or eliminating a patient’s symptoms. Because the surgery is done through the nostrils, without any external incisions, the outside of the nose and face does not swell and there is no visible bruising after the surgery. Most patients can work within a few days, in some instances the next day. The recovery following ESS is generally not difficult and is surprisingly painless. For approximately 4-6 weeks patients are seen in the office, periodically, to clear the nose and sinuses of mucous and secretions. This helps improve breathing and sinus drainage during the healing process.
Computer Assisted or Image Guided Sinus Surgery
Image guided surgery (IGS), also known as computer-assisted sinus surgery (CASS), relies on a computer processor into which the patient’s CT or MRI data is loaded preoperatively. During the operation, the position of the surgical instruments can be tracked on a monitor with an accuracy of 1-2 millimeters. This allows for the precise localization and removal of abnormal tissue while identifying and preserving critical surrounding structures. This equipment, which is continually updated based on movement of the surgical instruments, provides the surgeon with instant feedback concerning the location of the surgical instruments. This real time information permits more thorough and precise surgery.
