Ethmoidectomy or sphenoidotomy
What is an endonasal ethmoidectomy or sphenoidotomy?
A surgical procedure called ethmoidectomy or sphenoidotomy by the endonasal route involves removing part or all of the ethmoid or sphenoid, which are bony structures located in the upper part of the nose. Conditions such as nasal polyps, tumors or chronic infections are generally treated with this procedure.
What are the goals of surgery?
The objectives of sphenoidotomy or endonasal ethmoidectomy are as follows:
Ventilate the sinus cavities, treat chronic infectious sites or remove polyps that cause nasal obstruction.
Treat an illness: Conditions such as nasal polyps, tumors or chronic infections are generally treated with this procedure .
All cells and partitions of the ethmoid sinuses must be open: The neighboring sinuses (frontal sinus and sphenoid sinus ) are frequently opened deliberately during the procedure.
Removing polyps: once the polyps are removed from the nasal passages, the surgeon removes the bony partitions of the ethmoidal cells, leaving the walls in contact with them.
Improve breathing: Endo-nasal ethmoidectomy or sphenoidotomy can improve breathing by removing nasal obstructions.
To alleviate the symptoms of chronic sinusitis: After the failure of medical treatments, this intervention is intended for patients with symptoms of chronic sinusitis.
What are the indications for an ethmoidectomy or sphenoidotomy?
Recommendations for endonasal ethmoidectomy or sphenoidotomy are as follows:
Nasal polyps that obstruct the nasal passages can be removed by endonasal ethmoidectomy or sphenoidotomy.
Tumors: Sinus tumors can be treated with this procedure.
Persistent sinus infections can be treated by endonasal ethmoidectomy or sphenoidotomy.
Antibiotic-resistant bacterial sinusitis that cannot drain naturally can be treated with this procedure.
Sinus mycoses can be treated by ethmoidectomy or sphenoidotomy via the endonasal route.
Sinus mucoceles can be treated with this procedure.
A spontaneous or traumatic osteomeningeal gap can be closed by ethmoidectomy or sphenoidotomy via the endonasal route.
How does the surgery take place?
The process of endonasal ethmoidectomy or sphenoidotomy takes place as follows:
The procedure is carried out under general anesthesia.
The incision is made inside the nose.
The ethmoid or sphenoid may be dissected and removed in part or entirely.
The patient is monitored in the recovery room for a few hours after the procedure before returning to his room.
What is the duration of the intervention?
The duration of endonasal ethmoidectomy or sphenoidotomy varies from 1 to 2 hours, but it can vary from 1 to 30 minutes depending on the complexity of the procedure and the speed of healing of the patient.
What are the surgical consequences?
The consequences of endonasal ethmoidectomy or sphenoidotomy may be as follows:
Pain: Pain is usually moderate and can be relieved by pain medication that the doctor has prescribed.
After the procedure, some bleeding may occur, but it is usually minor and can be controlled with nasal tampons.
After the procedure, nasal congestion is common and can last several weeks.
Temporary loss of smell: after the procedure, temporary loss of smell is also common, but it is generally reversible.
Nasal tampons: After the procedure, tampons may be placed to control bleeding and prevent infections.
Postoperative care: Patients should follow the doctor's instructions regarding postoperative care, which may include the use of sprays nasal rinses.
What are the advantages ?
The benefits of endonasal ethmoidectomy or sphenoidotomy include:
Less invasive than traditional sinus surgery: endonasal ethmoidectomy or sphenoidotomy does not require external incisions, making it less invasive.
Shorter recovery time: Patients undergoing endonasal ethmoidectomy or sphenoidotomy can recover more quickly than patients undergoing conventional sinus surgery.
Less pain: An endonasal ethmoidectomy or sphenoidotomy, compared to conventional sinus surgery, can reduce patients' pain.
Less bleeding: compared to an ethmoidectomy or an endonasal sphenoidotomy, patients may have less bleeding after surgery.
By using an endoscope, surgeons can better visualize the operated area.
Treatment of specific diseases: Nasal polyps, tumors or chronic infections can be effectively treated with ethmoidectomy or sphenoidotomy via the endonasal route.
Improved breathing: By eliminating nasal obstructions, endonasal ethmoidectomy or sphenoidotomy can help to improve breathing.
Treatment of persistent sinusitis: After the failure of medical treatments, this intervention is intended for patients presenting symptoms chronic sinusitis.
What are the risks ?
There are risks associated with endonasal ethmoidectomy or sphenoidotomy, such as:
After the procedure, some bleeding may occur, but it is usually minor and can be controlled with nasal tampons.
Pain: Pain is usually moderate and can be relieved by pain medication that the doctor has prescribed.
After the procedure, nasal congestion is common and can last several weeks.
Temporary loss of smell: after the procedure, temporary loss of smell is also common, but it is generally reversible.
After the procedure, there is a risk of infection, but it is usually low.
There is a risk of complications related to anesthesia, just as with any surgical procedure.
Damage to surrounding structures: There is a risk of damage to surrounding structures, such as the optic nerves or the meninges.
Recurrence: The treated pathology may recur.
Surgical complications may include: The complexity of the procedure and the speed of healing of the patient determine the complications related to surgery.
How does recovery work and how long does it last?
Recovery time after an endonasal ethmoidectomy or sphenoidotomy can vary by several weeks depending on the complexity of the procedure and the speed of healing of the patient. Patients should follow the doctor's instructions regarding postoperative care, including the use of nasal sprays and nasal rinses. During the recovery period, patients should avoid strenuous physical activities and dusty areas.
Recovery time may be shorter than traditional sinus surgery because endonasal ethmoidectomy or sphenoidotomy is a less invasive procedure.
It is important to note that the recovery time depends on the complexity of the procedure and the speed of healing of the patient. To aid healing and reduce the risk of complications, patients should take prescribed medications.