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TRANSNASAL ENDOSCOPIC
SURGERY - Dr. P. THULASI DAS
POLYPS
Nasal polyps are very common in India, which can be cured by
Endoscopic surgery. Polyps are water-logged projections of nasal
mucous membrane, usually having their roots in the ethmoid sinuses.
They are usually multiple in number and produce blocking of the
nasal cavities. Their removal, using conventional methods, almost
always results in recurrence, and the patient has to undergo surgery
many times in his lifetime to prevent nasal blocks. Polyps are the
end product of inflammatory reaction to the ethmoid mucosa. Presence
of fungal material in the ethmoid elicits very rapid growth of
polyps. The basic principle involved in the treatment of polyps is
to marsupialise the ethmoid air cells and remove as much of the
polypogenic memberane as possible. Endoscopes offer excellent vision
and illumination, which are utilized to remove polypogenic membrane
precisely. For massive polyps with fungal sinusitis a total or
radical Endoscopic spheno - fronto - maxillo- ethmoidectomy is done.
At Sinus and Nose, we have 80% cure rate for polyps. Of the
remaining 20%, 10% are minor recurrences, which can be treated with
medicines.
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Debriders and shavers are extremely useful in removing initial
masses of polyps to rediscover the distorted anatomy. Debriders or
shavers are cutting machine and suction rolled into one. They suck
and keep the field clear; they cut the tissue and the cut tissue is
removed away from the nasal cavity by suction. Precise mucosa
preservation surgery is possible with debriders. At Sinus and Nose
we have a Karl-Storz shaver and Xomed debrider.
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