Sinusitis FAQ

Surgery Scheduled for Thursday

Question:

Laurie, good luck and relax! I know it is hard, the day of my surgery my blood pressure is always up. I ask for Vercid as soon as I get there to help me relax, it works. Glad your mom can be there for you and help with your child too. Keep us posted as to how you are doing. Trudy…What if the Hokey Pokey really is what it’s all about?

Response:

Laurie wrote: > I posted a couple of weeks ago about my upcoming surgery.  I am the > single Mommy with bad sinuses! > My pre-op paper list the surgery as: Bilateral Endopscopic > Spheno-Ethmoidectomy > and Maxillary antrostomy. > Not quite sure what all that means!  

By now you’ve gotten a good reply from Don Brady.  I’ll just add one more thing:  The sinus ostia (ducts) that drain the sinuses are quite narrow–as narrow as 2 mm.  That makes it difficult for thick mucus to drain the sinuses.  The antrostomy will widen the ducts of your maxillaries to as much as 10 mm, facilitating drainage. > I am really dreading the whole thing.   > The stress has had my high blood pressure in the 160/90’s and that > can’t be good!  He is having me see my primary care Doctor on Tuesday > to get him to assess and perhaps change my medication.

Hey, I was scared too.  In my case, I have some other health problems too, and I was worried about how they would impact the surgery.  So I discussed all that with my anesthesiologist. As long as your anesthesiologist is aware of your high blood pressure, and he’s aware of any other medical problems you have, you should have no problems with the surgery. But I will be honest with you:  The *after-effects* of sinus surgery can be a little messy, and you need to care for your healing sinuses carefully.  You should have received instructions from your surgeon as to how to care for your sinuses in post-op recovery.  If not, ask! Finally, you’re liable to feel a little weak and tired after the surgery.  If your child is at the age where you constantly have to run after him, you may want to ask a friend or relative to help with his care. Good luck!  Let us know how it turns out! — Steven D. Litvintchouk Email:  sdlit…@earthlinkNOSPAM.net Remove the NOSPAM before replying to me.

Response:

I posted a couple of weeks ago about my upcoming surgery.  I am the single Mommy with bad sinuses! My pre-op paper list the surgery as: Bilateral Endopscopic Spheno-Ethmoidectomy and Maxillary antrostomy. Not quite sure what all that means!   My Doctor expects surgery will take 3-5 hours.   He told me that he has not packed a patient in 10 years.  He says he uses a substance that is like "Jello" that is removed post-op. He tells me that with that I should have less pain. He also explained that the sinuses nearest my eyes may have invaded the bone, and that could cause problems.  The left ethmoid is extrmely small and he feels he will probably leave it alone, but clean out the right side. He said messing with it could be a major mistake (brain, carotid artery) I had to hear about all the risks involved again, this time for the benefit of my Mom who went to the pre-op appointment last Wednesday. She walked out of his office terrified. I told the Doctor, "just don’t let me die!!!!", he reassured me he had never lost a patient in surgery before. I had a terrible time last week with headaches.  I have started Predisone for the 5 days prior to surgery. The plan is still to spend one night in the hospital, just in case I have complications. I am really dreading the whole thing.   The stress has had my high blood pressure in the 160/90’s and that can’t be good!  He is having me see my primary care Doctor on Tuesday to get him to assess and perhaps change my medication. Thanks for listening once again! Laurie Mommy 2 Cody

Response:

On 25 Sep 2004 22:35:16 -0700, teddyb…@peoplepc.com (Laurie) wrote: >My pre-op paper list the surgery as: Bilateral Endopscopic >Spheno-Ethmoidectomy

Opening up the sphenoid and ethmoid sinuses (around and behind the eyes – see www.sinuses.com for locations) >and Maxillary antrostomy.

Opening up the maxillary (cheek) sinuses. >Not quite sure what all that means!  

See above. – Hide quoted text — Show quoted text ->My Doctor expects surgery will take 3-5 hours.   >He told me that he has not packed a patient in 10 years.  He says he >uses a substance that is like "Jello" that is removed post-op. >He tells me that with that I should have less pain. >He also explained that the sinuses nearest my eyes may have invaded >the bone, and that could cause problems.  The left ethmoid is extrmely >small and he feels he will probably leave it alone, but clean out the >right side. >He said messing with it could be a major mistake (brain, carotid >artery) ….. >I had a terrible time last week with headaches.  I have started >Predisone for the 5 days prior to surgery. >The plan is still to spend one night in the hospital, just in case I >have complications.

That all sounds good… >The stress has had my high blood pressure in the 160/90’s and that >can’t be good!

Those levels are not a problem really on a very short-term basis.  Be sure to get them down afterward…. Good luck!

Response:

Laurie, Best of luck to you. I found some information on Maxillary anstrostomy that may be helpful to you – here it is: ********** Antrostomy Description The surgical creation of a hole in the lateral nasal wall between the nasal passages and the sinus cavity in the cheek bone (the maxillary antrum). Anatomy and Physiology The sinus in the cheek bone (the Maxillary Antrum) lies below the eye and has the upper tooth roots in the bone of its floor. It should drain mucus and be ventilated via a small hole (the ostium) in the angle between the floor of the eye socket and outer wall of the nasal cavity. If this is blocked by mucous membrane swelling or a polyp mucus will accumulate and oxygen levels will drop. This allows the overgrowth of bacteria which are usually there but kept in check by being washed out in the mucus which normally escapes into the nasal passages. A sinus infection (sinusitis) results. Sinusitis may also result when a dental infection bursts into the sinus from below. Indications The creation of an antrostomy is indicated to allow drainage of pus and to reestablish normal mucus flow and ventilation of the sinus hopefully leading to resolution of the infection. It is also occasionally used to allow the biopsy or removal of a tumor or swelling within the sinus. Anaesthetic Although possible under local anaesthetic this procedure is usually done under a general anaesthetic Surgical Technique The outer wall of the nose has three folds of mucous membrane covered bone, the turbinates or conchae, looking not unlike old fashioned curtain pelmets and lying horizontally one above each other. The lower one (the inferior turbinate) covers a part of the outer nasal wall called the inferior meatus. Above this the middle turbinate covers the middle meatus and above the middle turbinate the superior turbinate covers the superior meatus. Traditionally an antrostomy is made in the inferior meatus by removing bone and mucous membrane, having first temporarily swung the inferior turbinate up and out of the way. More recently it has become more usual to create an antrostomy in the middle meatus effectively enlarging the natural ostium or drainage hole. It is felt that this is more likely to result in re establishment of natural patterns of mucus flow than an inferior meatal antrostomy. Length of Operation A simple antrostomy takes only a few minutes to perform, although it is often just part of a more complex sinus operation. Time in Hospital – This is a virtually painless procedure post operatively and is often carried out on a day case basis, unless part of a more complex procedure. Postoperative care may involve medical treatment of the underlying infection and nasal douches or steam inhalations to help promote drainage of secretions. Time off Work (limitations) Forceful nose blowing, strenuous exercise and exposure to be dust are to avoided for 2 weeks or until all signs of infection disappear. Risks and Complications Inferior meatal antrostomies may be associated with brisk nose bleeding at the time of surgery and occasionally with some diminished sensation in the upper teeth. Persistent infection despite apparent sinus drainage has been described by several authors and attributed to the unnatural pattern of mucus drainage causing a tendency to reinfection of the sinus by infected mucus re entering the sinus via the antrostomy. Most inferior meatal antrostomies will close after 3 to 5 years. Middle meatal antrostomy requires removal of bone closer to the eye socket and hence there is a greater risk of damage to the eye socket and its contents, although in practice this is extremely rare. Most middle meatal antrostomies remain open. Outcome and Prognosis Most antrostomies and in particular middle meatal antrostomies cause resolution of maxillary sinusitis. Occasionally infection persists particularly in the presence of congenital abnormalities of mucus flow eg Cystic fibrosis and those patients with a tendency to formation of nasal polyps. On 25 Sep 2004 22:35:16 -0700, teddyb…@peoplepc.com (Laurie) wrote: – Hide quoted text — Show quoted text ->I posted a couple of weeks ago about my upcoming surgery.  I am the >single Mommy with bad sinuses! >My pre-op paper list the surgery as: Bilateral Endopscopic >Spheno-Ethmoidectomy >and Maxillary antrostomy. >Not quite sure what all that means!   >My Doctor expects surgery will take 3-5 hours.   >He told me that he has not packed a patient in 10 years.  He says he >uses a substance that is like "Jello" that is removed post-op. >He tells me that with that I should have less pain. >He also explained that the sinuses nearest my eyes may have invaded >the bone, and that could cause problems.  The left ethmoid is extrmely >small and he feels he will probably leave it alone, but clean out the >right side. >He said messing with it could be a major mistake (brain, carotid >artery) >I had to hear about all the risks involved again, this time for the >benefit of my Mom who went to the pre-op appointment last Wednesday. >She walked out of his office terrified. >I told the Doctor, "just don’t let me die!!!!", he reassured me he had >never lost a patient in surgery before. >I had a terrible time last week with headaches.  I have started >Predisone for the 5 days prior to surgery. >The plan is still to spend one night in the hospital, just in case I >have complications. >I am really dreading the whole thing.   >The stress has had my high blood pressure in the 160/90’s and that >can’t be good!  He is having me see my primary care Doctor on Tuesday >to get him to assess and perhaps change my medication. >Thanks for listening once again! >Laurie >Mommy 2 Cody

Response:

Filed under: Maxillary sinusitis

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