1. Nasal Polypectomy
Wadie

2. Anatomy & Physiology
Occur at any site in the nasal cavity or paranasal sinuses but most often in the clefts of the middle meatus
Usually start at the osteomeatal complex of the nasopharynx (the sinus ostia)

3. Tests & Diagnostics Nasal endoscopy Imaging studies (CT or MRI)
Allergy tests
Test for cystic fibrosis
Test for chronic rhinosinusitis
Test for vasculitis

4. Random Details
Anesthesia: general or local with vasoconstricting agents administered to the nasal cavity
Positioning: supine
Supplies & Instruments: nasal set, nasal speculum, rhinoscope (for endoscopic,) and surgeon’s choice for method of polyp removal

5. Procedure
1. Time out
After vasoconstricting agents have reached a therapeutic level, the offending nasal cavity is retracted using a nasal speculum
The nasal canal is explored and polyps are removed (usually with a microdebrider)
Blood loss is checked, no suturing is required
Packing depends on surgeon’s preference

6. Methods for Excising Polyps
Lasers
Polyp snare
Polyp forceps
Microdebrider
Ex: the Stryker “hummer”

7. Post-op Considerations
Patient should be able to leave the same day
Corticosteroid nasal spray
Saline rinses
Polyps are very likely to reoccur especially in patients with chronic rhinosinisitis
Complications include hemorrhage and damage to surrounding structures