Nasal Polypectomy Wadie

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)

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

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

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

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

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

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