Chronic Sinusitis – For those patients who are unable to benefit from anti-allergic measures and medications, chronic sinusitis surgery becomes an important consideration in management. The simplest form of chronic sinusitis surgery is a sinus washout done under local anaesthesia. The cheek sinuses are irrigated to wash out pus within the sinuses, and to open the sinus ostia by forcing the irrigation fluid through it.
Some common Rhinosinusitis cases seen on CT scans
Improving sinus drainage with surgery
Sinus surgery in Singapore aims to restore sinus health by:
- Opening up blocked and narrowed sinus openings
- Removing diseased & abnormal tissue from within the sinuses (e.g. nasal polyps)
Functional Endoscopic Sinus Surgery (FESS) hastens recovery
FESS is a minimally invasive surgery done through the nose without any external cuts on the nose or face. It may be used for the treatment of:
- Sinus Infections
- Chronic sinusitis, Headaches and Congestion
- Fungal sinusitis
- Nasal polyps
- Complications of sinusitis
FESS surgery is performed through a computer imaging guidance system (IGS) with a video attachment to the endoscope, allowing the surgeon to look at a video monitor while operating. It is less of a physical strain on the surgeon. The FESS surgeon can spend a longer period on the sinus operation with increased precision and safety, leading to better outcomes for the patient.
Computer-Guided Navigation Sinus Surgery improves surgical precision
- Allows sinus surgeon to use high-resolution CT scan imaging data to navigate precisely and safely in the patient’s sinuses during surgery
- CT scans use X-rays to produce images
- Allows the surgeon to see into the patient’s sinus anatomy with X-ray vision!
- Helps the surgeon confirm his position in the patient’s sinuses
- Every point in the patient’s sinuses has an x, y & z coordinate (real coordinates)
- Image-guided surgery works by matching and co-relating the real coordinates with the virtual coordinates
- Produces 3D localisation information for navigation during surgery
- Allows surgeon to identify & avoid dangerous areas in the patient’s anatomy
- Enhances the safety of sinus surgery in Singapore
(For a better understanding of how an image guidance system is used in sinus surgery, please watch the video explanation listed at the end of this page, video 7).
Like pilots, surgeons require accurate navigation. A surgeon may occasionally need to locate the eye optic nerve, the base of the skull, the nasolacrimal duct, and carotid blood vessels during difficult sinus procedures. Computerised navigational instruments are available to provide guidance in these situations. If the anatomical features in the sinuses are altered by developmental factors or prior surgery, computer navigation is especially helpful. It allows the surgeon to navigate the intricate labyrinth of the nose and sinuses with ease.
Endoscopic Rod Improves visualisation
The Hopkin’s endoscopic rod, which is made of glass rod lenses with a fibreoptic bundle, allows a more accurate diagnosis of the causes of sinusitis and enhances the surgeon’s ability to perform sinus surgery by examining through the patient’s nostrils instead of having to make unsightly facial incisions.
Microdebrider is an oscillating vacuum shaver (or microdebrider) often used during sinus surgery. This surgical instrument works like a hybrid between a hair trimmer and a vacuum cleaner. The trimmer trims away unwanted abnormal tissues, while the vacuum suction cleans away unwanted blood and debris from the operation area.
Vacuum suction Microdebrider improves surgery safety
During sinus surgery, a microdebrider, also known as an oscillating vacuum shaver, is often used. This surgical instrument functions in a way that is similar to a hybrid between a hair trimmer and a vacuum cleaner. The trimmer removes undesirable abnormal tissues, while the vacuum suction removes blood and other debris from the area of operation.
Advantages of the Microdebrider
- Allows the surgeon to get rid of diseased tissue in a precise manner.
- Sharply cuts tissues without causing shearing and tearing which could occur when using conventional sinus surgery instruments.
- Eliminates unnecessary damage to the sinus tissues, resulting in reduced scarring and increased rapid healing.
- Allows timely and opportune removal of blood and tissue, keeping the operation site clean so the surgeon can proceed safely and smoothly under conditions of good visibility.
For more information on Balloon Sinuplasty, please click here
1. Understand why your sinus & nose is blocked
Dr Kevin Soh describes the many reasons for a blocked nose in this video. He uses engaging graphics and videos as illustrations. Identify enlarged adenoids, nasal polyps, and a deviated septum.
2. How To Remove Fungus In Your Sinus
Dr Kevin Soh explains fungal sinusitis in this video and how it can result in nose polyps. Learn how he approaches the maxillary sinus.
3. How is Functional Endoscopic Sinus Surgery Performed?
In this video, Dr Kevin Soh explains endoscopic sinus surgery using an example from a real case. Understand the different stages of the operation as seen during live surgery.
4. How is Functional Endoscopic Sinus Surgery Performed?
Dr Kevin Soh describes functional endoscopic sinus surgery in this video. What to do if you’ve had endoscopic sinus surgery in the past yet still have ethmoid and frontal sinusitis, and how to adequately open the frontal sinus and get rid of the ethmoid sinuses properly.
5. How is Functional Endoscopic Sinus Surgery Performed?
In this video, Dr Kevin Soh describes a case of sinusitis after titanium dental implantation. Functional endoscopic sinus surgery (FESS) was performed.
6. Sinusitis, Mucocele, Cyst in the Ethmoid Sinus
In this video, Dr Kevin Soh explains the removal of a cyst in the sinus without injuring the eye/brain.
7. Image Guided Sinus Surgery, Computer Navigation, for Sinus Surgery
In this video, Dr Kevin explains how image-guided sinus surgery works.
8. How To Read CT Sinus Scans
Dr Kevin Soh uses segments from a CT sinus scan to describe the anatomy of the nose and sinuses. While listening to jazz music, learn about the sinuses. The Mozart Effect is in action!