What are Endoscopic Ethmoidectomy and Antrostomy
Endoscopic ethmoidectomy and antrostomy are surgical procedures to treat long-term (chronic) sinusitis. Sinusitis is soreness and inflammation of the sinuses.
Sinuses are air pockets in face bones near your forehead and cheeks. Sinusitis can prevent the normal drainage of mucus from the sinuses. It can also allow bacteria, viruses, and funguses to grow, which can lead to infection.
If you have infected, diseased, or blocked (obstructed) sinuses that have not improved with other treatment, you may need one or both of the following procedures:
- Ethmoidectomy. This is a procedure to remove diseased tissue and bone and to widen the drainage openings of the ethmoid sinuses. These sinuses are located high in the nose, between the eyes. They drain through small openings into the nose.
- Antrostomy. This is a procedure to widen the drainage openings of the maxillary sinuses. These are large sinuses in the cheek area. They drain into the inside of the nose.
The goal of the procedure(s) is to help the sinuses drain properly and to decrease the risk of sinus infections.
The procedures are done using a thin, lighted scope (endoscope) and other instruments that are inserted into your nose. The surgeon makes no incisions on your face.
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Infection.
- Bleeding.
- Scarring inside the nose.
- Allergic reactions to medicines.
- Damage to other structures or organs, such as the eye or a tear duct.
- Leaking of brain fluid (cerebrospinal fluid) caused by an opening into the brain.
What happens before the procedure?
Staying hydrated
Follow instructions from your health care provider about hydration, which may include:
- Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.
Eating and drinking restrictions
Follow instructions from your health care provider about eating and drinking, which may include:
- 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
- 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
- 6 hours before the procedure – stop drinking milk or drinks that contain milk.
- 2 hours before the procedure – stop drinking clear liquids.
General instructions
- Ask
your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines unless your health care provider tells you to take them.
- Taking over-the-counter medicines, vitamins, herbs, and supplements.
- Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
- Plan to have someone take you home from the hospital or clinic.
- Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
- You
may have an exam or testing. This may include:
- Examining the inside of your nose with an endoscope.
- CT scan of your sinuses.
What happens during the procedure?
- To lower your risk of infection, your health care team will wash or sanitize their hands.
- An IV will be inserted into one of your veins.
- You
will be given one or more of the following:
- A medicine to help you relax (sedative).
- A medicine to numb the area (local anesthetic).
- A medicine to make you fall asleep (general anesthetic).
- Your surgeon will place medicine inside your nose to shrink the tissue and reduce bleeding.
- The endoscope will be placed inside your nose. A camera attached to the scope will send images to a TV screen in the operating room.
- The scope will be used to locate your maxillary sinus. Using additional instruments, the surgeon will widen the drainage opening for this sinus.
- The ethmoid sinus area will also be located and examined through the scope. Any diseased or obstructing tissue will be removed. Drainage openings for the ethmoid sinuses will be widened.
- Absorbable material will be packed inside your nose.
- Additional removable packing may also be placed in your nose.
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
- The removable packing may be removed before you go home.
- Do notdrive for 24 hours if you were given a sedative.
Summary
- Endoscopic ethmoidectomy and antrostomy are surgical procedures to treat long-term (chronic) soreness and inflammation of the sinuses (sinusitis).
- The surgery is done inside the nose using a thin, lighted scope (endoscope) and other instruments.
- The goal of the surgery is to help the sinuses drain properly and to decrease the risk of sinus infections.
- Follow instructions from your health care provider about eating and drinking before the procedure.
Endoscopic Ethmoidectomy and Antrostomy, Care After
This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.
What can I expect after the procedure?
After the procedure, it is common to have:
- Mild pain.
- A stuffy nose (nasal congestion).
- Some bloody drainage from your nose.
Follow these instructions at home:
Medicines
- Take over-the-counter and prescription medicines only as told by your health care provider.
- If you were prescribed an antibiotic medicine, take it as told by your health care provider.Do notstop taking the antibiotic even if you start to feel better.
- Do notdrive or use heavy machinery while taking prescription pain medicine.
Nose care
- If you have a gauze pad bandage (dressing) under your nose, keep this dressing clean. Change it if it gets soaked with nasal drainage.
- Check your nasal dressing often for signs of thick discharge, more blood, or more discharge of clear fluid.
Follow instructions from your health care provider about using saline nasal sprays or washing out (irrigating) your nasal cavity.
Managing pain and swelling
- Keep your head raised (elevated) when you are lying down. You can use a pillow to do this.
- If
directed, put ice on the affected area:
- Put ice in a plastic bag.
- Place a towel between your skin and the bag.
- Leave the ice on for 20 minutes, 2–3 times a day.
Activity
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Do notlift anything that is heavier than 10 lb (4.5 kg) until your health care provider says that it is safe.
- Do notbend over until your health care provider says that it is safe.
- Ask your health care provider when it is safe for you to drive.
- Avoid
these activities as directed by your health care provider:
- Blowing your nose.
- Coughing or sneezing. If you cannot stop a sneeze, sneeze with your mouth open.
- Straining on the toilet.
General instructions
- Do notuse hot water when taking a bath or shower. Do notswim or use a hot tub until your health care provider approves.
- Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These products can delay healing. If you need help quitting, ask your health care provider.
- To
prevent or treat constipation while you are taking prescription pain
medicine, your health care provider may recommend that you:
- Drink enough fluid to keep your urine pale yellow.
- Take over-the-counter or prescription medicines.
- Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
- Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
- Keep all follow-up visits as told by your health care provider. This is important. You will need to return to see your surgeon about 1 week after the procedure.
Contact a health care provider if:
- You
have:
- Chills or a fever.
- Thick, bloody, or watery discharge from your nose.
- A headache or stiff neck.
- Any change in vision.
- Your pain is not controlled by your pain medicine.
- You are not able to breathe through your nose after your packing is removed.
Get help right away if:
- You have heavy bleeding from your nose.
- You have any loss of vision.
Summary
- After the procedure, it is common to have mild pain, a stuffy nose (nasal congestion), and some bloody drainage from your nose.
- Take over-the-counter and prescription medicines only as told by your health care provider. Follow instructions from your health care provider about using saline nasal sprays or washing out (irrigating) your nasal cavity.
- Ask your health care provider what activities are safe for you.
- Do notuse hot water when taking a bath or shower. Do notswim or use a hot tub until your health care provider approves.
