FESS and septoplasty

50 yo man comes in with recurrent inflammation in his nose alleviated with taking contac (major ingredient acetominophan [paracetamon] - mechanism of action not completely understood but proposed to inhibit COX and PSE [pseudoephedrine hydrochloride] - sympathomimetic drug of the amphetamine chemical classes used for nasal/sinus decongestant] and persistent headache that recently developed. Upon examination, he was found to have crooked nasal septum needed for correction and sinusitis. Later it was told that his infection was developed after use of nasal irrigation (repetitive use of expired decongestant nasal sprays)



FESS [functional endoscopic sinus surgery] with septoplasty was suggested

crooked nasal septum

FESS

Functional endoscopic sinus surgery  is the mainstay in the surgical treatment of sinusitis and nasal polyps, including bacterial, fungal, recurrent acute, and chronic sinus problems. Ample research supports its record of safety and success.

FESS is a relatively recent surgical procedure that uses nasal endoscopes (using Hopkins rod lens technology) through the nostrils to avoid cutting the skin. These endoscopes have diameters of 4mm (adult use) and 2.7mm (pediatric use) and come in varying angles of view from 0 degrees to 30, 45, 70, 90, and 120 degrees. They provide good illumination of the inside of the nasal cavity and sinuses.

FESS came into existence because of pioneering work of Messerklinger and Stamberger (Graz, Austria.) Other surgeons have made additional contributions (first published in USA by Kennedy in 1985).^[1]

Septoplasty
Under general or local anesthesia, the surgeon works through the nostrils, making an incision in the lining of the septum to reach the cartilage targeted in the operation. Sufficient cartilage is preserved for structural support. After the septum is straightened, it may then be stabilized temporarily with small plastic tubes, splints, or sutures internally.

Septoplasty

Post-operation video: septoplasty