Functional Endoscopic Sinus Surgery( FESS)
To study the management of the
patients of various nasal and para nasal sinuses
diseases with endoscopic sinus surgery in terms of
age, gender, disease pattern, surgical procedures,
complications and recurrence rate.
Methods: In this descriptive study 146 patients of
different sinonasal disease treated with endoscopic
sinus surgery were included. Patients with CSF leak,
nasolacrimal duct obstruction , polyps,with and
without history of allergy and asthama were
included. Patients with mucormycosis, invasive
fungal sinusitis, malignancy and very elderly were
not included. Pre-operative CT scan was a pre
requisite in all patients. Fibreoptic light was passed
through the canaliculi to identify the lacrimal sac or
after dilating the puncta with a lacrimal probe,it
was passed into the superior and inferior canaliculi
to know the position of lacrimal sac .The lacrimal sac
is located lateral to the maxillary line at its superior
edge. Drill was used to create a window.All patients
had their visual acuity , colour vision and
funduscopy done prior to surgery. Flourescein dye
was used for CSF rhinorhea demonstration prior to
CSF leak repair preoperatively. On the 4th
postoperative day the patients had removal of their
crusts and had examination of nasal cavity.
Results: Mean age was 33 years. The commonest
presenting feature was nasal obstruction and nasal
discharge. Most of the patients had allergic fungal
sinusitis though we did manage to do isolated cases
of sphenoiditis, a couple of DCR and of CSF
Rhinnorhea. The most common complication we
encountered was recurrence of disease followed by
periorbital pain and bruising and pain.
Conclusion: Endoscopic sinus surgery is the
standard of care in modern rhinology and more work
is required in our country to promote its training and
use for the betterment of patients.
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