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Often untimely treatment of colds causes various complications. A common cold can provoke inflammation in the paranasal sinuses. First, there is swelling of the nasal mucosa – rhinitis.
If there is no proper therapy or there are factors that aggravate the course of the disease, inflammation affects the narrow passages connecting the nasal cavities with the paranasal sinuses.
Factors that increase the risk of developing ethmoiditis include congenital narrowing of the passages or chronic diseases of the nasopharynx.
What happens when the passages become inflamed? Since they are anatomically very narrow (only a few millimeters), even a small inflammatory process provokes their complete closure.
This prevents the movement of air and the outflow of mucus, that is, mucus begins to actively accumulate in the sinuses. If the process is provoked by an infectious agent, in a short time the mucus turns into pus.
Conservative treatment in this case does not bring the desired result – surgical intervention is necessary, the main purpose of which is to remove obstacles to the movement of mucus and air. The operation is one of the least traumatic and is performed in stationary conditions.
The essence of endoscopic ethmoidectomy
Ethmoidectomy is a procedure in which the infected tissues of the narrow passages are removed. Removal can occur through both internal and external incisions. The main goal is to connect the air cells of the ethmoid bone, due to which the natural waste of mucus from the sinuses is restored.
During the operation, not only infected tissues are removed, but a special drainage tube is installed, which accelerates the removal of mucus and pus. There are different ways of destroying the partitions between the lattice cells. In modern medicine, a microdebrider or special forceps can be used for this purpose. Each of the methods has its own characteristics and advantages.
Thus, the use of a microdebrider reduces the risk of accidental damage to the orbit or mucous membrane and makes the process of tissue destruction faster.
But when the affected tissues are removed with pointed forceps, the specialist has the opportunity to fully palpate the bony septa, due to which he sees the real distance to the base of the skull, which, in turn, also reduces the risk of accidental injuries.
Symptoms of ailment
It is important to know the main symptoms of ethmoiditis in order to detect the development of the disease in a timely manner and seek medical help. The main symptom of the disease is a prolonged runny nose, not amenable to drug treatment.
If rhinitis is accompanied by pain in the frontal part of the head, we can confidently talk about the accumulation of a large amount of mucus in the paranasal sinuses. The pain is aching.
When the accumulated mucus becomes infected and turns into pus, the pain may increase, the bridge of the nose begins to swell, and redness appears. These symptoms indicate acute ethmoiditis requiring immediate treatment. If signs of illness appear, you should make an appointment with an otorhinolaryngologist, who will determine further actions.
Indications and contraindications
Before the operation, it is important to undergo a complete examination in order to exclude contraindications. For example, if a patient has poor blood clotting, the destruction of the lattice partitions can provoke a large blood loss. And if there is an infection in the blood, infection of the affected area is not excluded.
Ethmoidectomy is prescribed for:
- the presence of an inflammatory process inside the paranasal sinuses;
- chronic polysinusitis;
- the formation of benign tumors and growths on the nasal mucosa, preventing natural airflow or outflow of mucus;
- chronic or acute ethmoiditis.
The contraindications of the procedure include the period of exacerbation of chronic ailments, systemic blood diseases, acute disorders of endocrine processes in the body, the development of infection.
How is the operation?
Before the procedure, the patient is required to pass a number of necessary tests – a general urine test; general and biochemical blood test; blood clotting test. Additionally, X-ray or computed tomography of the area under study is prescribed.
Endoscopic ethmoidectomy has a number of significant advantages over other methods of restoring the functions of the narrow passages connecting the nasal cavities with the paranasal sinuses.
The main advantage is the minimally invasive procedure. Due to this, the course of the operation is associated with minimal risks of complications, and the recovery period is quite fast and painless. In general, endoscopic surgery is a modern medical technique based on the use of endoscopic equipment.
The endoscopic method involves the use of a pair of endoscopes during surgery, which makes it possible not only to illuminate and fully examine the area affected by the infection, but also to display a two-dimensional image on the monitor. Thus, other pathologies can be detected during the procedure, for example, a curvature of the nasal septum. In this case, the specialist first eliminates the curvature, thereby improving access to the passages, and then penetrates into the ethmoid sinus.
Having reached the ethmoid sinus, the doctor removes the existing growths and benign neoplasms, then performs a resection of the bone fragments. At the final stage of the procedure, a drainage tube is installed.
In some cases, a total ethmoidectomy is required. The operation involves resection of the middle turbinate. As a result, the middle nasal passage is fully opened, which improves visualization. In order to prevent the occurrence of postoperative bleeding, the layered membrane of the nose at the sites of exposure is subjected to electrocoagulation.
The operation itself lasts an average of 30-60 minutes – it all depends on the complexity of the case. In the presence of a large number of polyps, the duration of the procedure may increase.
In most cases, on the first day after surgery, the patient is under constant medical supervision within the walls of a medical institution. Then he can be sent home.