Polypotomy is a manipulation that allows you to get rid of polyps, restore normal nasal breathing, and also get rid of the accompanying unpleasant symptoms (loss of smell, hearing, sleep, etc.)
Contraindications:
- bronchial asthma;
- poor blood clotting;
- cardiovascular diseases.
Used equipment:
- polyp loops for the nasal cavity;
- radio wave loop for removal of polyps of the nasal cavity;
- rhinoshaver (microdebrider).
Polyps are formations that occur in the paranasal sinuses and descend into the nasal cavity, interfering with normal air circulation and full breathing. Outwardly, they look like small bunches of grapes. When they grow, they not only make it difficult to breathe, but can cause unpleasant symptoms that cause discomfort and interfere with normal life: loss of smell, hearing, sleep. People turn to the clinic for the removal of polyps in the nose already when such signs of the disease appear as:
- it is difficult to breathe through the nose; vasoconstrictor drops do not make life easier, and you have to breathe through your mouth;
- due to poor air circulation in the nasal cavity, pathogenic microflora develops, causing frequent viral diseases, accumulation of mucus and pus;
- the patient does not leave the feeling that there is a foreign body in the nose;
- frequent headaches.
How to delete?
There are three methods of getting rid of polyposis: laser removal of polyps in the nose, removal under the control of an endoscope and a loop. The operation itself is called polypotomy.
- Laser removal is the most delicate and safe method. It is performed under local anesthesia and lasts about 20 minutes. Suitable for those patients who cannot be given general anesthesia, and for children. The only disadvantage of the procedure is that only single polyps can be removed in this way; it is not possible to remove them inside the sinuses. The price for laser removal of nasal polyps in Moscow clinics depends directly on the degree of polyposis growth and the pricing policy of the clinic.
- With the help of an endoscope, you can see polyps in the most inaccessible corners, including in the sinuses. Moreover, the risk of recurrence of polyposis is sharply reduced. The image from the endoscope camera is displayed on the monitor, and it becomes possible to see the number of polyps and their size. The operation is performed both under local anesthesia and under general anesthesia.
- If the formations are large, they need to be removed with a loop. The loop can be tearing and cutting. The first is used when endoscopic polypotomy is performed for the first time, the second - during a second operation. You can use the loop of the Surgitron apparatus - this is a more gentle way. First, local anesthesia is performed with a solution of lidocaine, then an injection with an anesthetic. The whole procedure takes about an hour. With this method, you can get rid of multiple neoplasms, but only those that are in the nasal cavity. The method is contraindicated in patients with bronchial asthma, poor blood clotting and cardiovascular diseases. An unpleasant consequence of the operation is the possibility of re-formation of polyps within a year.
Our doctors
Forecast
After the intervention, great attention must be paid to the hygiene of the nasal cavity. You can not sharply blow your nose. Nose crusts must be removed very carefully. Do not eat very hot food. Breathing normalizes within a few days after endoscopic polypotomy, the sense of smell returns within 30 days. At home, you need to rinse your nose with products like Aquamaris, Aqualor, etc. and take allergy medications. And of course, observation by an otorhinolaryngologist is necessary.
Endoscopic polypotomy with us
The cost of nasal polyp surgery depends on several factors. First of all, on the degree of growth of formations. The more advanced the disease, the longer, harder and more expensive this operation will cost. The cost in Moscow of this operation also depends on the chosen removal method. So the cost of laser polypotomy of the nose in Moscow will cost more than conventional polypotomy.
The cost of removing nasal polyps with a laser, loop or endoscope in our clinic has remained unchanged for 3 years now.
To find out the exact cost of manipulations, you need to contact the specialists of our clinic for primary diagnosis. ENT doctors will conduct a comprehensive examination, based on the results of which the degree of the disease, the number of formations, their size will be clear, and one of the methods of the operation will be proposed. After examination, the ENT will announce the exact cost of nasal polypotomy with a laser, loop or endoscope.
You can find out how much the procedure in the clinic costs on the website or at the appointment with the ENT
ENT doctor's consultation
* - the cost of admission is included in the cost of the operation
ENT diagnostics
ENT manipulation
Possible ENT manipulations in the postoperative period
| medical service | price, rub. |
|---|---|
| Removal of tampons from the nasal cavity with treatment of the nasal cavity | 500 |
| Sanitation of the nasal cavity | 500 |
| Nasal toilet | 500 |
| Session of laser photodynamic therapy of the nasal cavity and nasopharynx | 1000 |
| Laying medicinal ointment in the nasal cavity | 500 |
| Session of ultrasonic medicinal irrigation (device "TONZILOR-M") | 1000 |
| Session of infrared laser therapy of the nasal cavity and nasopharynx | 200 |
| Session of ultraviolet irradiation of the nasal cavity and nasopharynx | 200 |
| Session of vibroacoustic therapy in the projection of the maxillary sinuses | 200 |
| Session of magnetotherapy with the device "POLYUS - 2D" | 200 |
| Percutaneous infrared laser treatment with RVB device (Italy) | 200 |
** - discount is provided for complex treatment of the disease
Nasal polyps are a problem that affects approximately 4% of all inhabitants of the planet. Pathological proliferation of mucous tissues in the nasal cavities leads to the appearance of these benign formations, which may resemble peas, mushrooms or grapes in shape. As a result, the affected person feels gradually increasing nasal congestion, which, over time, gives him more and more inconvenience. When the disease reaches the last, most advanced stage, the patient can no longer breathe through his nose. In addition to the elementary inconvenience, the presence of polyps in the nasal cavities can cause a whole range of respiratory diseases in chronic and acute forms.
Why do nasal polyps appear, why are they dangerous
Nasal polyps are hypertrophied, overgrown mucous tissue that takes the form of clustered multiple tumors. The reasons for the appearance are polyetiological in nature. Their appearance can be facilitated by the anatomical features of the structure of the nasal cavities, for example, the curvature of the nasal septum or too narrow nasal passages, chronic inflammatory processes of the mucous membranes (pharyngitis, ethmoiditis, sinusitis). Allergic people with diagnosed hay fever, asthmatic bronchitis, and allergic rhinitis are susceptible to the development of polyps. Another factor that contributes to the formation of polyps is cystic fibrosis.
Against the background of chronic inflammation of the mucosa, the tissue tries to fight the destructive process in order to weaken or compensate for the pathological phenomenon. Compensatory function is carried out by increasing the area of the mucous membrane, which takes the form of polyps. The good quality of formations is explained by the fact that pathological changes do not affect the structure and functions of the cells themselves, and do not cause their degeneration.
In men, this disease is determined approximately 4 times more often than in women.
The development of nasal polyps goes through three stages: at first, the polyps are of small size, and the affected person does not even feel their presence. Further, gradually, they occupy more volume of the nasal cavities, which makes it more difficult for the patient to breathe. The feeling of nasal congestion increases every day. The third stage is considered the most neglected, when a person cannot breathe normally through his nose at all, and congestion does not go away after the use of medications.
In a normal state, the air enters the body through the nose, warmed up, moistened and cleaned of small foreign particles. Constant mouth breathing, when the air is not heated to the desired temperature, contributes to the development of certain diseases:
- tracheitis;
- bronchitis;
- pneumonia;
- pharyngitis, and some others.
Such a pathology of the respiratory tract can even shorten the life of the affected person, as it exposes him to a constant risk of various diseases in acute and chronic forms.
Diagnosis and treatment of polyps
Unpleasant symptoms that the patient himself can pay attention to are the first thing the doctor pays attention to when the patient first comes to see him. Depending on the stage of development of polyps, their manifestations may differ. At the very beginning of the disease, the patient may not feel nasal congestion, and have no problems with nasal breathing, but his voice becomes noticeable nasal.
In addition, symptoms of the appearance of polyps in the nose can be such conditions:
- increased fatigue;
- headache;
- sleep and olfactory disturbances;
- sensation of a foreign body;
- when the polyps reach large sizes, an unpleasant aftertaste may be felt in the mouth;
- frequent sneezing;
- increased secretion of mucus from the nose.
The growing connective tissue can put pressure on the auditory tube, causing the patient to hear worse, and he may develop otitis media.
If nasal polyps are formed in infancy, the child develops a malocclusion and sucking movements are disturbed, he is not able to swallow the food bolus normally, so malnutrition and malnutrition are observed in such children.
The attending physician directs the patient to endoscopy and rhinoscopy to determine the cause of nasal breathing difficulty. To assess the extent of damage to polyps, a computed tomography may be prescribed.
In addition, the patient will need to pass a general blood test and a bacterial swab from the nasal cavities. If the formation of polyps occurs against the background of allergic reactions, the patient is assigned an allergy test.
Treatment of nasal polyps can occur in two ways:
- conservative therapy;
- surgical removal.
Conservative treatment includes drug therapy, physiological procedures (washing of cavities, special gymnastics), diet.
Surgical intervention does not require a full-fledged operation, tissue incisions or crushing of bone structures. Removal is done:
- using an endoscope and a shaver;
- laser.
Technology of laser removal of nasal polyps
The impact on the mucous tissue with a laser occurs in the form of a minimally invasive endoscopic procedure, which is characterized by low trauma for healthy tissues located close to the affected ones. Through the introduction of an endoscope with a camera and special optics or a camera, a nozzle producing a laser beam penetrates into the nasal cavities. The laser destroys the leg of the neoplasm, after which the cut-off tissue is removed, and the wound is subjected to coagulation. The operation is performed with minimal blood loss.
Indications and contraindications for surgery
The implementation of laser removal of polyps in the nose is prescribed in cases where the patient is concerned about such symptoms and pathologies:
- complete violation of nasal breathing;
- chronic sinusitis, sinusitis;
- curvature of the nasal septum;
- snoring and impaired sense of smell;
- severe bronchial asthma, which is accompanied by nasal congestion;
- mucopurulent discharge from the nose.
It is advisable to prescribe this method of getting rid of polyps if a single polyp is found.
Laser removal of polyps in the nose also has a number of contraindications:
- pregnancy;
- diseases of internal organs;
- exacerbation of any infectious diseases;
- exacerbation of bronchial asthma or allergic rhinitis;
- acute forms of obstructive bronchitis or hay fever;
- colds, fever, hypertension.
Any exacerbations must first be transferred to a state of remission, after which an operation can be performed.
Advantages and disadvantages of the laser removal method
A study of the statistics of the results of the procedure suggests that, compared with a traditional surgical operation, laser intervention:
- does not require general anesthesia;
- can be carried out not only in a hospital, but also in an outpatient clinic;
- has a low degree of trauma;
- carried out quickly;
- occurs with a minimal likelihood of bleeding, due to the simultaneous coagulation of damaged tissues.
The main disadvantages of the operation are that effective laser removal is possible only if the neoplasms are small and single. It should also be noted that the procedure does not affect the causes of the disease, but only helps to cope with their consequences, so the probability of recurrence is about 50%.
How is the removal of nasal polyps with a laser
On the eve of the operation, the patient should not take food and liquids 6 hours before it starts, and dinner should be light in the evening.
Taking any medication before the procedure must be agreed with the doctor who will carry it out.
Before starting the removal, the surgeon cleans the nasal passages from pus and mucus, after which he injects local anesthesia into the operated person.
When the anesthesia has worked, the doctor inserts a laser light guide into the nasal cavity - a device that produces radiation. In 30-60 seconds, the neoplasm is heated by a laser beam to 100 degrees, its cells lose moisture and are destroyed, thanks to which the doctor can cut off the polyp at the base. With a special medical tweezers, the doctor removes the cut-off polyp. The laser beam also produces tissue coagulation.
The duration of the procedure is about 15 minutes. Even though anesthesia is used, it can cause some discomfort and pain to the patient.
After completing the removal manipulations, the doctor checks their effectiveness using an endoscope. If necessary, laser exposure is repeated after 7 days.
Postoperative period: rehabilitation and recovery of the patient
Laser removal is one of the gentle methods of surgical intervention, but after it it is still necessary to follow some rules that contribute to the rapid and safe healing of the wound. In the first few days after the procedure, the patient should not blow his nose or otherwise clear his nose, and it is also forbidden to eat hot food. During this period, it is undesirable to lift weights, as this can cause bleeding.
In addition, you should avoid being in the sun, as well as staying in dirty and dusty rooms. At home, it is necessary to do wet cleaning twice a day, using a gauze mask, in addition, the home must be periodically ventilated.
Allergy sufferers are shown a diet. As a restorative therapy, the doctor may prescribe some drugs - hormonal sprays, antihistamines, which can be started 3-4 days after the intervention.
Postoperative recovery lasts approximately 14-20 days.
Laser exposure to polyps that have grown in the nasal cavity is an operation that minimally injures the mucous tissues in the nose. In the process, the doctor uses a laser beam that literally cuts off the polyp from its base, and at the same time cauterizes the wound to prevent bleeding or pathogens from entering there. At the same time, healthy, closely located tissues are practically not affected.
Benign neoplasms that are round or drop-shaped, painless, which form in the nasal cavity due to the growth of the mucous membrane - this is nasal polyps.
Outwardly, they look like a pea, a drop or a bunch of grapes. Approximately 3-5% of people suffer from the disease, and men are several times more likely than women. The disease manifests itself as characteristic mucous secretions and constant nasal congestion.
The difference between polyposis and rhinitis is that after using vasoconstrictor drugs, breathing is not restored, the patient is forced to continue breathing through the mouth.
Surgery to remove polyps in the nose. Indications
- for a long time the patient has a stuffy nose or there is no breathing through the nose at all;
- pronounced deformed (curved) nasal septum;
- the presence of complications of polyposis (bronchial asthma, atrophic rhinitis);
- impaired taste and smell, in some cases a complete loss of sensitivity;
- snoring, nasality, headaches;
- constant, nasal discharge (unpleasant smell, rarely bloody).
The only effective treatment option for tumors is surgical removal.
How are nasal polyps removed?
Several existing surgical options:
- polypotomy;
- removal with a shaver;
- laser operation;
- endoscopic removal.
Any of these methods requires some preparation of the patient. To do this, they do x-rays, according to indications, computed tomography, blood tests, and conduct drug preparation.
Removal of polyps in the nose in modern surgical practice is carried out according to an individually selected technique.
Polypotomy ordinary
Such an intervention is too painful and is currently very rarely prescribed by specialists. Nose growths are removed using a special steel loop or Lange hook. It is more often used in cases where there is a need to remove several growths.
used in cases where there is a need to remove several growths.
Surgical intervention technique
:
anesthesia is carried out locally (novocaine 1% solution is injected directly into the growth). The loop (through the nostril) captures the polyp by the leg. The doctor narrows the lumen of the loop and cuts off the formation. There are practically no scars after polypotomy.
This procedure is strictly contraindicated when:
- any diseases in the acute period,
- diseases of the hematopoietic system and heart,
- bronchial asthma.
After operation
After the performed polypectomy, the mucosa must be disinfected, and the organ is tamponed with turundas. Tampons are removed after 24 hours, and the mucosa is lubricated with Synthomycin emulsion.
If necessary, the specialist prescribes for the nose. The patient stays in hospital for 5-7 days, and the recovery period takes 2-3 weeks. Source: website
Endoscopic removal of nasal polyps
Endoscopic removal is a technique that allows you to remove modified tissues and, if necessary, correct the nasal septum. After surgery, traumatic scars and scars do not remain in the nose.
Methodology :
Local anesthesia is used during the intervention.
an endoscope with a camera is inserted into the nasal cavity (through the nostril). An image of the nasal cavity is displayed on a computer screen.
Contraindications to the intervention are:
- chronic or allergic bronchitis and rhinitis,
- bronchial asthma,
- in women - menstruation.
Postoperative period
Immediately after the operation, the patient has an unpleasant feeling (slight discomfort), which disappears after 3-6 hours. Relief of nasal breathing occurs after the operation in 24-48 hours, and the sense of smell is restored within a month.
The patient is discharged from the hospital in a day, and after 3 days the person returns to his usual life. In the period after the operation, it is necessary to exclude blowing your nose.
Removal with a shaver
One of the methods of endoscopic surgery, which with maximum accuracy allows you to get rid of formations and overgrown mucosa. The intervention is performed under local or general anesthesia.
Shaver- a device that crushes growths, then sucks them into a special tip. The device with maximum accuracy removes the build-up to healthy tissue.
Methodology :
The operation to remove polyps is low-traumatic, bleeding occurs in 0.5% of the operated patients, the risk of complications and relapses is minimal. This technique allows you to remove polyps in the sinus cavity, as well as to keep the healthy mucosa intact as much as possible.
Shaver- the only technique using which, the occurrence of repeated growths does not happen. Contraindications: acute viral infections and inflammatory processes.
Postoperative period
The patient stays in the hospital for up to 5 days. All this time, saline washings are carried out (in order to get rid of tissue residues).
In order to prevent the growth of connective tissue, local use of steroid preparations is recommended. Antibiotics are prescribed to prevent secondary infection.
Laser removal of nasal polyps
using a laser, a new modern technique. The operation is performed on an outpatient basis, under local anesthesia.A specialist inserts laser equipment and an endoscope with a camera into the nasal cavity.
The laser beam directed at the formation heats its cells, and this causes their death. During the operation, the laser coagulates the vessels, which prevents bleeding.
The main advantage: infection of the wound is completely excluded. This technique is the safest among all known, therefore it is used for children and people who suffer from bronchial asthma.
Disadvantages of the procedure: during the operation, the sinuses are not opened, so it is impossible to remove the polypous tissue from them, and this may cause a relapse in the future.
Contraindications:
- pregnancy period,
- the presence of multiple polyps in the nose,
- obstructive bronchitis,
- spring-summer period.
Period after surgery: what to do
After removal, the patient is at home, but for several days he goes to see the doctor. During the week it is recommended to cancel sports, it is forbidden to visit the sauna or bath (these procedures can cause bleeding). Special medications will help prevent relapse.
All materials on the site are prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative and are not applicable without consulting the attending physician.
Polyps are outgrowths of the mucous membrane due to excessive proliferation of its glandular tissue. Polyps can form anywhere in the body where there is a mucous membrane. The nasal cavity is no exception. It is believed that about 4% of the population has nasal polyps.
The causes of polyps are different, mainly:
- Violation of the aerodynamics of the nasal cavity.
- Chronic inflammatory process in the paranasal sinuses.
- Allergy, in this case, polyposis is usually combined with bronchial asthma.
Polyps can form both from the mucosa of the nasal cavity itself, and (more often) from the mucosa of the paranasal sinuses. At the same time, polyps that have arisen in the sinuses of the nose “fall out” through the fistulas into the nasal cavity and continue to increase in size and block the nasal passages. In children, antrochoanal polyps (derived from the maxillary sinus) are more common, in adults - ethmoid polyps (growing from cells of the ethmoid labyrinth).
Polyps in the sinuses are usually multiple, outwardly they resemble a bunch of grapes. With excessive growth, they come out of the fistulas of the sinuses and are located in the nasal cavity.
Why polyps need to be removed
In the initial stage, polyps are tried to be treated conservatively, but usually these measures do not work. Sooner or later, they still have to be removed surgically.
Removal of polyps is one of those operations that many patients themselves ask doctors for. Mainly because the violation of nasal breathing greatly disrupts normal life. A person cannot breathe through his nose, he does not feel very well from this, it prevents him from working, and no one frees him from work.
Who is shown the removal of polyps
Intervention is indicated for the following groups of patients:
- Patients with complete nasal congestion.
- The combination of polyposis with a curvature of the nasal septum.
- The combination of polyps with chronic rhinitis, chronic sinusitis, not amenable to conservative treatment.
Preparing for the operation
At the first examination, the ENT doctor performs a rhinoscopy at the reception. Polyps with rhinoscopy are usually clearly visible.
However, to clarify their number, size, degree of damage to the nasal mucosa and sinuses, clarifying examinations are usually prescribed:
- X-ray of the paranasal sinuses.
- Computed tomography of the sinuses.
- Videoendoscopic examination of the nasal cavity and sinuses.
When the indications and scope of the operation are determined, it is necessary to choose the right time and prepare for it. So, with purulent rhinitis or rhinosinusitis, it is necessary to undergo a course of antibiotic therapy based on the results of bakposev purulent discharge.
No operation scheduled:
- During the flowering season, when the course of allergic rhinitis and asthma worsens.
- For acute infectious diseases
- Decompensated course of chronic diseases of the heart, liver, kidneys.
- Violation of blood clotting.
- During pregnancy.
2 weeks before the operation, you must undergo:
- General blood and urine tests.
- Coagulogram.
- Biochemical analysis.
- Electrocardiography.
- Chest x-ray.
- Blood for markers of viral hepatitis, syphilis, HIV.
- Therapist's review.
A few days before the operation, drugs that prevent blood clotting (aspirin, warfarin) are canceled. Decongestants and anti-inflammatory drugs (ketotifen, dexamethasone) are prescribed.
Types of operations to remove nasal polyps
To date, the following types of interventions are carried out:
- The usual polypotomy. The oldest, most traumatic, but also the cheapest operation.
- Endoscopic removal of polyps.
- Removal of polyps with a laser.
- Radio wave polypotomy.
It must be said that nasal polypotomy is very often combined with other operations:
- With drainage of the paranasal sinus in chronic sinusitis, ethmoiditis, sphenoiditis.
- Correction of deviated nasal septum.
- With resection of the nasal concha (conchotomy).
Conventional polypotomy
Removal of polyps is carried out with a special polyp loop: the loop is thrown over the polyp and gradually tightened at its base, pulled out and torn off. The art of the surgeon should not be to cut the polyp with a loop, but to pull it out with a leg (“with a root”). The risk of recurrence with such a correct removal is much less.
The operation is usually performed under local infiltration anesthesia with novocaine, lidocaine or ultracaine. Additionally, the anesthetic is applied to the nasal mucosa (together with vasoconstrictor drugs).
The position of the patient is sitting, a tray for flowing blood is placed under the chin. The duration of the operation is 40-60 minutes.
Usually, all polyps visible during anterior rhinoscopy are removed. Those polyps that were not noticed during the first operation are removed after 1-2 weeks.
After the removal of one or more polyps, the nasal cavity is tamponed with turundas lubricated with petroleum jelly and a sling-like bandage is applied.
The next day, the turundas are removed, the nasal cavity is washed with antiseptics and saline solutions. After 3-5 days, with a favorable course, the patient is discharged from the hospital.
Disadvantages of the method:
- The operation is the most traumatic, always accompanied by bleeding of one degree or another.
- The longest recovery period.
- This method can remove polyps that only grow in the nasal cavity. That is, if a polyp grows from the sinus, it is impossible to remove it completely to the base.
- This method is most often accompanied by relapses (up to 70%). That is, the polyps grow back within a year.
To benefits The method can be attributed to its availability and low cost, since in this case expensive equipment is not required.
Endoscopic surgery
Endoscopic surgery of the nasal cavity and paranasal sinuses is increasingly gaining a niche in the surgical treatment of this area. With the help of a microendoscope, almost all operations in the nose, including the removal of polyps, can be performed.
The endoscope displays a magnified image on the monitor screen. This allows the surgeon to perform manipulations both in the nasal cavity and in the cavities of the paranasal sinuses with maximum accuracy.
Endoscopic removal of polyps can be performed under local or general anesthesia. The choice of anesthesia depends both on the volume and expected duration of the operation, age (general anesthesia is used for children under 7 years of age), and on the preferences of the patient himself.
Endoscopic removal of polyps can be performed in three ways:
- Polypotomy with microinstruments without shaver.
- Removal of polyps with a shaver (microderiber).
- Shaver removal with navigation.
removal of polyps with a shaver
Removal of polyps with a shaver is the most convenient way of this type of operation. A shaver is a special tool that has a tip with a set of various cutting nozzles and suction. The use of a shaver allows you to very accurately, within healthy tissues, with minimal trauma, remove all polyps both in the nose and in the sinuses.
The shaver is brought to the polyp, cuts it off together with the leg, crushes and sucks.
The use of video navigation makes it possible to revise the paranasal sinuses and remove all polyps in them (mainly in the cells of the ethmoid labyrinth).
The whole procedure lasts 50-60 minutes. After the operation, the nasal cavity is plugged for a day. Terms of inpatient treatment - 2-3 days. Sometimes the patient can be sent home immediately.
Video: endoscopic shaver removal of nasal polyps
After polypotomy
The patient usually stays in the hospital for observation for several days. A day later, the turunda is removed, the nasal cavity is washed with antiseptics and lubricated with synthomycin ointment or petroleum jelly to soften the crusts. For the same purpose, irrigation of the nasal cavity with saline solutions or the use of oil drops (Pinosol, sea buckthorn oil) is used.
Antibiotics are prescribed to prevent infectious complications. A week after the removal of polyps, the use of anti-inflammatory and antiallergic drugs (Nasonex spray) is recommended.
In the postoperative period, you can not:
- Pick crusts in the nose.
- Blow your nose hard.
- Take hot food.
- Take a hot bath or shower.
- Lift weights.
- Take alcohol.
According to patients, nasal breathing is restored after a few days, and the sense of smell resumes within a month.
Complications that may occur after a polypectomy:
- Bleeding.
- Inflammation - rhinitis, rhinosinusitis.
- The formation of adhesions.
- Re-formation of polyps (unfortunately, recurrence of polyps is a major problem even in endoscopic surgery, the recurrence rate is about 50%).
Removal of polyps with a laser
Laser removal of polyps is perhaps the safest method of polypectomy. Removal of polyps with a laser can be performed on an outpatient basis, under local anesthesia.
It is often used to remove polyps in children, as well as those with chronic diseases.
The essence of the operation is that the polyp tissue is simply “evaporated” under the influence of high-precision laser energy. The operation is performed under the control of the endoscope. The procedure is quick and takes no more than 15-20 minutes. Bleeding is not observed, as the laser seals the vessels. The risk of infection is also minimal. Nose packing is not required.
However, the use of laser polypotomy is limited: only single polyps can be removed by this method, and only those located in the nasal cavity. With multiple polyps and polyposis of the paranasal sinuses, laser treatment will not solve the problem.
Radio wave polypotomy
It is carried out by the Surgitron apparatus using a radio wave loop. The operation is also almost bloodless and can be performed on an outpatient basis. It is used to remove only large and medium polyps.
Main conclusions
Let's summarize:
- Surgical treatment of polyps is a thankless task. None of the operations to remove polyps from the nose guarantees their re-growth.
- The smallest percentage of relapses gives complete endoscopic removal of polyps in the nasal cavity and in the paranasal sinuses. When removed in this way, the time until the re-formation of polyps is stretched to 5-6 years.
- If the patient has the opportunity to choose, then you need to choose a clinic with modern video endoscopic equipment, with sufficient experience in performing such operations. Of all the methods, the most effective is the shaver removal of polyps with navigation.
- It is advisable to simultaneously eliminate all defects that can contribute to the re-formation of polyps (correct the crooked nasal septum, resect the hypertrophied nasal concha).
- After the removal of polyps, it is necessary to follow all the recommendations, as well as use agents that inhibit the growth of polyposis tissue (mainly local hormonal preparations), undergo an examination and treatment by an allergist.
The cost of polyp removal surgery
The most budgetary option is polypotomy in the usual way using a polyp loop. It can be carried out free of charge in any ENT department. In paid clinics, it costs from 2000 rubles (on the one hand).
Endoscopic removal of polyps will cost from 15 to 35 thousand rubles (depending on the volume of the operation, the rank of the clinic, the duration of inpatient treatment). The operation under general anesthesia will cost up to 70 thousand rubles.
Laser removal of a polyp will cost about 8-10 thousand rubles.
Video: removal of polyps in the nose in the Health program
Removal of polyps in the nose with a laser- a minimally invasive operation, during which the destruction of polypous tissue is performed using a laser beam under the control of an endoscope. The indication for intervention is polyposis of the nasal cavity. The technique can be used in patients with bronchial asthma and patients with deviated nasal septum. The intervention is performed in a hospital under local anesthesia against the background of mandatory preoperative therapy and postoperative treatment to prevent recurrence. Removal of polyps in the nose with a laser is carried out without incisions. The formation is destroyed in the region of the stem and removed, the base of the polyp is coagulated.
Polyps are benign growths of the nasal mucosa caused by structural changes in epithelial tissues. The occurrence of polyps is facilitated by allergic diseases (allergic rhinitis, hay fever, bronchial asthma), chronic inflammation of the paranasal sinuses (sinusitis, ethmoiditis, frontal sinusitis), anatomical disorders of the nasal cavity structure (narrow nasal passages, deviated nasal septum), etc. As polyps grow, they can block the nasal passages, cause difficulty or complete blockage of nasal breathing, cause constant runny nose or sneezing, purulent or mucous discharge from the nose, headaches, worsening or disappearance of the sense of smell.
Specialists in the field of otolaryngology use several methods for removing polyps in the nose: using a laser, polyp loop, polypotomy, endonasal endoscopy, radio wave method, cryosurgery and other methods. The advantages of removing nasal polyps with a laser are low invasiveness of the operation, maximum sterility of the laser procedure, minimization of blood loss due to the coagulating effect of the laser, and endoscopic control of the surgical process. The limitations of the method are associated with the number of polyps; in the case of widespread polyposis, polypotomy is more often resorted to.
Indications and contraindications
The need for surgery is due to the possible malignancy of polyps, as well as the constant symptoms that cause and maintain these formations. Excision of polyps in the nose with a laser is indicated in the case of single formations that cause nasal congestion, difficulty in nasal breathing, impaired olfactory function, inflammation in the paranasal sinuses, discharge from the nasal passages, and snoring. The technique can be recommended for patients with bronchial asthma. The flexible light guide of the laser allows the removal of polyps even with a deviated nasal septum.
Contraindications to surgery are bronchial asthma and chronic obstructive bronchitis in the acute stage. Intervention is not performed during pregnancy and during the flowering period of plants that cause allergies. Before surgical treatment, rhinoscopy, CT or radiography of the paranasal sinuses are performed, a study of general clinical blood parameters and a coagulogram is prescribed, and desensitizing preparation is carried out.
Methodology
The procedure for removing polyps in the nose with a laser is carried out in an ENT hospital under local anesthesia and endoscopic control. The otolaryngologist on the monitor assesses the prevalence of the polyposis process. Under optical control, the doctor brings the laser light guide to the polyp. Under the action of a laser, polypous tissues instantly heat up, and coagulation of the mucosal vessels occurs at the same time. The laser has a dual effect: it cuts off dense old polyps like a surgical knife in the base area, and evaporates young polyposis tissues containing enough water. With the help of tweezers, the formations are removed from the nasal cavity. The operation lasts 15-20 minutes. If necessary, additional sessions of laser destruction are prescribed with an interval of 7-10 days.
After operation
Exposure to a laser beam eliminates bleeding and the formation of postoperative scars, and almost immediately improves nasal breathing. After the intervention, endoscopic quality control of the operation is carried out, drug therapy is prescribed and a consultation with an allergist-immunologist. Removal of polyps does not eliminate the causes of polyposis sinusitis, therefore, relapses are possible in the long term.
The cost of removing polyps in the nose with a laser in Moscow
Excision of polyps using a laser and endoscopic techniques is a modern minimally invasive technique used by doctors of specialized centers and multidisciplinary medical institutions that have otolaryngology departments and have the appropriate equipment. The price of removing polyps in the nose with a laser in Moscow is determined by the organizational and legal status of a medical organization, the level of professionalism of the operating otolaryngologist, and the technical characteristics of laser and endoscopic equipment.
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