One of the biggest advancements has been surgeons' ability to
reduce bleeding of the sinuses during surgery, which improves healing
and limits painful post-op nasal packing. "That's where patients really
suffer," says Dr. Scher.
There are several new practices and tools that improve patients'
recovery after FESS, says Dr. Scher. Smaller tissue cutting tools that
include hemostatic elements like laser or radiofrequency — as well as
the introduction of absorbable hemostatic pastes and dissolvable
nasal packing — limit bleeding. These products and devices reduce
packing, which is removed a few days after surgery in a procedure
that is uncomfortable for patients and time-consuming for surgeons.
Additionally, instruments such as small microdebriders — tradition-
ally used in orthopedic cases — that cut tissue while providing suc-
tion to remove tissue and polyps claim to provide better mucosal
preservation and improve healing, says Dr. Lane, although clinical
research is limited. Many of the new surgical tools becoming available
are cumbersome, he adds, though they are improving.
Post-op care models are evolving too. While eliminating or reducing
packing is one way to stop discomfort, another easy and cost-effective
way to facilitate healing is to irrigate the sinuses. According to Dr.
Lane, patients can use irrigation "squeeze bottles" — found in many
drugstores — filled with a solution of saline, steroids and/or antibi-
otics after surgery. The irrigation helps reduce inflammation and keep
the sinuses moist, keeping your patients more comfortable. "A lot of
patients come back and say they had no pain at all," says Dr. Lane.
"Generally speaking, the nose tolerates surgery pretty well."
S te ro i d - e l u t i n g s te nts l i m it i nf l a m m at io n
There is also now a more efficient way to get steroids into the sinuses
after surgery that the doctors say is the next big thing: steroid-eluting
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