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TRANSNASAL ENDOSCOPIC SURGERY - Dr. P. THULASI DAS

SINUSITIS

 "Sinusitis cannot be cured” and “Once a puncture always a puncture” are some of the myths circulated among the general public. Indiscriminate puncture(antral wash) and septal operations which have not offered any relief for the patient are responsible for these myths. Sinusitis means different things to different people. Headache, nasal block, sneezing, watering from the nose are some of the symptoms attributed to sinusitis. Sinusitis actually means an inflammation of the mucosal lining of the sinuses with or without collection of pus inside the same.

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The natural mucociliary clearance mechanism transports the mucous secreted by the glands towards the natural ostium of the sinus.

Sinuses are actually air containing chambers in the skull bone and they are situated around the nose.They all open into the nose and they normally contain air. The sinuses are also lined by the same mucous membrane which lines the nose. Now it is recognized that most of the sinus infections spread from the nose and once the sinus is infected the drainage is blocked owing to mucosal swelling since all these sinuses open into the nose through narrow openings.

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The natural ostium of the sinus is blocked by polyps and the mucous gets collected inside the sinus .

The problem is further aggravated by polyps, deviated septum etc. With the Endoscopic techniques it is possible to widen the natural opening of all the sinuses to provide satisfactory drainage, thereby preventing further problems. Previously, each sinus was tackled individually when diseased, and artificial openings made for drainage never functioned satisfactorily. Moreover, Endoscopic sinus surgery is done through the external openings of the nose and patient morbidity and complications are much less. Endoscopic sinus surgery provides lasting and permanent relief from true chronic sinusitis.

This surgery is more popularly known as Functional Endoscopic Sinus Surgery (FESS). Functional Endoscopic Sinus Surgery has limited meaning. The radical Endoscopic spheno - fronto - maxillo - ethmoidectomy we do for massive polyps and fungal sinusitis would not fit into the original description of FESS by Dr. Kennely and Prof. Stammberger. Hence we prefer the term Endoscopic Sinus Surgery (ESS).

 
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