Home | Contact Us | FAQ | Search & Site Map | Link to Us
Sign In | Join | Other 45 Sites in Network
Home
Discussion Groups
General
GeneralCardiologyVisionDentistryPharmacyLaboratoryNutritionAlternative
Diseases and Disorders
AIDSAlzheimer'sArthritisAsthmaCancerBreast CancerDiabetesEpilepsyGlaucomaHepatitisHerpesLupusProstate BPHProstate CancerProstatitisSinusitisTinnitus

Medical Forum / Diseases and Disorders / Sinusitis / September 2004

Tip: Looking for answers? Try searching our database.

Surgery Scheduled for Thursday

Thread view: 
Enable EMail Alerts  Start New Thread
Thread rating: 
Laurie - 26 Sep 2004 06:35 GMT
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
Don Brady - 26 Sep 2004 06:48 GMT
>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.

>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
[quoted text clipped - 7 lines]
>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!
iJah - 26 Sep 2004 06:52 GMT
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.

>I posted a couple of weeks ago about my upcoming surgery.  I am the
>single Mommy with bad sinuses!
[quoted text clipped - 37 lines]
>Laurie
>Mommy 2 Cody
iamthezookeeper - 26 Sep 2004 14:34 GMT
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?
Steven D. Litvintchouk - 26 Sep 2004 17:34 GMT
> I posted a couple of weeks ago about my upcoming surgery.  I am the
> single Mommy with bad sinuses!
[quoted text clipped - 4 lines]
>
> 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!

Signature

Steven D. Litvintchouk
Email:  sdlitvin@earthlinkNOSPAM.net

Remove the NOSPAM before replying to me.

 
Sign In
Join
My Latest Posts
My Monitored Threads
My Blog
My Photo Gallery
My Profile
My Homepage

Start New Thread
Enable EMail Alerts
Rate this Thread



©2008 Advenet LLC   Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.