FESS is the common name for a large number of nose and sinus surgeries that deal with chronic inflammation of polyps, cysts, chronic inflammation of the lacrimal sac, benign tumors and some malignancies. In addition to polyps, endoscopic surgery also treats other diseases. FESS endoscopic operations on the sinuses and paranasal cavities are performed at Atlas General Hospital.
Prof Dr. Aleksandar Trivić: ” Today, with the appropriate equipment the range of diseases that can be treated in this way has significantly expanded. Malignancies are widely treated in the world with an endoscopic approach. Of course, this requires additional equipment, because when you are dealing with malignant diseases, then there is no compromise. When it comes to malignant diseases, everything that is suspected to be malignant must be removed. We perform sinus cysts surgery that is one of the easier things for patients.
Over 60% of people have a cyst in the jaw sinuses. Naturally, we will not operate on asymptomatic cysts. Most of these cysts in the jaw sinuses are found, for example, at the dentist, but there is another problem.
For example, in patients who do implants or sinus lifts, because there has been bone resorption and they do not have enough bone thickness to place a quality and good place for the implant, they require jaw sinus surgery. Once, when the Caldwel Luc surgery was performed, I have just mentioned it previously, – from six to eight months patients have to wait after such surgeries to have a sinus lift, and then another six months to wait for the implant to be placed. Today, after endoscopic sinus surgery where we keep a healthy part of the mucosa, literally after a week to 10 days, patients can move on to solve their dental problem. ”
This surgical method is used to correct deviated septum. This is called septoplasty in medicine. Nasal deviation can lead to severe symptoms where surgery is the only way out.
Prof Dr. Aleksandar Trivić: “ Deviations can be innate and acquired. Congenital means that there has been an excessive development of the cartilage of the nasal septum. The cartilage bends to one side and thus performs mechanical obstruction of breathing on that side. What is problematic, that is, good in the beginning, is that patients breathe well on the other side. However, as in life when we would only exercise only one arm and that muscle grows, so it is with this nasal cavity. In the nasal cavity, into which more air enters, there is hypertrophy, a natural enlargement of the nasal shell. At one point, the patient can no longer breathe on either side.
The patient should seek surgical help when breathing heavily through the nose. Not every deviation is for surgery. When the patient himself feels and says that he cannot breathe from that right side – that is a signal for us to look at the nose, see how severe deviation is, of course, to make also an imaging. Earlier, X-rays of the paranasal sinuses were performed, and today is certainly the era of CT- computed tomography, which is the gold standard for sinuses and nose, and then we could talk about surgery. I would like to note that functional surgery is so called because it restores the patient’s respiratory function. ”
The patient leaves the hospital the day after the surgery without bruising. He wears tampons for four days, and when the tampons are removed, no one will see that there was an intervention. Apart from the expert team, the condition for performing this type of endoscopic surgery is modern equipment that ensure safe work.
Of course, there are special conditions, but we have them here at Atlas General Hospital. These are endoscopes, a digital resolution camera with a large monitor. This allows us to see every polyp cell and reduce the possibility of recurrence of the disease. So we have all the instruments that are required. Today, everything is like a video game, so medicine is going in that direction. A specific scanner is made in that device and a path is drawn along which the instrument will guide us to make the operation even safer for the patient.
As Professor Trivić told us, the benefit is that surgeons know exactly where they are at all times and how far they can go in the intervention. It is important for patients to drastically reduce the possibility of complications.