Nasal surgeries

- Endoscopic sinus surgery
Endoscopic sinus surgery, or functional endoscopic sinus surgery (FESS), is done for those with chronic sinus symptoms where non-surgical treatment methods have failed. For these patients, surgery may be advised to remove abnormal tissue (polyps) or bone that is causing blockage or chronic infection. Sinus surgery may also involve a septoplasty to straighten a deviated septum. Essentially the goal for sinus surgery is to flush out infected material and open up blocked passages to allow your sinuses to drain normally, relieving symptoms, enhancing airflow and decreasing the number of infections experienced.

Endoscopic sinus surgery is a minimally invasive surgical procedure. It is done under general anaesthesia using a specialised tube-like tool with a camera (an endoscope) through the nose, so there is no need for incisions on the face. With this camera, Dr van Lierop can see where the sinuses are blocked and how best to improve airflow through the nose and improve symptoms by removing polyps, scar tissue, and other structural obstructions. Most people can go home the same day, once the effects of the anaesthetic have worn off. You may have temporary nasal packing in place to absorb excess fluid while your tissues heal when you wake up, but this will be removed shortly after surgery. It normally takes 1-2 weeks to recover from endoscopic sinus surgery.

- Septoplasty
Septoplasty is a surgery done by your ENT specialist to straighten and repair a deviated septum. The nasal septum is made up of bone and cartilage and separates the nose into the two cavities that we know as the nostrils. When the septum is skew or crooked, it can cause problems with the airflow through the nostrils.

A deviated septum may be caused by trauma, but may also be something you are born with. Either way, the only way to fix a deviated septum is through a surgery known as a septoplasty. Your ENT may suggest straightening your septum if you are struggling with chronic sinus infections due to poor drainage or as part of the treatment for severe nosebleeds.

During septoplasty, Dr van Lierop will make a small incision on the inside of the nasal cavities under general anaesthesia. Through this incision parts of the bone and cartilage of your nasal septum may be cut, trimmed and removed so that the nasal septum can be repositioned in the middle of the nose. The small incision will be closed with stitches, and your nose may be packed with nasal packing to assist healing. Once you are awake and the anaesthesia has worn off, the nasal packing will be removed, and you will be allowed to go home.

Once a septoplasty is healed, you'll likely find it's easier to breathe. Your surgeon can discuss what septoplasty can achieve for you. It normally takes 1-2 weeks to recover from surgery fully.

- Turbinate surgery
Turbinate surgery, or a tubinoplasty, is a surgery done to asses and reduce the size of the inferior turbinate to improve airflow through the nasal cavities. The nasal turbinates are fleshy prominences inside the walls of your nasal cavity. Nasal allergies or other chronic sinus conditions may cause these turbinates to become congested and inflamed. When enlarged they hinder proper airflow through the nose. It can also cause snoring, difficulty sleeping, and nosebleeds (epistaxis).

Turbinate reduction is also commonly recommended in conjunction with other procedures such as sinus surgery, nasal endoscopy, nasal cautery or septoplasty to relieve the nasal blockage, enhance your nasal airflow and also allow for the corticosteroid nasal sprays to work more effectively. Surgery is typically performed under general anaesthesia, using minimally invasive tools. Using an endoscope which is fitted with a camera, and tiny instruments, Dr van Lierop can make small incisions into each side of the nasal cavity to reduce the size of the turbinates. Cauterisation or specialised shavers are then used to shrink the excessively enlarged turbinate in size. Dissolvable material is then placed into the nasal cavities after the surgery to help with healing and recovery can be expected in about a week or two. You will still need to make use of allergy medications to prevent enlargement of the turbinates again.

- Surgery for nosebleeds
Nosebleeds that originate at the back of the nose (posterior nosebleeds) that do not respond to treatment may be treated by surgery. While there are a number of surgical approaches to treat these nosebleeds, your ENT will know which one is best suited for you when diagnosing you.

Prior to surgery, Dr van Lierop will insert a thin tube fitted with a camera into your nostril. This will allow him to isolate and repair the specific blood vessel that is causing nosebleeds.

Surgery is generally done under general anaesthesia, with minimally invasive tools. Trans-nasal endoscopic tools are inserted into the nostril to either dissect, clip or cauterize the specific blood vessel and its branches at the back of the nose. Depending on the severity of the case, you may be allowed to go home after the anaesthesia has worn off. Recovery generally takes about a week or two.

- Endoscopic DCR
Endoscopic dacryocystorhinostomy (DCR) is a surgery done to create a new opening of the tear duct into the nose. It is generally indicated for those who have a blocked tear duct that fails to respond to non-surgical treatment. The tear duct drainage system normally allows for drainage of tears into the nasal cavity. When it becomes blocked, it can cause the eye to become watery and irritated, causing problems with vision. An endoscopic dacryocystorhinostomy (DCR) is then done to bypass the obstruction and restore proper drainage of tears.

An endoscopic dacryocystorhinostomy (DCR) is usually performed under general anaesthesia. It is done through minimally invasive techniques, using an endoscope fitted with a camera. This thin tube is inserted into the nasal cavity and guided up towards the lacrimal sac (tear duct reservoir). This sac is then cut open to restore drainage and bypass the obstruction. After surgery, the nasal cavities may be packed to allow for better healing. This packing is then removed as soon as you wake up from surgery. There may be minimal bruising around the eye/s after surgery, but this should go away within a few days. You may also have small silicone tubes left in the tear duct system. These will be removed 6 weeks after surgery. You will also be prescribed eye drops and a nasal spray.