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Nasal Polypectomy

Nasal Polypectomy. Wadie. Anatomy & Physiology. Occur at any site in the nasal cavity or paranasal sinuses but most often in the clefts of the middle meatus Usually start at the osteomeatal complex of the nasopharynx (the sinus ostia ). Tests & Diagnostics. Nasal endoscopy

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Nasal Polypectomy

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  1. Nasal Polypectomy Wadie

  2. Anatomy & Physiology • Occur at any site in the nasal cavity or paranasal sinuses but most often in the clefts of the middle meatus • Usually start at the osteomeatal complex of the nasopharynx (the sinus ostia)

  3. Tests & Diagnostics • Nasal endoscopy • Imaging studies (CT or MRI) • Allergy tests • Test for cystic fibrosis • Test for chronic rhinosinusitis • Test for vasculitis

  4. Random Details • Anesthesia: general or local with vasoconstricting agents administered to the nasal cavity • Positioning: supine • Supplies & Instruments: nasal set, nasal speculum, rhinoscope (for endoscopic,) and surgeon’s choice for method of polyp removal

  5. Procedure 1. Time out • After vasoconstricting agents have reached a therapeutic level, the offending nasal cavity is retracted using a nasal speculum • The nasal canal is explored and polyps are removed (usually with a microdebrider) • Blood loss is checked, no suturing is required • Packing depends on surgeon’s preference

  6. Methods for Excising Polyps • Lasers • Polyp snare • Polyp forceps • Microdebrider • Ex: the Stryker “hummer”

  7. Post-op Considerations • Patient should be able to leave the same day • Corticosteroid nasal spray • Saline rinses • Polyps are very likely to reoccur especially in patients with chronic rhinosinisitis • Complications include hemorrhage and damage to surrounding structures

  8. http://www.entsurgery.net/nasal-polyps-removal.html

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