Bilateral Functional Endoscopic Sinus Surgery, Bilateral Submucous Resection Of The Inferior Turbinates (SMRITs), And Septoplasty
Functional Endoscopic Sinus Surgery (FESS) is so named because it is designed to restore the normal mucus clearing function of the sinuses by opening up their natural drainage passages with minimal trauma. It is performed through the nostril without any external incisions. It is recommended only after medical management has been unsuccessful in controlling chronic or frequently recurring sinus problems. The choice to undergo sinus surgery, continue medical management, or do neither each come with their own risks. The risks of surgery include: the risks of anesthesia reaction or complication, uncontrolled bleeding during the procedure which might necessitate aborting or altering the procedure, postoperative bleeding, orbital complications such as bleeding or muscle injury which could cause permanent visual impairment, intracranial injury (brain injury or infection), leakage of cerebrospinal fluid which might require a subsequent procedure to repair, persistent or worsening nasal obstruction, failure to manage polyps (recurrence or progression), improper healing in the sinuses, and recurrent nasal or sinus infections. Most of these are typically the result of poor patient compliance or failure to address a concern in a timely manner, so it is critical that sinus surgery patients comply with all postoperative instructions and medication prescriptions, and that they return as scheduled for each postoperative office visit. Typically, at those visits, the sinuses will be examined endoscopically, cleaned, and mucus and old blood will be removed to ensure the sinuses properly heal without infection. In the case of an unintended structural injury such as those described above, your surgeon is well trained on how to best correct or treat the complication. The likelihood of any serious complication occurring is well under 1%.
Septoplasty is an operation to correct a deformity in the divide between the two sides of the nose (the septum). Typically performed to improve nasal breathing, the procedure may also be used to allow adequate visibility of the inside of the nose for treatment of polyps, inflamed tissue, tumors or bleeding. When the nasal septum is deformed surgery is the only effective treatment. Because septoplasty only involves the inside the nose, it does not affect outward appearance of the nose. The undesirable results that may occur from a septoplasty include a hole in the septum, failure to completely improve breathing, postoperative bleeding, nasal crusting, and in very rare instances an unintended change in the appearance of the nose.
Submucous resection of the inferior turbinates (SMRIT) is a procedure to treat the symptoms of nasal obstruction (stuffy nose), as a result of chronic turbinate hypertrophy. The procedure typically involves the use of a suction debrider (a 2 mm diameter suction tube with a spinning blade inside) that gently removes stroma (blood-filled spaces) while preserving the normal mucosal lining of the nose, though other techniques may be used at the surgeon’s discretion. Results of the procedure can vary, but they are typically excellent and lasting. SMRIT may cause temporary nasal stuffiness, crusting, bloody drainage, and mild pain for a few days. These symptoms generally resolve within one week. Non-narcotic, over-the-counter analgesic medication is generally sufficient for controlling any pain that may result from this procedure if no other procedures are performed at the same time.