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Endoscopic surgery

Endoscopic surgery is the least traumatic type of surgical treatment of pathologies. The intervention is carried out through pinpoint punctures. This minimizes the need for large incisions. At the K+31 center, otolaryngologists provide care in a multidisciplinary 24-hour hospital and outpatient department.

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Indications and contraindications

Functional endoscopic sinus surgery (FESS) involves not just eliminating the problem, but also preserving or restoring natural functions. After the operation, free breathing is restored, local immune defense is increased, and mucus removal is improved.

The following indications for endoscopic surgery are distinguished:

  • Permanent nasal congestion
  • Accumulation of mucus in the nasal passages and nasopharynx
  • Feeling of discomfort, pressure in the sinuses
  • Regular acute purulent sinusitis
  • Lack of positive effect after using medications (for chronic sinusitis)
  • Presence of nasal polyps (or development of polypous rhinosinusitis)
  • Chronic and frequently recurring inflammatory processes in the sinuses (sinusitis, ethmoiditis, sphenoiditis, frontal sinusitis, polysinusitis and pansinusitis)
  • Cysts in the maxillary sinuses

Endoscopic abdominal surgery is not performed against the background of acute infectious diseases or exacerbation of chronic pathologies.

Indications and contraindications

Endoscopic treatment methods in otolaryngology

There are several endoscopic therapy methods. Here are the main ones:

  • Sinusrotomy
  • Mainorrhoethmoidotomy
  • Polysinusotomy

According to doctors, not every identified cyst or polyp requires immediate surgical intervention. If a small tumor is detected that does not affect breathing and does not cause complications, the doctor prescribes conservative therapy.

Maxillary sinusotomy

About the method

This endoscopic operation is performed against the background of the presence of polyposis-purulent sinusitis. Other indications:

  • Irreversible changes in the sinus that can lead to destruction of the bone structure
  • The presence of foreign objects in the sinus (for example, filling materials that can get there during dental procedures)
  • Repeated episodes of chronic sinusitis (more than 3 cases per year)
  • Fungal infection in the sinus (develops as a result of long-term use of antibiotics)

Surgery is not performed for some acute and chronic diseases and against the background of problems with blood clotting.

Features of surgical intervention

Before the operation, the patient undergoes an examination, which includes blood tests (general, biochemical + for antibodies to HIV, hepatitis B and C), fluorography, ECG and examination by a therapist.

Immediately before the intervention, the doctor performs endotracheal anesthesia. It is carried out using the drug “Sevoran”. This type of anesthesia is easily tolerated and resembles normal sleep. Awakening after anesthesia goes smoothly, the patient does not feel any discomfort.

Operation types

There are 2 methods of intervention - microsinusrotomy and endoscopic maxillary sinusotomy through the nose.

The first option is carried out in the treatment of purulent and hyperplastic sinusitis. It involves making a small incision (about 5-7 mm) under the upper lip - this is required to provide access to the maxillary sinus.

Using an instrument with a sharp end (trocar) allows the doctor to penetrate the mucous and bone structure and create accurate access to the sinus. An endoscopic camera and specialized instruments are inserted through the formed channel, with which the surgeon performs the operation.

Endoscopic maxillary sinusotomy through the nose is the newest method of treating sinusitis. This operation is recommended for those who have chronic purulent or hyperplastic sinusitis, accompanied by damage to the entire sinus mucosa. The intervention is carried out through the middle or lower nasal passage. This allows you not only to examine the sinus, but also to improve its drainage.

After the operation, the patient is monitored in the hospital for some time, and then returns home and continues recovery under the supervision of a doctor. At home, he undertakes to keep the nasal cavity clean and remove any crusts that form - this is necessary for successful healing.

A likely complication of surgery on the maxillary sinuses is the risk of damage to one of the main nerve branches of the face. Against this background, severe pain appears. However, the probability of this risk with microsinlusrotomy is only 5-10%.

Other treatment methods in otolaryngology

Maxillary ethmoidotomy

This is a rather complex operation on the maxillary and ethmoid paranasal sinuses. It is usually prescribed against the background of:

  • Rapid progression of purulent sinusitis
  • The presence of aggressive inflammation in the ethmoid bone
  • Presence of polyps

Surgery is performed under general anesthesia.

Polysinusotomy

This is an extensive endoscopic surgical treatment. The operation is performed on 2 or more paranasal sinuses. The main objectives of the intervention include improving the passage of air through the sinuses, preventing the accumulation of mucus and correcting the overgrown mucous membrane.

General information about endoscopic surgery

Indications and contraindications

Surgical intervention is performed against the background of chronic polysinusitis and polypous rhinosinusitis. It is also prescribed if it is present in the paranasal sinuses:

  • Kist
  • Mucocele (tumor-like formations filled with mucous contents)
  • Foreign bodies

The main contraindications are exacerbation of chronic diseases, problems with blood clotting and severe (general somatic) health conditions.

Preparation for surgery

Before surgery, it is necessary to take a general blood test with a leukocyte formula. You will also need to take a biochemical blood test (the important indicators are AST, ALT, bilirubin, total protein, electrolytes, iron, creatinine, urea and glycosylated hemoglobin).

Additional research:

  • Coagulogram
  • Tests for infectious diseases (HIV 1, 2, p24 HBs, HBsAg antigens, antibodies to hepatitis C viruses, syphilis)
  • General urine analysis
  • Ultrasound of the veins of the lower extremities
  • ECG with interpretation
  • CT (X-ray) of the chest organs

The patient also needs to obtain a conclusion from a gynecologist (relevant for women over 18 years old) about the absence of contraindications to the operation. Additionally, you should obtain advice and a physician’s opinion on your state of health and readiness for surgery.

Features of the intervention

The operation is performed under general anesthesia. The surgeon inserts instruments into the paranasal sinuses through its cavity, removes damaged areas of the mucous membrane and tumors. After this, the doctor restores natural drainage and removes pathological contents from the sinuses.

The risk of complications during and after the intervention is 35-40%. They are:

  • Intraoperative. These include injuries to organs near the operated area (in particular, there is a possibility of hematomas, damage to the optic nerve and muscles)
  • Early. These complications appear in the first 24 hours after the intervention. This category includes bleeding and infections that have penetrated the wound
  • Late (occurs after a month or more). Scars appear that contribute to the re-development of the disease

After the operation, the patient remains in the hospital for 1 day. The next day, the doctor examines him and cleanses the nasal cavity - this helps accelerate the regeneration of the mucous membrane. After this, the person is discharged.

Recovery after endoscopic sinus surgery

For the first few days after endoscopic sinus surgery, you should remain in bed and keep your head elevated. This is necessary in order to reduce pain and inflammation. You need to sleep on 2 or 3 pillows.

For several hours after the intervention, bleeding may appear. They usually stop within 24-72 hours. In addition, slight bruising and redness around the eyes sometimes appear - these symptoms go away on their own.

Severe pain can be relieved with analgesics prescribed by your doctor. The duration of their administration usually does not exceed 3-5 days. Cold compresses will help relieve mild pain and inflammation. They should be applied to the operated area for 10-15 minutes. You need to make compresses 2-3 times a day.

In most cases, people who undergo endoscopic plastic surgery return to normal activity within 1-2 weeks. Complete recovery and disappearance of symptoms occurs within 1 to 6 months. To speed up rehabilitation and reduce the risk of complications after endoscopic interventions, it is necessary:

  • Be careful. Don't blow your nose for a week after surgery. Do not clean your nose with cotton swabs or remove any tampons, splints, or tubes until your doctor allows it.
  • Rinse your nose with sea water 5-6 times a day (this is necessary to restore breathing). If the doctor has prescribed antibacterial drugs and ointments, they should be used strictly according to schedule
  • Avoid crowded places (this is necessary in order not to catch a new infection in the first week after discharge)
  • Postpone visiting saunas and baths (high temperatures increase swelling)

If your nose starts bleeding, tilt your head back and use gentle breathing techniques. Nasal sprays should not be used without a doctor's permission. 5-7 days after the operation, you must visit a doctor for a follow-up examination.

Our doctors

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Sadikov
Ilya Sergeyevich
Head of the Clinic for Otorhinolaryngology, Otorhinolaryngologist
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Tetzoeva
Zalina Muratovna
Head of the department of otorhinolaryngology, otorhinolaryngologist
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Kochetkova (Minavnina)
Yulia Vladimirovna
Otorhinolaryngologist
Osipova
Irina Andreevna
ENT doctor
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Gutenko (Selenina)
Tatyana Vitalievna
ENT doctor
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Lapshina
Anastasia Andreevna
Otolaryngologist, audiologist
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Samarin
Nikolay Evgenyevich
ENT doctor
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Krahovetsky
Nikolay Nikolaevich
ENT doctor
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Lopatin
Andrew Stanislavovich
Chief Specialist in Otorhinolaryngology
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Portnyagina
Maria Pavlovna
Audiologist-otorhinolaryngologist
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Kaspranskaya
Galina Rustemovna
Otorhinolaryngologist, otoneurologist, audiologist
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Koblova
Tatyana Alexandrovna
ENT doctor
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Petlyov
Alexei Anatolevich
Otolaryngologist
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Punkov
Maxim Anatolevich
ENT doctor
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Varenkova
Olga Vladimirovna
Otorhinolaryngologist
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Sadikova
Yulia Alexandrovna
Otorhinolaryngologist
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Timurzieva
Alina Borisovna
Otorhinolaryngologist
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Budeikina
Liliya Sergeevna
Otorhinolaryngologist, phoniatrist
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Shishmareva
Elena Vladimirovna
Otorhinolaryngologist
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Kornienko
Roman Anatolievich
Otorhinolaryngologist
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Budnitskaya
Elena Vasilievna
Otorhinolaryngologist
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Varvyanskaya
Anastasia Vladimirovna
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Akhmedov
Magomed Akhmedovich
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Zosimenko
Nina Alexandrovna
Otolaryngologist
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Vizgunova
Anna Alekseevna
Otorhinolaryngologist
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Gogoreva
Naila Rostislavovna
Otorhinolaryngologist
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Price

Polysinusotomy using video endoscopic technologies (according to the FESS method), unilateral
from 60 400 ₽
Infundibulotomy using video endoscopic technologies (according to the FESS method) 1 sinus
from 44 300 ₽
Removal of polyps of the nasal passages using video endoscopic technologies (according to the FESS method) 2 degrees of complexity
from 59 050 ₽
Endoscopic endonasal examination of the paranasal sinuses (according to the FESS method)
from 51 700 ₽
Septoplasty (cristotomy) (using the FESS method)
from 29 550 ₽
Septoplasty 1st degree of complexity (according to the FESS method)
from 73 200 ₽
Septoplasty 2nd degree of complexity (according to the FESS method)
from 56 100 ₽
Septoplasty 3rd degree of complexity (according to the FESS method)
from 66 450 ₽
Septoplasty 4 degrees of complexity (according to the FESS method)
from 73 750 ₽
Septoplasty 5th degree of complexity (according to the FESS method)
from 81 100 ₽
Opening of the ethmoidal bulla using video endoscopic technologies (according to the FESS method)
from 61 200 ₽
Polysinusotomy using video endoscopic technologies (according to the FESS method)
from 82 650 ₽
Removal of polyps of the nasal passages using video endoscopic technologies (according to the FESS method) for polypous polysinusitis
from 103 250 ₽
Removal of polyps of the nasal passages using video endoscopic technologies (using the FESS method)
from 66 450 ₽
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Reviews 6

Zalina Muratovna, super professional doctor. I am being observed and had surgery with her two weeks ago to remove tonsils. With her light hand, healing is going very well. I definitely recommend the doctor. In addition to her professionalism, she is also a very pleasant doctor to talk to! Thank you, Zalina Muratovna! Elena P.
29.07.2024
Pogibelnaya Elena Anatolyevna
I came to Yulia Alexandrovna with otitis media. She cured me quickly, it was even strange. It always seemed that in paid clinics everything was structured so that the patient would undergo as many different tests as possible and come to appointments as often as possible. The doctor prescribed me medications, gave me instructions and that was the end of it, because after a few days I felt better. Thank you for your individual approach, attention and quality knowledge.
12.07.2024
Regina
Nikolai Nikolaevich performed surgery on my tear ducts. In this review I want to once again convey to him my deepest gratitude. He is a surgeon from God. I am glad for all future patients with the problem of dacryocystology (and on its basis, for example, dangerous purulent processes), if they end up being treated by Nikolai Nikolaevich.
12.07.2024
Tamara Veniaminovna
Many thanks to Zalina Muratovna!!! I had severe otitis media. Other doctors in other clinics whom I initially contacted could not help. Life has become a nightmare. Pain, deafness, panic attacks, deterioration in health. And when I finally found this wonderful doctor, I came back to life. In 2 days of intensive I came back to life, and then competent treatment returned everything to its place. Thank you for a full and bright life. Good luck and happiness to everyone
30.05.2024
Tatyana Grigorievna Sokolova
Zalina Muratovna is a doctor from God! Thanks to her, my entire family’s noses can breathe, their ears can hear, and their throats don’t hurt)))
23.05.2024
Stepanova Oksana Nikolaevna
I would like to express my gratitude to my attending physician - the wonderful otorhinolaryngologist Anastasia Vladimirovna Varvyanskaya for his professionalism, attentiveness and kindness! And also to all employees of the K+31 West clinic who took part in the operation and the pre/postoperative period, these are: head of the ENT department Zalina Muratovna Tetsoeva, anesthesiologist Kristina Inalovna Siukaeva, head of the anesthesiology and resuscitation department Zarina Igorevna Sypkova, all nurses, secondary and to the junior medical staff, Alexander, who drove me to the operating room and back, hospitalization managers, administrators and everyone, everyone, everyone! I had surgery on March 14, 2024 for a deviated nasal septum and hypertrophied nasal turbinates (septoplasty + osteoconchotomy). I have been suffering from difficulty breathing through my nose for a long time. I got an appointment with Dr. A.V. Varvyanskaya. I immediately realized that I was ready for surgery with this specialist. The surgery and recovery went flawlessly. Finally, after many years of torment, my nose could breathe freely. Thank you!
01.05.2024
Gorlachev Pavel Dmitrievich
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