Features of the sphenoid sinus
The sphenoid sinus is located deeper than all the others, in the center of the base of the skull. Its inflammation often manifests itself atypically: headache in the back of the head or crown, drainage of discharge down the back wall of the pharynx, sometimes visual disturbances - and remains unrecognized for years. Sphenotomy opens the sinus and restores outflow. The operation requires special care: the optic nerve and internal carotid artery pass nearby.
What is endoscopic sinus surgery
Functional endoscopic surgery (FESS) is the current standard of care for chronic sinusitis and nasal polyposis. Unlike old radical operations through an incision under the lip, access is through natural pathways - the nostril, and the video endoscope gives the surgeon an enlarged image.
The key word here is “functional”: the goal is not to remove the sinus, but to restore its normal functioning by expanding the natural anastomosis and removing what interferes with the outflow.
What can be done endoscopically
- expand the anastomosis of the maxillary sinus (maxillary sinus, infundibulotomy)
- open the cells of the ethmoidal labyrinth (ethmoidotomy)
- open the sphenoid sinus (sphenotomy)
- remove polyps with a shaver - with minimal trauma to the mucous membrane
- correct nasal septum (septoplasty)
- reduce the volume of the nasal turbinates (conchoplasty)
Why is the volume of the operation different?
Chronic sinusitis is rarely limited to one sinus. Using tomography data, the surgeon determines in advance which sinuses are involved and on which side, and plans the volume: from one manipulation on one side to several stages on both. That is why operations are classified by the number of stages - this directly reflects the volume and duration of the intervention.
Recovery
Nasal breathing is not restored immediately: the first days the nose is blocked due to swelling and crusts. Complete healing of the mucous membrane takes 4–8 weeks, and during this period, postoperative examinations with cleaning of the nasal cavity are critical - without them, the anastomosis may become overgrown again.