TRANSNASAL ENDOSCOPIC SURGERY - Dr. P. THULASI DAS
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.
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.