Nowadays, endoscopic surgery has started to be used in every field of medicine and this has made numerous operations more comfortable and has minimized bleeding during the operation. Sinusitis surgery has been started to be performed more easily thanks to the angled telescopes placed into the nose. Working with a lighted camera system in a narrow and dark area such as the nose and sinuses affects the success of the operation for sure.
In endoscopic sinusitis surgery, which can be performed under both general and local anesthesia, my personal preference is general anesthesia. Our aim is to expand the areas where the sinus canals open to the nose and to clean tissues such as polyps and granulation if any. Sinuses should be removed particularly in case of any cystic formation. Surgery is performed by inserting the endoscope into the nose. However, in special cases, we may also need to reach the sinus from the inside of the mouth, from the upper part of the teeth. The combined approach can be applied in cases where there is a deviation in the nose which makes it difficult to work and causes nasal congestion or there is a growth in the nasal concha: both sinusitis and intranasal pathology can be handled at the same operation. Even if the operation is successful, bleeding can be seen both in the intraoperative and postoperative periods. Although bleeding occurring like leakage stops spontaneously, major bleeding may require the insertion of Merocel and silicon into the nose.
The complications that are more common in the inexperienced hands decrease with increasing knowledge and experience of the surgeon. Close proximity to the eye area may cause damage to the delicate structures during surgery. Since the sinuses have close proximity to the eyehole, tissue around here may be damaged, resulting in damage to the delicate structures there (eyeball and visual nerve) during the surgery. In cerebral trauma, cerebrospinal fluid called CSF fistula may leak through the nose. This condition, which must be fixed during surgery, may cause meningitis if overlooked. Particularly in pathologies related to sphenoid sinus surgery, damage to the vessels, which are important in the brain circulation, can cause very difficult-to-stop and life-threatening bleeding.