Safe Treatment Options During COVID-19
SINUPLASTY
Last reviewed August 31, 2020
372 Cases Studied
Findings: SAFE IN THE OFFICE SETTING
Last reviewed August 31, 2020
372 Cases Studied
Findings: SAFE IN THE OFFICE SETTING
Chronic Sinusitis affects over 30 million people each year, making it one of the most common health problems in the U.S. It is more prevalent than heart disease and asthma and has a greater impact on quality of life than chronic back pain or congestive heart failure.
SINUPLASTY is an option for the treatment of chronic sinusitis in some patients and has been studied for COVID-19 safety in nine states at this time. View our Guidance Report on the safety of SINUPLASTY.
Your doctor will determine if you are a good candidate and you may be eligible for a procedure performed in the office, under local, oral or IV anesthesia. An evaluation is required to determine the best approach for you.
Benefits of In-Office Sinuplasty
To learn more about the various companies that have created equipment for this procedure please visit these sites.
Your doctor will determine if you are a good candidate and you may be eligible for a procedure performed in the office, under local, oral or IV anesthesia. An evaluation is required to determine the best approach for you.
Benefits of In-Office Sinuplasty
- Avoiding General Anesthesia: Sinuplasty is an option for patients who decline or are ineligible for general anesthesia.
- Fast Recovery: While recovery time varies with each patient, most patients who undergo the in-office procedure can return to normal activities and work within 2 days.
- Safe Procedural Setting: Patients can avoid travelling to the hospital during the pandemic and have the procedure performed safely in the office.
- High Patient Satisfaction: The majority of patients who have Sinuplasty In-Office would recommend the procedure to family and friends.
- Potential for Significant Cost Savings: Some eligible patients may have lower out-of-pocket costs if the procedure is performed in a lower cost of care setting, such as the office.
To learn more about the various companies that have created equipment for this procedure please visit these sites.
To START A CONSULT with a surgeon in your area that offers SAFE SINUPLASTY click HERE
NASAL ENDOSCOPY
Last reviewed August 31, 2020
1,437 Cases Studied
Findings: SAFE IN THE OFFICE SETTING
Last reviewed August 31, 2020
1,437 Cases Studied
Findings: SAFE IN THE OFFICE SETTING
At the time of this writing, this procedure has been studied for safety during the COVID-19 pandemic. View our Guidance Statement on the safety of performing this procedure HERE.
Nasal Endoscopy is a test to view the inside of the nose and sinuses to check for problems.
The test takes about 1 to 5 minutes. Your health care provider may:
This test does not hurt.
During the procedure, your provider may:
Your provider may recommend nasal endoscopy if you are having:
Nasal endoscopy helps with the diagnosis of:
There is very little risk with a nasal endoscopy for most people.
ref: https://medlineplus.gov/ency/article/007627.htm
Nasal Endoscopy is a test to view the inside of the nose and sinuses to check for problems.
The test takes about 1 to 5 minutes. Your health care provider may:
- Spray your nose with a medicine to reduce swelling and numb the area.
- Insert the nasal endoscope into your nose. This is a long flexible or rigid tube with a camera at the end to look inside the nose and sinuses.
- Examine the inside of your nose and sinuses.
- Remove polyps, mucus, or other masses from the nose
This test does not hurt.
- You may feel discomfort or pressure as the tube is put into your nose.
- If spray is used it numbs your nose. It can numb your mouth and throat, and you may feel like you cannot swallow. This numbness goes away in 20 to 30 minutes.
- You might sneeze during the test. If you feel a sneeze coming on, let your provider know
- You may have a nasal endoscopy to figure out what is causing problems in your nose and sinuses.
During the procedure, your provider may:
- Look at the inside of your nose and sinuses
- Take a sample of tissue for a biopsy
- Do small surgeries to remove polyps, excess mucus, or other masses
Your provider may recommend nasal endoscopy if you are having:
- A lot of sinus infections
- Lots of drainage from your nose
- Face pain or pressure
- Sinus headaches
- A hard time breathing through your nose
- Nose bleeds
- Loss of sense of smell
Nasal endoscopy helps with the diagnosis of:
- Polyps
- Blockages
- Sinusitis
- Swollen and runny nose that will not go away
- Nasal masses or tumors
- A foreign object (like a marble) in the nose or sinus
- Deviated septum (many insurance plans require a nasal endoscopy prior to surgery to correct it)
There is very little risk with a nasal endoscopy for most people.
- If you have a bleeding disorder or take blood-thinning medicine, let your provider know so they are extra careful to decrease bleeding.
- If you have heart disease, there is a small risk that you could feel lightheaded or faint.
ref: https://medlineplus.gov/ency/article/007627.htm
To START A CONSULT with a surgeon in your area that offers SAFE NASAL ENDOSCOPY click HERE
TURBINATE REDUCTION
Last reviewed July 13, 2020
413 Cases Studied
Findings: SAFE IN THE OFFICE AND OPERATING ROOM SETTING
Last reviewed July 13, 2020
413 Cases Studied
Findings: SAFE IN THE OFFICE AND OPERATING ROOM SETTING
At the time of this writing, this procedure has been studied for safety during the COVID-19 pandemic. View our Guidance Statement on the safety of performing this procedure HERE.
Turbinate Reduction Surgery
The inside walls of the nose have 3 pairs of long thin bones covered with a layer of tissue that can expand. These bones are called nasal turbinates.
Allergies or other nasal problems can cause the turbinates to swell and block airflow. Surgery can be done to fix blocked airways and improve your breathing.
There are several types of turbinate procedures currently being performed:
Turbinectomy:
Turbinoplasty:
Radiofrequency or laser ablation:
Your provider may recommend this procedure if:
Risks for this surgery are:
Before the ProcedureAlways tell your provider:
During the days before your surgery:
Many people have good short-term relief from radioablation. Symptoms of nasal blockage may come back, but many people still have better breathing 2 years after the procedure.
You will have some discomfort and pain in your face for 2 or 3 days. Your nose will feel blocked until the swelling goes down.
The nurse will show you how to take care of your nose during your recovery.
Ask your doctor when you can go back to normal activity. It may take up to 2 months to heal completely.
ref: https://medlineplus.gov/ency/article/007563.htm
Turbinate Reduction Surgery
The inside walls of the nose have 3 pairs of long thin bones covered with a layer of tissue that can expand. These bones are called nasal turbinates.
Allergies or other nasal problems can cause the turbinates to swell and block airflow. Surgery can be done to fix blocked airways and improve your breathing.
There are several types of turbinate procedures currently being performed:
Turbinectomy:
- All or part of the lower turbinate is taken out. This can be done in several different ways, but sometimes a tiny, high-speed device (microdebrider) is used to shave off the extra tissue.
- The surgery may be done through a lighted camera (endoscope) that is placed into the nose.
- You may have general anesthesia or local anesthesia with sedation, so you are asleep and pain-free during surgery.
Turbinoplasty:
- A tool is placed in the nose to change the position of the turbinate. This is called the outfracture technique.
- Some of the tissue may also be shaved off.
- You may have general anesthesia or local anesthesia with sedation, so you are asleep and pain-free during surgery.
Radiofrequency or laser ablation:
- A thin probe is placed into the nose. Laser light or radiofrequency energy goes through this tube and shrinks the turbinate tissue.
- The procedure can be done in the health care provider's office using local anesthesia.
Your provider may recommend this procedure if:
- You have trouble breathing though your nose because the airways are swollen or blocked.
- Other treatments, such as allergy medicines, allergy shots, and nose sprays have not helped your breathing.
Risks for this surgery are:
- Scar tissue or crusting in the nose
- Loss of feeling in the skin on the nose
- Change in the sense of smell
- Fluid buildup in the nose
- Return of the nasal blockage after surgery
Before the ProcedureAlways tell your provider:
- If you are or could be pregnant
- What drugs you are taking, including medicines, supplements, or herbs you bought without a prescription
- If you have more than 1 or 2 alcoholic drinks a day
During the days before your surgery:
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin), and any other medicines that make it hard for your blood to clot.
- Ask your provider which medicines you should still take on the day of your surgery.
Many people have good short-term relief from radioablation. Symptoms of nasal blockage may come back, but many people still have better breathing 2 years after the procedure.
You will have some discomfort and pain in your face for 2 or 3 days. Your nose will feel blocked until the swelling goes down.
The nurse will show you how to take care of your nose during your recovery.
Ask your doctor when you can go back to normal activity. It may take up to 2 months to heal completely.
ref: https://medlineplus.gov/ency/article/007563.htm
To START A CONSULT with a surgeon in your area that offers SAFE TURBINATE REDUCTION click HERE
FUNCTIONAL ENDOSCOPIC SINUS SURGERY
Last reviewed July 13, 2020
129 Cases Studied
Findings: SAFE IN THE OFFICE AND OPERATING ROOM SETTING
Last reviewed July 13, 2020
129 Cases Studied
Findings: SAFE IN THE OFFICE AND OPERATING ROOM SETTING
At the time of this writing, this procedure has been studied for safety during the COVID-19 pandemic. View our Guidance Statement on the safety of performing this procedure HERE.
What is functional endoscopic sinus surgery (FESS)?
FESS is a minimally-invasive approach to the sinus cavities using endoscopes (telescopes) to view the important structures of the nose and sinuses. The endoscope is inserted through the nose. The view with the endoscope allows for better identification of the underlying disease, which in turn allows the surgeon to be precise, careful, and thorough with minimal damage to normal surrounding tissue. All sinuses can be viewed directly during FESS and obstructing tissue or disease can be removed as indicated. FESS allows for less tissue removal, more rapid tissue healing, and shorter recovery periods. The surgery is often performed on an outpatient basis.
When is FESS indicated?
Most commonly FESS is indicated for people with chronic sinus problems who do not respond to medical treatments.
The diagnosis of chronic sinusitis is based on symptoms, nasal examination (i.e., nasal endoscopy), sinus CT findings, and response to previous treatments. The majority of people with sinusitis do not require surgery. However, in some people symptoms persist despite prolonged medical treatments and FESS is indicated to help control the problem. With proper patient selection and evaluation, research has proven FESS to be 70-90% successful in improving symptoms of sinusitis and related nasal and sinus problems. FESS is not a “cure” for sinusitis, but is helpful in managing symptoms of the chronic nature of the disease. The most common indications for FESS include chronic infection, nasal obstruction or blockage and nasal polyps.
What can you expect during FESS?
What can you expect after functional endoscopic sinus surgery?
What are the risks of FESS?
As with any surgical procedure, FESS has associated risks. Although the chance of a complication occurring is small, it is important that you understand the potential complications and ask your surgeon about any concerns you may have.
Bleeding: Most sinus surgery involves some degree of blood loss, which is generally well tolerated by the patient. If there is significant bleeding the may need to stop the surgery. Although most patients do not require nasal packing, a few patients will require a small nasal pack to be removed 1-3 days after surgery. Minor dripping of blood for 1 to 2 days following surgery is normal. Blood transfusion is very rarely necessary and is given only if the patient’s health would otherwise be compromised.
Recurrence of disease: Although FESS provides significant symptomatic benefits for the vast majority of patients, surgery is not a cure for most forms of sinusitis. Therefore, you can expect to continue with your sinus medications even after successful sinus surgery, although in general your requirements for such medications should be lessened. In some instances, additional “touch-up” surgery may be necessary to optimize your surgical outcome. This may be necessary in 5-10% of cases.
Spinal fluid leak: The sinuses are located near the brain. This means there is a rare chance of creating a leak of spinal fluid (the fluid surrounding the brain) or injuring the brain. Also called a cerebrospinal fluid (CSF) leak, the reported incidence of this is less than 1% of cases. Should the rare complication of a CSF leak occur, it may create a potential pathway for infection, which could result in meningitis. If a CSF leak were to occur, it might require surgical closure and extend your hospitalization.
Visual problems: There have been isolated reports of visual loss after sinus surgery. The potential for recovery in such cases is not good. In addition, orbital (eye) injury resulting in double vision, blurring vision, or excessive tearing from the eye are additional potential complications. Fortunately, such a complication is rare. The reported incidence is less than 1% of cases.
Other risks: Other uncommon risks of surgery include alteration of sense of smell or taste; persistence and/or worsening of sinus symptoms and facial pain and swelling or bruising of the area around the eye.
ref: https://www.nationaljewish.org/conditions/tests-procedures/adult-surgery-procedures/functional-endoscopic-sinus-surgery-fess
What is functional endoscopic sinus surgery (FESS)?
FESS is a minimally-invasive approach to the sinus cavities using endoscopes (telescopes) to view the important structures of the nose and sinuses. The endoscope is inserted through the nose. The view with the endoscope allows for better identification of the underlying disease, which in turn allows the surgeon to be precise, careful, and thorough with minimal damage to normal surrounding tissue. All sinuses can be viewed directly during FESS and obstructing tissue or disease can be removed as indicated. FESS allows for less tissue removal, more rapid tissue healing, and shorter recovery periods. The surgery is often performed on an outpatient basis.
When is FESS indicated?
Most commonly FESS is indicated for people with chronic sinus problems who do not respond to medical treatments.
The diagnosis of chronic sinusitis is based on symptoms, nasal examination (i.e., nasal endoscopy), sinus CT findings, and response to previous treatments. The majority of people with sinusitis do not require surgery. However, in some people symptoms persist despite prolonged medical treatments and FESS is indicated to help control the problem. With proper patient selection and evaluation, research has proven FESS to be 70-90% successful in improving symptoms of sinusitis and related nasal and sinus problems. FESS is not a “cure” for sinusitis, but is helpful in managing symptoms of the chronic nature of the disease. The most common indications for FESS include chronic infection, nasal obstruction or blockage and nasal polyps.
What can you expect during FESS?
- In most cases you will receive general anesthesia for your surgery. With general anesthesia, you will be asleep for the entire surgery.
- Some times nasal packing is used during sinus surgery to control bleeding. If bleeding occurs that is difficult to control, packing will be placed. It would then be removed within 1 to 3 days after the surgery. Newer packing materials that the body absorbs may also be used in select cases. This means the packing does not need to be removed.
- When your surgery is over, most people feel well enough to go home the day of surgery. Some people may require a one night stay in the hospital. This may be true if extra recovery time is needed or if you have other medical problems that require special medical attention.
What can you expect after functional endoscopic sinus surgery?
- Follow-up visits often take place at 1 week, 3 weeks and 6 weeks after surgery. This may be adjusted based on your doctors recommendation. After these visits, we often recommend you return every 3 months until your condition is stable and your symptoms improve.
- You may receive prescriptions for pain medicine right after surgery. You may also receive medicine for oral steroids (decrease swelling) and antibiotics.
- Do not blow your nose for the first week following surgery.
- You will often start nasal saline washes of the nose twice a day starting 24 to 48 hours after surgery.
- Avoid exercise and limit any exertion for at least 2 week following surgery. This includes no bending, lifting (more than 10 pounds) or straining. Your surgeon will be able to advise you when it is safe to begin exercising again.
- Plan on taking about 1 week off from work to recover from surgery.
- Do not fly anywhere for 2 weeks, SCUBA dive for 4 weeks or swim for 2 weeks.
What are the risks of FESS?
As with any surgical procedure, FESS has associated risks. Although the chance of a complication occurring is small, it is important that you understand the potential complications and ask your surgeon about any concerns you may have.
Bleeding: Most sinus surgery involves some degree of blood loss, which is generally well tolerated by the patient. If there is significant bleeding the may need to stop the surgery. Although most patients do not require nasal packing, a few patients will require a small nasal pack to be removed 1-3 days after surgery. Minor dripping of blood for 1 to 2 days following surgery is normal. Blood transfusion is very rarely necessary and is given only if the patient’s health would otherwise be compromised.
Recurrence of disease: Although FESS provides significant symptomatic benefits for the vast majority of patients, surgery is not a cure for most forms of sinusitis. Therefore, you can expect to continue with your sinus medications even after successful sinus surgery, although in general your requirements for such medications should be lessened. In some instances, additional “touch-up” surgery may be necessary to optimize your surgical outcome. This may be necessary in 5-10% of cases.
Spinal fluid leak: The sinuses are located near the brain. This means there is a rare chance of creating a leak of spinal fluid (the fluid surrounding the brain) or injuring the brain. Also called a cerebrospinal fluid (CSF) leak, the reported incidence of this is less than 1% of cases. Should the rare complication of a CSF leak occur, it may create a potential pathway for infection, which could result in meningitis. If a CSF leak were to occur, it might require surgical closure and extend your hospitalization.
Visual problems: There have been isolated reports of visual loss after sinus surgery. The potential for recovery in such cases is not good. In addition, orbital (eye) injury resulting in double vision, blurring vision, or excessive tearing from the eye are additional potential complications. Fortunately, such a complication is rare. The reported incidence is less than 1% of cases.
Other risks: Other uncommon risks of surgery include alteration of sense of smell or taste; persistence and/or worsening of sinus symptoms and facial pain and swelling or bruising of the area around the eye.
ref: https://www.nationaljewish.org/conditions/tests-procedures/adult-surgery-procedures/functional-endoscopic-sinus-surgery-fess
To START A CONSULT with a surgeon in your area that offers SAFE FUNCTIONAL ENDOSCOPIC SINUS SURGERY click HERE