Removal of polyps in the nose. Operation: laser, shaver, endoscopic removal. How nasal polyps are removed using a shaver and how much it costs Removal of nasal polyps by radio wave method

nasal polyps- These are rounded benign, painless to the touch formations that are the result of an overgrowth of the nasal mucosa. Outwardly, they look like a pea, a mushroom or a bunch of grapes.

According to statistics, nasal polyps are one of the most common complications of chronic rhinitis. Nasal polyposis affects 1-4% of the population. Men are 3-4 times more susceptible to it than women. Anthrochoanal polyps are more common in children, while ethmoid polyps are more common in adults.

The disease is manifested by nasal congestion and mucous secretions. Unlike the common cold, breathing does not improve after the use of vasoconstrictor drops. The person is forced to breathe through the mouth. And as a result, dry air enters the lungs, insufficiently purified from dust and allergens. This causes frequent respiratory illnesses and asthma. As a result, polyposis reduces the life expectancy of a person by 6 years.

nose anatomy

The internal structure of the nasal passages is more complex. The nasal cavity is formed by the nasal septum, which consists of a vertical plate of the ethmoid bone, vomer and cartilage. For many people, this septum is curved. Minor changes are considered a variant of the norm.

The nasal cavity has four walls:

• lateral
• internal
• top
• lower

Between the nasal septum and the nasal conchas is a space called the common nasal passage. In the lateral sections of the nose there are three nasal passages, each of which corresponds to the nasal concha. The opening of the nasolacrimal canal opens in the lower nasal passage.

Also, the lumens of the paranasal sinuses open into the nasal cavity. These are small "pockets" in the bones of the skull that contain air.

• The maxillary sinus is located in the upper jaw
• The frontal sinus is located in the frontal bone
• Ethmoid labyrinth in the ethmoid bone
• Sphenoid sinus in the main (sphenoid) bone

1. Prevents hypothermia. Warms cold air before it enters the lungs.
2. Humidifies and filters the air from dust, allergens and microorganisms. Detains these particles on the hairs and mucous membranes, neutralizes and prevents them from entering the respiratory tract.
3. Participates in the formation of voice, playing the role of a resonator.
4. Provides odor discrimination.

On the surface there are goblet and ciliated cells with numerous cilia, as well as short and long intercalated epitheliocytes, which are responsible for renewing mucosal cells.

The protective function of the inner lining of the nose is provided by ciliated cells of the ciliated epithelium. Each of them has 250-300 cilia a few microns long. Cilia retain the smallest particles of substances that are contained in the air. With oscillatory movements, the cilia sends these substances to the nasopharynx.

The protective factor is mucus, which is produced in the nose by mucous glands and goblet cells. It prevents the nasal cavity from drying out, and foreign particles also stick to it. Then this contaminated mucus is pushed out by the movement of the cilia and a natural cleansing of the respiratory tract occurs.

Causes of nasal polyps

If the disease is not treated, then it can drag on and become chronic. A prolonged inflammatory process undermines local immunity and the strength of the mucous membrane. But she tries to fulfill her functions by increasing the area. As a result, it begins to grow intensively and thicken due to the growth of connective tissue. It often occurs in the paranasal sinuses. At a certain point, hyperplastic (overgrown) mucosa exits the sinus opening into the nasal cavity - this is commonly called a polyp.

The cause of the appearance of polyps can be:

• frequent colds and infectious diseases, accompanied by a runny nose
• chronic sinusitis (inflammation of the paranasal sinuses - sinusitis, frontal sinusitis, ethmoiditis)
• allergic rhinitis caused by inhalation of household and library dust, plant pollen, fungal spores, animal hair, particles of household chemicals, chromium compounds
• a severe curvature of the nasal septum, causing respiratory failure and mucosal overgrowth
• hereditary tendency to form polyps
• pathological reaction of the immune system

According to the place of origin, polyps are divided into:

• Anthrochoanal - often arise from the mucosa of the maxillary sinus. Settled on one side. More common in children.
• Ethmoidal- develop from the mucosa lining the ethmoid labyrinth. Occur on both sides of the nasal septum. Affect adults.

• First stage - polyps cover only a small part of the nasal space
• The second stage - the connective tissue grows so much that it covers a significant part of the lumen of the nasal cavity.
• The third stage - polyps completely block the respiratory passage.

Symptoms of nasal polyps

With nasal polyposis, the following symptoms occur:

• Prolonged difficulty in nasal breathing, feeling of nasal congestion. This is due to the fact that the overgrown mucosa partially or completely blocks the lumen of the nasal passage.


• Runny nose, mucous or mucopurulent discharge. These are signs of secondary infection and intense work of the mucous glands.


• sneezing with polyps in the nose, it occurs due to the fact that the outgrowth of the mucous membrane touches the cilia, and they perceive it as a foreign object. And sneezing is a defensive reaction that allows you to get rid of it.


• Olfactory disorders, up to a complete loss of sensitivity to odors. With the growth of connective tissue, the work of receptor cells that perceive odors is disrupted in the polyp.


• Headache is a consequence of compression of the overgrown tissue of nerve endings. The lack of oxygen caused by polyps causes oxygen starvation of the brain. Often pain is associated with inflammation of the paranasal sinuses.


• Voice disturbances, nasality. The nose is the organ that takes part in the formation of the voice. With polyposis, the passage of air is disturbed and this causes the person to speak “into the nose”.

Treatment of nasal polyps

With allergic rhinitis, which is one of the causes of the disease, a number of allergy tests are performed. This is necessary in order to determine what exactly causes allergies. After that, it is necessary to avoid contact with this substance and undergo a course of treatment with antiallergic drugs (Loratadine, Cetirizine).

If the cause is chronic inflammation of the sinuses, then these diseases are treated with antibiotics (Macropen, Ceftriaxone).

In the event that polyps are caused by aspirin intolerance, it is necessary to exclude from the menu all foods rich in salicylates (strawberries, gooseberries, cherries, currants), some food additives and dyes. Also stop taking all non-steroidal anti-inflammatory drugs that contain acetylsalicylic acid.

Treatment with topical steroids (Beclomethasone, Mometasone, Fluticasone) helps to reduce the size of nasal polyps, relieve inflammation and swelling of the mucosa. They give a good therapeutic effect, but have a significant drawback. Treatment requires long-term use of large doses of steroids, and this can cause serious side effects.
For treatment, mast cell membrane stabilizers - cromoglycates (Ketotifen, Cromoglycate sodium) are used, which can stop the release of histamine in the body. This substance causes manifestations of allergies, swelling of the mucous membranes and increased activity of the respiratory tract.

In recent years, immunotherapy has become widespread. To restore the functions of the immune system, immunocorrective preparations of bacterial origin are used (Ribomunil, Polycomponent vaccine VP-4). They contain bacterial antigens and nonspecific immunomodulators in the form of lipopolysaccharides. These funds cause the production of special antibodies in the body, which increase immunity.

In the event that the patient turned to the doctor at a late stage or when drug treatment did not work, an operation to remove polyps may be prescribed.

Indications for surgical removal of polyps are:

1. frequent asthma attacks
2. complete nasal congestion
3. bloody or foul-smelling discharge from the nose
4. severe deviated nasal septum
5. inflammation of the paranasal sinuses
6. smell and taste disorders

1. What medications the person is taking (such as anti-inflammatory birth control)
2. About the presence of chronic diseases
3. About problems with the cardiovascular system
4. About cases of allergy to medicines and other substances

Be sure to do blood tests: general, biochemical, clotting.

Medical preparation for surgery:

• Ketotifen is prescribed 10 days before the procedure to eliminate allergies.
• 3 days before surgery, a daily administration of Dexamethasone solution is prescribed to prevent inflammation, allergic reactions and edema
• On the eve of the operation, sleeping pills and a cleansing enema are usually prescribed.
• A few hours before the operation, a 2% solution of Clemastine (an anti-allergic and sedative drug) is administered.
• An hour before the procedure, an injection of diphenhydramine (intramuscularly 3-5 ml of a 1% solution) and atropine sulfate (subcutaneously 1 ml of a 0.1% solution) is given, they have an analgesic and sedative effect.

How to remove nasal polyps. Operation types

Conventional polypotomy

On the day of surgery, you must refrain from eating. The procedure is performed under local anesthesia. 2 ml of 1% novocaine solution is injected into the area of ​​the polyp. A loop is inserted through the nostril and the polyp is captured with it. Gradually, the lumen of the loop is narrowed around the stem of the polyp and cut off. The Lange hook is used when it is necessary to remove a polyp that has arisen from the ethmoid labyrinth. The duration of the procedure is from 45 minutes to an hour.

During the operation, the patient sits in a chair and holds a kidney-shaped coxa. His head is covered with a sterile sheet. After the operation, the mucosal surface is disinfected. If necessary, the nose is plugged. Turundas soaked in vaseline are inserted into the nose and secured with a sling-like bandage. This procedure leaves no scars and bleeding is usually very minor.

After the operation, the patient remains in the hospital for several days. Tampons are removed the next day and smeared with synthomycin ointment. As prescribed by the doctor, the patient goes to wash the nose. After 5-7 days, the doctor discharges the patient home. The full recovery period takes from 10 to 20 days.

Contraindications to this procedure are: an acute period of colds, blood clotting disorders, heart problems. In bronchial asthma, a simple polypotomy can cause status asthmaticus. Therefore, it is advisable for such patients to choose another method for removing polyps.

A significant disadvantage of this intervention is that the polyp re-grows in 70% of cases. And the patient may need a second operation after 6-12 months.

Endoscopic surgery

After the operation, there is a feeling of discomfort, which passes quite quickly. The patient feels a significant relief of breathing. For 2-3 days, bloody or mucous (not purulent) discharge is possible. After a day, the patient is discharged home, and after 3 days he can go to work.

In the postoperative period, Pinosol oil drops are prescribed 3 times a day for a period of 5 days. Then spray Nasonex.

Contraindications: exacerbation of bronchial asthma and chronic bronchitis, flowering period of plants, if they are the cause of allergic rhinitis. In women, the operation is planned in such a way that it does not coincide with menstruation.

Removal with a shaver

A shaver or microdebrider removes polyps to healthy tissue as accurately as possible. He, as it were, crushes neoplasms and sucks them up. The operation is less traumatic and allows you to preserve the healthy mucosa as much as possible. The risk of bleeding is minimal. If necessary, the doctor can correct all anatomical defects of the nose and remove polyps inside the sinuses. This is the only method after which there are practically no repeated polyps.

After the operation, the patient remains in the hospital for 3-5 days. During this period, rinsing with saline is prescribed to remove residual tissue, antibiotics to prevent secondary infections. Topical steroid preparations are prescribed to prevent the re-growth of connective tissue.

Contraindications to the procedure: acute inflammatory processes, colds, the risk of allergies.

Removal of polyps with a laser

After the operation, the patient should come to see a doctor for several days to control the condition of the mucosa. It is not recommended to drink alcoholic beverages, go to the bathhouse and play sports. This may cause bleeding. Special aerosols are often prescribed to prevent the recurrence of polyps.

A contraindication to the procedure is pregnancy, obstructive bronchitis, flowering period of plants, multiple nasal polyps. A significant disadvantage is that during this operation the sinuses are not opened and the polypous tissue in them is not removed.

Answers to frequently asked questions

What is the effectiveness of the treatment of polyps with folk remedies?

Treatment of polyps with folk remedies eliminates the very cause of the disease. Natural components act on the body in a complex way. They help restore the normal functioning of the nasal mucosa and reduce the size of polyps.

However, if the connective tissue has grown strongly, and the polyp has reached a large size, then with the help of natural remedies it will not be possible to get rid of it. In this case, the tumor needs to be removed. And after the operation, folk remedies are used to prevent recurrent polyps.

Treatment of nasal polyps with folk remedies

1. Recipe from a series
   The stem and flowers of fresh succession are crushed. Then pour boiling water at the rate of 1 tbsp. l. strings in 200 ml of water and boil for 10 minutes over medium heat. The resulting broth is cooled and filtered. Using a pipette, 2-3 drops are instilled into each nasal passage, 2 times a day. The course of treatment lasts 20 days.


2. Anise Drops
   It is necessary to take 15-20 g of dry anise and grind it. Pour the grass with 100 ml of alcohol and let it brew for 8 days in the refrigerator. Shake the tincture thoroughly before use. Then dilute with boiled water at room temperature in a ratio of 1:3. The resulting composition must be instilled 3 times a day, 10 drops in each nostril. The course continues for 15 days. If the polyps have not gone away, take a break for 2 days and continue treatment.


3. Horsetail decoction for the nose
   To prepare a decoction, you need to take 2 tbsp. tablespoons of dry chopped horsetail and pour 250 ml of boiling water. Cover and let it brew for half an hour, then strain. The decoction must be alternately drawn in each nostril 10 times a day. A new portion is prepared daily.


4. Drops from St. John's wort and celandine
   Take powder from dry St. John's wort and mix with butter in a ratio of 1:4. Steam the mixture for 7-10 minutes. Add celandine juice to the resulting mass, at the rate of 1 drop of juice per 1 teaspoon of a mixture of St. John's wort and oil. Dip 2 drops 4-5 times a day. The course of treatment is 10-15 days.

1. Ointment from propolis
   To prepare this medicine, you need to take 15 gr. homemade propolis, 10 gr. vaseline and 25 gr. butter. Thoroughly mix the components until a homogeneous consistency is obtained. Then cotton swabs are soaked with this ointment and placed in both nostrils. The procedure must be done overnight. The course of treatment lasts 20-30 days. The ointment must be stored in the refrigerator.


2. The simplest ointment
   Take fresh, but thickened honey. Dip a cotton swab in it and anoint problem areas in the nose. Do the procedure 3 times a day for 20-30 days. Usually, before the end of the course, the polyps resolve.


3. Ointment mix of oils
   You can make a mixture of: wild rosemary oil - 20%, St. John's wort oil - 20%, sea buckthorn oil - 40%, propolis tincture - 15%, honey -5%. Cotton flagella are impregnated with this composition and polyps are lubricated. The procedure must be done 5 times a day. The course lasts 10-15 days.

1. propolis inhalation
   Take a piece of solid propolis and put it in a metal bowl. Heat over medium heat until smoke with a characteristic odor appears. Remove the dishes from the fire and inhale the propolis smoke with your nose. Be careful! The procedure can lead to internal burns of the respiratory tract.


2. Chamomile and celandine inhalation
   You need to take 2 tbsp. spoons of chopped chamomile and celandine. Pour boiling water over and put on a small fire. After the broth boils, remove from heat and carefully inhale the steam. The procedure is preferably done 2 times a day for 10-15 days. Then take a break for 5 days and repeat the treatment for another 10 days.

Celandine is one of the most popular plants, which is used both in folk and traditional medicine. Celandine contains alkaloids, flavonoids, saponins, organic acids, vitamins A, C, essential oils. This plant has antifungal, anti-inflammatory and tonic properties, relieves swelling and heals wounds.

Due to its medicinal qualities, celandine is effectively used to combat nasal polyps. For medical purposes, the stem, roots and flowers of celandine are used. This medicinal plant is harvested during the flowering period. The root is cleaned from the ground and stored in a dark, cool place. The grass is dried and stored in paper bags.

Celandine is a poisonous plant. It is necessary to strictly follow the recipes and dosage when using any medicine from this plant.

1. Drops from celandine
   To prepare drops, you need to take a fresh root and flowers of celandine. Rinse them thoroughly with running water. Then grind in a blender or meat grinder. Squeeze the resulting mass through gauze, decanting the juice into a clean glass container. Then let it brew for 5 days in a dark, cool place. After that, the drops are ready for use. Using a pipette, instill 2-3 drops daily into each nostril, 3 times a day. The duration of the course is 10 days.
   Juice from a freshly picked stem is also used as drops. Bury 1-2 drops of pure juice, 2 times a day, for 10-15 days. Then you need to take a break for 10 days. Repeat the course 3-5 times.


2. Infusion of celandine
   Take 1 tsp. chopped dry celandine, place in an enameled container and pour 200 ml. steep boil. Cover with a lid and let it brew for half an hour. Strain the resulting infusion through cheesecloth. Soak cotton swabs with the product and alternately insert into each nasal passage for 15 minutes 2 times a day. The course of treatment is 2 months. Then you need to take a break for 1 month and repeat the course.
   An infusion of celandine is also used to wash the sinuses. This method is most effective in the treatment of polyps in the nose. The infusion is poured alternately into each nostril and spit. The procedure must be done 2-3 times a day for 15 days.

How to treat nasal polyps in a child?

It is necessary to conduct allergy tests to establish what exactly causes irritation of the mucosa. If the patient's contact with this allergen is eliminated, then there is a chance that the polyps will stop growing and begin to decrease.
After it turns out which products are allergic, you can proceed to the treatment of polyps in a child with folk methods.

The safest procedures for the baby are salt washings. Salt solution can be purchased at a pharmacy or you can make your own. This will require a liter of boiled water and two teaspoons of sea or ordinary salt. Rinse the nose with a warm composition 4-5 times a day using a 5 ml syringe.

Salt and iodine. The composition disinfects, dries and kills the infection in the nose. To prepare it, dissolve an incomplete teaspoon of salt in 300 ml of warm water and add 3 drops of iodine. Inhale the solution alternately, then one, then the other nostrils.

Small polyps in children are treated with medications:

• antibiotics (Augmentin, Azimed)
• antiallergic drugs (Cetrin)
• mast cell membrane stabilizers (ketotifen)
• steroid drugs (beclomethasone)

But if the polyps are already large enough, then surgery is required. Signs that a child needs to have polyps removed are:

• nasal congestion for several weeks
• smell disorders
• headache
• profuse mucopurulent discharge
• hoarseness

How are nasal polyps removed?

1. Loop removal. In the ENT departments of hospitals, you will be offered a polypectomy (surgery to remove a polyp) with a cutting loop. Most often, it is performed under local anesthesia through the nostril.


2. Endoscopic removal of polyps. An endoscope is a device that allows the surgeon to see what is happening inside the nose on a monitor screen. The device that directly removes polyps is called a shaver. It crushes the polyp tissue and removes it from the nose. Through natural openings, the shaver penetrates into the paranasal sinuses and removes polyps there. Thus, it is possible to completely get rid of the altered tissue and prevent the recurrence of the disease.


3. Removal of polyps with a laser. The laser beam evaporates moisture from the fabric. Formations "dry" significantly decrease in size and then are easily removed. This is the most bloodless method that does not cause complications.

What to do after removal of polyps?

Oil drops should be instilled into the nose: Pinosol or sea buckthorn oil. This will speed up the healing. They are used 3-5 days 3-4 times a day.

Salt sprays are used to flush germs and allergens from the mucous membrane. They can be used for a long time; they are a prophylactic against SARS.

Assign local funds based on steroids. They do not cause systemic side effects. The drugs are designed to prevent the re-growth of polyps. They have anti-allergic and anti-inflammatory properties. The most effective remedy is Nasonex spray.

You need to be attentive to your health. If you do not take action, the polyps can grow large, lead to sinusitis, otitis media, deviated septum, and even cancer. If on examination by a doctor, a diagnosis of "polyps" was made, do not despair. Modern traditional and folk medicine offer many treatment options for this problem.

Nasal polyps are benign neoplasms
which look like small rounded formations and are formed as a result of prolonged irritation of the nasal mucosa and paranasal sinuses.

The presence leads to the development of a number of undesirable symptoms, which can only be eliminated with the help of surgical intervention.

Removal of polyps in the sinuses. Indications for surgery

Before performing surgery in connection with polyposis neoplasms of the nasal cavity, it should be determined whether there are indications for their removal. There are absolute and relative indications for surgical removal of polyps in the nose.

Absolute indications for surgery to remove nasal polyps:

Relative indications for surgery:

• The appearance of snoring.
• Voice change (hoarseness).
• Hyposmia.
• Periodic headache and dizziness.
• Sensation of a foreign body in the nose.

Contraindications to surgery

The presence of polyposis neoplasms in the nose is not in all cases an indication for their removal during surgery. There are local and systemic contraindications to the removal of polyps.

Systemic contraindications for surgery to remove polyposis neoplasms:

• Attack of bronchial asthma.
• Blood diseases such as hemophilia, acute leukemia, thrombocytopenic purpura.
• Decompensated conditions of the cardiovascular system (myocardial infarction, coronary heart disease, hypertensive crisis, collapse, etc.).

Local contraindications for surgery:

• Acute diseases of the nose and paranasal sinuses (, acute sinusitis).

If you have a history of the nasal cavity, you should consult with an oncologist before the operation.

Nasal polyps operation. Description of the method

There are a large number of different methods of surgical removal of polyps. To date, the operation to remove polyps in the nose is performed under general anesthesia. The essence of surgical intervention is to excise pathological neoplasms. Polypotomy (surgical intervention to remove polyps) is performed in a sitting position of the patient.

Technique for the operation to remove polyps in the nose:

1. First of all, anterior and posterior rhinoscopy should be performed using nasal mirrors.
2. Sanitize the nasal cavity and paranasal sinuses with a hypertonic solution or Humer pharmacological agent.
3. Dry the nasal cavity with a cotton swab.
4. Consistently lubricate the nasal mucosa twice with 10% dicaine solution to reduce its sensitivity during surgical excision of neoplasms.
5. Find out the location of the legs of polyps, their number and size.
6. Insert the snare into the nose under visual control.
7. Conduct an audit of the nasal cavity with the help of a loop outlet.
8. Put a loop on a polyp or a group of polyps (if they are small).
9. Move the loop up to the head of the polyp.
10. After feeling the solid consistency of the head of the polyp, tighten the loop.
11. Remove the loop with polypous masses from the nasal cavity and put in a special tray.

Especially important!

An important criterion that prevents recurrence is the removal of the polyp along with the stem. Therefore, you should carefully tighten the loop so as not to cut off the head of the polyp, but to pull the polyp along with the leg from the nasal cavity.

Methods for removing polyps in the nose

Modern methods of surgery to remove polyps help to avoid the formation of scars and adhesions in the nasal cavity. In addition to the usual polypotomy, there are such methods for eliminating polyposis:

• . Endoscopic removal is one of the most accurate removal methods. The operation is performed using a special medical endoscope with a camera. This allows you to achieve complete removal of even the smallest formations and at the same time not damage the surrounding structures of the nasal cavity.
• Removal with a shaver (microdebrider). The essence of this technique is the grinding of neoplasms and their absorption. The operation is less traumatic and is performed under the control of a screen monitor.
• . Under the influence of laser beams, the neoplasm disappears. The advantage of this method is the additional coagulation of the vessels and the prevention of the spread of infection to the surrounding structures.
• . With the help of the Lange hook, it is possible to remove not only nasal polyps, but also polyps with localization in the choanal area.

Ways to remove polyps in the nose:

Symptoms after removal of polyps

In the vast majority of cases, the postoperative period proceeds without significant complications.

In particular cases, postoperative symptoms are presented:

• The development of minor bleeding. This symptom develops as a result of damage to the vessels of the nasal cavity.
• The formation of adhesions and adhesions after surgery in the nasal passages. This symptom develops 2-3 months after surgery. Patients again complain of aggravated nasal breathing. This symptomatology requires prompt dissection of the newly formed adhesions.
• Disease recurrence. The development of relapses is possible if there was an incomplete removal of polyps or the doctor removed only the head of the polyp.
• Accession of infectious complications. Infectious complications are added in the case of an operation in the acute period of diseases of the nose or paranasal sinuses. Infectious agents can spread through the hematogenous or lymphogenous route and lead to systemic manifestations of an infectious disease.
• Headaches. Headaches are a transient symptom that disappears after 3-5 days. The temperature after removal of polyps in the nose is kept at around 37.
• Difficulty in nasal breathing and loss of smell as a result of the development of edema. This symptom is a physiological response to surgery. Normally, the restoration of the respiratory and olfactory function of the nose occurs 3-5 days after the operation.

More modern methods of operational influence prevent the development of postoperative symptoms.

The correct tactics of the patient in the postoperative period will help to avoid the recurrence of the disease and the development of many dangerous complications (recurrence of the disease, bleeding, etc.).

1. In the first days after surgery to remove polyps, antibacterial drugs (Ceftriaxone, Suprax) should be taken. These pharmacological preparations will help to avoid the development of complications of an inflammatory nature. Antibiotics should be taken for 3-5 days of the postoperative period.
2. Also, after the operation, otolaryngologists recommend instilling oil-based drops (Pinosol, sea buckthorn oil) into the nasal cavity, because they contribute to faster healing of the postoperative wound and prevent the formation of adhesions and adhesions in the nasal passage.
3. The next step after the operation is the regular sanitation of the nasal cavity with saline or Humer's pharmacological agent. Sanitation should be carried out from 5 to 14 days after surgery.
4. In the first days of the postoperative period, topical steroids (Nasonex) are recommended. These medicines do not cause side effects from other organs and systems and at the same time prevent the development of relapses of the disease.

In the treatment after removal of polyps in the nose, it is recommended to use 30% propolis ointment. Swabs are wetted and placed in the nose. The duration of the procedure is 2 weeks

Propolis ointment after removal of polyps in the nose

Recovery after removal of polyps in the nose

Rehabilitation after removal of polyps in the nose does not require long-term measures. In order to avoid complications after the operation, the following doctor's instructions should be followed for five days:

• Follow a gentle regimen.
• Avoid hot food and drinks. Hot drinks and food lead to vasodilation and provoke the development of bleeding.
• Don't lift weights. An increase in systemic arterial pressure is also a risk factor for bleeding.
• Avoid prolonged sun exposure.
• Not located in a dusty environment.
• Do wet cleaning in the house twice a day
• Carry out timely ventilation in the apartment.
• Do not come into contact with infectious patients

An increase in the overall resistance of the body and a positive psychological attitude of patients will also help to avoid complications in the postoperative period.

Removal of polyps in the nose video:

Polyposis is an overgrowth of glandular tissue in the nose and paranasal sinuses under the influence of histamines and other inflammatory mediators. An operation to remove polyps is necessary to normalize nasal breathing, reduce the risk of respiratory diseases and eliminate deformities of the nasal septum that have appeared due to polyposis.

If a patient complains of shortness of breath, altered sense of smell and copious discharge from the nose, traditional diagnostics is performed. First, the doctor uses an illuminator, then an endoscope, which allows you to assess the condition of the sinuses.

In addition, radiological methods can be used: computed or magnetic resonance imaging. In such cases, the doctor pays special attention to the paranasal sinuses. Depending on the degree of polyposis and the patient's condition, a decision is made on the methods of treatment.

Indications for removal

In some cases, doctors prescribe conservative drug treatment, including a course of various anti-inflammatory, immunomodulatory and other drugs.

However, there are serious indications for surgery to remove polyps:

• large or multiple polyps that are not amenable to conservative treatment;
• curvature of the nasal septum due to tissue growth;
• the occurrence of a number of other adverse pathological conditions due to polyposis.

One of the types of surgery to remove polyps in the nose is recommended by the doctor, taking into account the patient's condition. There are loop, cryogenic, laser removal techniques, as well as using a shaver and radio waves.

General contraindications

There are contraindications to the operation to remove polyps. Local are limited to inflammatory processes in the nose of various etiologies (rhinitis, sinusitis, etc.).

Systemic:

• serious blood diseases (leukemia, hemophilia, thrombocytopenic purpura);
• cardiovascular diseases (ischemia, collapse, hypertension);
• bronchial asthma in the acute period.

Anesthesia

Removal of nasal polyps using radio waves, laser or shaver in children under 7 years of age is performed under general anesthesia. Such anesthesia is used for a significant number of formations. In other cases, local anesthesia is used. Before the operation, a sedative drug is injected intramuscularly.

Then a 10% solution of lidocaine and vasoconstrictor drugs are sprayed into the nasal cavity or applied applicatively to prevent swelling and improve visibility. After that, a 2% anesthetic drug is injected into the intervention area (this can be lidocaine or ultracaine).

During removal, the patient is fully aware of what is happening. Local anesthesia is relevant only for the removal of formations within the nasal cavity.

Loop polypectomy

An operation to remove polyps in the nose, in which the doctor wields the so-called Lenge hook, which is essentially a cutting loop, is called a loop polyectomy. The removal mechanism is as follows: the doctor inserts the instrument into the nostril, covers the polyp with a loop and tightens the loop, cutting off the polyp.

Thus, it is possible to save the patient from several growths in one session. With a single polyp, the duration of the operation is from 45 minutes to an hour. The cutting loop is used to remove polyps that have grown from the ethmoid labyrinth. Before the start of the process, 2 ml of a 1% solution of novocaine is injected into the mucosa in the immediate vicinity of the polyp.

At the end of the operation, the mucous membrane is disinfected, with the help of a cape-like bandage, tampons soaked in petroleum jelly are fixed. Approximately within a week the patient is under inpatient observation. During this time, tampons are removed, synthomycin ointment is applied, and if necessary, washing is carried out. The entire recovery period usually takes 10-20 days.

The main disadvantage of the method is the probability of recurrence up to 70%. In this case, it will be necessary to repeat the procedure after 6-12 months.

radio wave surgery

Surgery to remove polyps in the nose using radio waves is proposed as a more bloodless alternative to the traditional clipping of growths. Such an operation can be performed on an outpatient basis without the use of tampons.

However, in this case, the risk of recurrence of formations is also high. In addition, the radio wave method is used only for medium and large polyps, usually single ones.

After removing polyps in the nose with the radio wave method, you need to follow a number of rules that will help the body recover faster after surgery:

• avoid serious physical exertion;
• minimize contact with people with ARVI, influenza or other airborne infections;
• adhere to a diet that excludes spicy, fried, salty foods;
• refrain from hot food (to prevent bleeding).

Complications after loop and radio wave removal

Even experienced doctors are not always able to perform the operation without subsequent complications.

They might look like this:

• slight bleeding from the nose appears due to damage to the capillaries and their slow recovery.
• Quite often, after 2-3 months after the operation, adhesions are found in the patient. In this case, the patient usually complains of the resumption of problems with nasal breathing. The only solution to the problem is cutting adhesions under local anesthesia and subsequent inpatient observation.
• Reappearance of growths. Most often, this is caused by insufficiently high-quality removal of formations or their presence in the paranasal sinuses.
• Inflammatory process against the background of bacterial infection. A rare case when, at the time of surgery, an infectious process developed in the patient's sinuses or nasal passages in the acute phase.
• subfebrile temperature considered almost normal after this kind of surgery.
• Headaches are often associated with fever. Usually patients complain about it for no more than 5 days.
• Edema and weak sense of smell or its absence are also frequent companions of the postoperative period. These symptoms usually go away after 3-4 days.

Endoscopic surgery

This type of surgery is usually performed under local anesthesia and includes two types: laser removal and shaver removal. In both cases, an endoscope with a camera is inserted into the nostril, which transmits the image to the monitor.

This technique allows you to examine in detail all the details of formations and remove them without injuring healthy tissues. In addition, using an endoscope, it is possible, if desired, to correct the structure of the nose, for example, to save the patient from the displacement of the nasal septum resulting from polyposis.

After such an operation, the patient will not have scars or scars, only unpleasant sensations that soon disappear. The first 2-3 days, bloody or mucous discharge may be observed. In the hospital, the patient observes only the first day, after 3 days he can start working.

Contraindications

Endoscopic intervention is postponed during the period of exacerbation of bronchial asthma or chronic bronchitis, as well as during the flowering of plants that provoke allergic rhinitis. Women should plan the operation so that it does not fall during the period of menstruation.

Removal with a shaver

This is a convenient and popular way to remove growths. The operation is performed by endoscopy. The doctor, using a special nozzle, examines the affected area, accurately cuts off the detected polyp, and then crushes it in the same place and sucks it off.

The advantages of the method are its high accuracy, the ability to conduct an audit of the paranasal sinuses and extremely low trauma. The time of the operation varies from 45 minutes to 1 hour, depending on the severity of the disease.

At the end of the operation, tampons are placed in the nose, which are removed after a day. Usually the patient is under inpatient observation for 2-3 days. If the degree of polyposis is low, he can be allowed to go home immediately after the intervention. The functions of the glandular tissue and olfactory abilities are restored gradually over a period of about a month.

If there are many polyps and if they are large, special preparation will be required. This is largely due to the need to use general anesthesia in such cases. The patient takes a general blood test, biochemical and coagulation tests.

It is also necessary to do computed tomography and conduct a thorough endoscopic examination, the results of which will clear the expected duration of the operation, the duration of inpatient observation and subsequent prognosis.

7 days before the intervention, the patient takes 40 mg of Prednisolone daily. If the operation needs to be carried out urgently, despite the acute infectious and inflammatory process in the nose and its sinuses, the symptoms are eliminated with the help of antibiotic therapy. For this, as a rule, local preparations are used.

In addition, a week before the operation, it is necessary to stop taking Aspirin, anti-inflammatory drugs and vitamin E, since these substances have a strong effect on blood clotting. Subsequently, they are not recommended to be used for some time after the operation.

As for food, the last meal before the operation can take place the day before the operation. It should be a light dinner. No food or drink is allowed on the day of the intervention. To relieve thirst, you can suck on ice or rinse your mouth with water.

During the entire postoperative period, it is prohibited:

• mechanically remove crusts from the nose (pick with fingers or other objects). Salt flushing is suggested as an alternative;
• blow your nose intensively and forcefully;
• consume hot food or drinks;
• the same applies to hot baths, saunas, inhalations. All this provokes excessive blood flow and can cause bleeding;
• experience significant physical exertion;
• drink alcohol, because it dilates the blood vessels.

Complications after surgery

Despite careful adherence to supportive measures, any patient may experience unpleasant complications:

• heavy bleeding;
• inflammatory process on the background of rhinitis or rhinosinusitis;
• tissue scarring and adhesions;
• recurrence of new polyps. With this method, the probability of recurrent polyposis is 50%. At the same time, the interval between the occurrence of formations can be from 4 to 7 years.

Operation with a laser

Laser removal of polyps in the nose is recognized as the most advanced method. The doctor can perform the operation on an outpatient basis, using an endoscope and local anesthesia. Most often, this method is used to rid children of growths.

The laser blade literally vaporizes the polyp due to the heating beam. It gradually decreases and disappears. Healthy tissues do not suffer, there is no bleeding. Laser surgery has a minimum of contraindications and can be performed at any age.

It is the fastest (no more than 20 minutes), accurate and efficient. During the operation, the laser “solders” the blood vessels, which greatly reduces the risk of infection in the postoperative period. In this regard, tampons are not placed in the nose.

However, it also has its shortcomings. The laser is not used in the presence of several polyps, especially if they differ in size. Also, laser surgery can only be performed within the nasal cavity.

Cryosurgical removal

If the laser affects the polyp through elevated temperatures, then the cryosurgical method is often called freezing. Few choose it. It, like a laser, is one of the most non-traumatic types of removal of formations, both on the mucous membranes and on the skin.

The doctor directs a jet of liquid nitrogen to the area of ​​the polyp, the fluid in its tissues is frozen, the cells are destroyed, and the polyp ceases to receive nutrition through the bloodstream. The duration of freezing is usually 30 seconds, then the doctor pauses and repeats the cauterization until the tissues of the polyp are sufficiently destroyed.

The procedure is performed under local anesthesia with 2% solutions administered by injection. In some cases, applicative application of more saturated solutions (up to 10%) is practiced. After a few days, the devoid of food growth falls off. If it has not peeled off, a second operation is necessary. This is only possible after 3 weeks.

For successful rehabilitation, the patient must follow a few simple rules:

• wear a sterile bandage that will protect the nose from getting dust and pathogens on the mucous membranes;
• Take systemic antibiotics as prescribed by your doctor. In this case, consultation is necessary to get rid of the consequences of such prophylaxis (for example, dysbacteriosis, disorders of the mucous microflora);
• use anti-inflammatory drugs in the form of tablets and sprays;
• if necessary, use painkillers.

Medications after surgery

The operation to remove polyps in the nose involves the use after it of a number of drugs that restore the body and preventing the development of relapse:

Price

The cheapest way is to use polyp removal services with a cutting loop. Usually this method is practiced in free clinics. When applying to a paid institution, the cost of the procedure will be approximately 2000 rubles.

The price for endoscopic removal varies from 15 to 30 thousand rubles. The cost of the operation is affected by the status of the clinic, the location and number of polyps, the duration of the necessary inpatient treatment. Laser removal costs 8-10 thousand rubles.

The operation, which takes place under general anesthesia, is not affordable for everyone, as it costs about 70 thousand rubles. In addition, the cost of the operation may vary depending on the region of residence.

Modern medicine offers operations to remove polyps in the nose, performed by different methods. In the conservative treatment of polyposis, the maintenance and activation of immunity plays a significant role.

The same can be said about the postoperative period. Regardless of the choice of type of surgery, adherence to recommendations for the postoperative period will reduce the risk of recurrence and reduce the likelihood of complications.

Video about the operation to remove polyps in the nose

Getting rid of polyps in the nose:

Removal of polyps in the nose without surgery:

Nasal polyps are benign neoplasms
which look like small rounded formations and are formed as a result of prolonged irritation of the nasal mucosa and paranasal sinuses.

The presence of polyps in the nose leads to the development of a number of undesirable symptoms, which can only be eliminated with the help of surgical intervention.

Removal of polyps in the sinuses. Indications for surgery

Before performing surgery in connection with polyposis neoplasms of the nasal cavity, it should be determined whether there are indications for their removal. There are absolute and relative indications for surgical removal of polyps in the nose.

If you don’t want to go under the surgeon’s knife, then read about the modern treatment of nasal polyps.

Absolute indications for surgery to remove nasal polyps:

• Complete absence of nasal breathing.
• Increase in asthma attacks.
• Anosmia (complete absence of the sense of smell).
• Attachment of symptoms of inflammation of the paranasal sinuses.
• Frequent occurrence of discharge from the nose with an unpleasant odor and an admixture of blood.
• Development of deformity of the nasal septum.
• Chronic course of purulent-inflammatory processes of the nose and paranasal sinuses.

Relative indications for surgery:

• The appearance of snoring.
• Voice change (hoarseness).
• Hyposmia.
• Periodic headache and dizziness.
• Sensation of a foreign body in the nose.

Contraindications to surgery

The presence of polyposis neoplasms in the nose is not in all cases an indication for their removal during surgery. There are local and systemic contraindications to the removal of polyps.

Systemic contraindications for surgery to remove polyposis neoplasms:

• Attack of bronchial asthma.
• Blood diseases such as hemophilia, acute leukemia, thrombocytopenic purpura.
• Decompensated conditions of the cardiovascular system (myocardial infarction, coronary heart disease, hypertensive crisis, collapse, etc.).

Local contraindications for surgery:

• Acute diseases of the nose and paranasal sinuses (acute rhinitis, acute sinusitis).
• allergic rhinitis.

If you have a history of oncological pathology of the nasal cavity, you should consult with an oncologist before the operation.

There are a large number of different methods of surgical removal of polyps. To date, the operation to remove polyps in the nose is performed under general anesthesia. The essence of surgical intervention is to excise pathological neoplasms. Polypotomy (surgical intervention to remove polyps) is performed in a sitting position of the patient.

Technique for the operation to remove polyps in the nose:

1. First of all, anterior and posterior rhinoscopy should be performed using nasal mirrors.
2. Sanitize the nasal cavity and paranasal sinuses with a hypertonic solution or Humer pharmacological agent.
3. Dry the nasal cavity with a cotton swab.
4. Consistently lubricate the nasal mucosa twice with 10% dicaine solution to reduce its sensitivity during surgical excision of neoplasms.
5. Find out the location of the legs of polyps, their number and size.
6. Insert the snare into the nose under visual control.
7. Conduct an audit of the nasal cavity with the help of a loop outlet.
8. Put a loop on a polyp or a group of polyps (if they are small).
9. Move the loop up to the head of the polyp.
10. After feeling the solid consistency of the head of the polyp, tighten the loop.
11. Remove the loop with polypous masses from the nasal cavity and put in a special tray.

Especially important!

An important criterion that prevents recurrence is the removal of the polyp along with the stem. Therefore, you should carefully tighten the loop so as not to cut off the head of the polyp, but to pull the polyp along with the leg from the nasal cavity.

Modern methods of surgery to remove polyps help to avoid the formation of scars and adhesions in the nasal cavity. In addition to the usual polypotomy, there are such methods for eliminating polyposis:

• Endoscopic surgery. Endoscopic removal is one of the most accurate removal methods. The operation is performed using a special medical endoscope with a camera. This allows you to achieve complete removal of even the smallest formations and at the same time not damage the surrounding structures of the nasal cavity.
• Removal with a shaver (microdebrider). The essence of this technique is the grinding of neoplasms and their absorption. The operation is less traumatic and is performed under the control of a screen monitor.
• Laser removal of polyps. Under the influence of laser beams, the neoplasm disappears. The advantage of this method is the additional coagulation of the vessels and the prevention of the spread of infection to the surrounding structures.
• Crochet Lange removal. With the help of the Lange hook, it is possible to remove not only nasal polyps, but also polyps with localization in the choanal area.

With all this, there are methods for removing polyps without surgery!

Ways to remove polyps in the nose:

In the vast majority of cases, the postoperative period proceeds without significant complications.

In particular cases, postoperative symptoms are presented:

• The development of minor bleeding. This symptom develops as a result of damage to the vessels of the nasal cavity.
• The formation of adhesions and adhesions after surgery in the nasal passages. This symptom develops 2-3 months after surgery. Patients again complain of aggravated nasal breathing. This symptomatology requires prompt dissection of the newly formed adhesions.
• Disease recurrence. The development of relapses is possible if there was an incomplete removal of polyps or the doctor removed only the head of the polyp.
• Accession of infectious complications. Infectious complications are added in the case of an operation in the acute period of diseases of the nose or paranasal sinuses. Infectious agents can spread through the hematogenous or lymphogenous route and lead to systemic manifestations of an infectious disease.
• Headaches. Headaches are a transient symptom that disappears after 3-5 days. The temperature after removal of polyps in the nose is kept at around 37.
• Difficulty in nasal breathing and loss of smell as a result of the development of edema. This symptom is a physiological response to surgery. Normally, the restoration of the respiratory and olfactory function of the nose occurs 3-5 days after the operation.

More modern methods of operational influence prevent the development of postoperative symptoms.

The correct tactics of the patient in the postoperative period will help to avoid the recurrence of the disease and the development of many dangerous complications (recurrence of the disease, bleeding, etc.).

1. In the first days after surgery to remove polyps, antibacterial drugs (Ceftriaxone, Suprax) should be taken. These pharmacological preparations will help to avoid the development of complications of an inflammatory nature. Antibiotics should be taken for 3-5 days of the postoperative period.
2. Also, after the operation, otolaryngologists recommend instilling oil-based drops (Pinosol, sea buckthorn oil) into the nasal cavity, because they contribute to faster healing of the postoperative wound and prevent the formation of adhesions and adhesions in the nasal passage.
3. The next step after the operation is the regular sanitation of the nasal cavity with saline or Humer's pharmacological agent. Sanitation should be carried out from 5 to 14 days after surgery.
4. In the first days of the postoperative period, topical steroids (Nasonex) are recommended. These medicines do not cause side effects from other organs and systems and at the same time prevent the development of relapses of the disease.

In the treatment after removal of polyps in the nose, it is recommended to use 30% propolis ointment. Swabs are wetted and placed in the nose. The duration of the procedure is 2 weeks

Propolis ointment after removal of polyps in the nose

Rehabilitation after removal of polyps in the nose does not require long-term measures. In order to avoid complications after the operation, the following doctor's instructions should be followed for five days:

• Follow a gentle regimen.
• Avoid hot food and drinks. Hot drinks and food lead to vasodilation and provoke the development of bleeding.
• Don't lift weights. An increase in systemic arterial pressure is also a risk factor for bleeding.
• Avoid prolonged sun exposure.
• Not located in a dusty environment.
• Do wet cleaning in the house twice a day
• Carry out timely ventilation in the apartment.
• Do not come into contact with infectious patients

An increase in the overall resistance of the body and a positive psychological attitude of patients will also help to avoid complications in the postoperative period.

Removal of polyps in the nose video:

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.

1. The main problem that polyps cause is difficulty in nasal breathing. That is, when they grow, they mechanically block the nasal passages, the air cannot freely pass into the nasopharynx. Vasoconstrictor drops in this case will be ineffective. The patient breathes through his mouth, which is not physiological and unpleasant.
2. The second problem that often accompanies patients with polyps is a violation of the sense of smell. Polyps overlap the mucous membrane of the olfactory zone. Lack of sensitivity to smells greatly reduces the quality of life.
3. Blocking the natural communications of the paranasal sinuses with the nasal cavity, polyps lead to a violation of the cleansing of the sinuses from mucus and microbes, which causes a chronic inflammatory process in the sinuses. And this is a rather serious complication. So, purulent sinusitis can lead to serious consequences up to meningoencephalitis and sepsis.
4. If a person breathes not through his nose, but through his mouth, then the air is not warmed up, not cleaned and humidified properly. All this increases the risk of developing pharyngitis, tonsillitis, laryngitis, bronchitis, pneumonia and bronchial asthma.
5. Inadequate nasal breathing leads to some hypoxia of the brain, as a result of which a person experiences frequent headaches, poor sleep, fatigue, and impaired performance.

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:

1. X-ray of the paranasal sinuses.
2. Computed tomography of the sinuses.
3. 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.

Operation is not assigned:

• 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:

1. General blood and urine tests.
2. Coagulogram.
3. Biochemical analysis.
4. Electrocardiography.
5. Chest x-ray.
6. Blood for markers of viral hepatitis, syphilis, HIV.
7. 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:

1. With drainage of the paranasal sinus in chronic sinusitis, ethmoiditis, sphenoiditis.
2. Correction of deviated nasal septum.
3. 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.

The advantages of the method include 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:

1. Polypotomy with microinstruments without shaver.
2. Removal of polyps with a shaver (microderiber).
3. 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:

1. Bleeding.
2. Inflammation - rhinitis, rhinosinusitis.
3. The formation of adhesions.
4. 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, since 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 desirable 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 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

Nasal polyps are an overgrowth of the epithelial tissue of the mucous membrane of the labyrinth or maxillary sinus. Some ENT specialists classify them as benign tumors. Others prefer to consider polyps separately because their structure is more consistent with unaltered, normal tissues.

The average prevalence of the disease in the world is 1-4%. It does not belong to the category of dangerous, but is recurrent: in 70% of cases, polyps reappear after removal.

Reasons for the formation of polyps

Nasal polyps (the official medical name for the disease is polyposis rhinosinusitis) can have completely different etiologies. However, such a remark can be made in relation to most tumors and growths similar to them. Among the most common causes are the following:

• Allergy and accompanying symptoms (runny nose, sneezing, cough).
• Chronic infectious diseases associated with the nose or paranasal sinuses (sinusitis, rhinitis).
• Some physiological conditions accompanied by hormonal changes (pregnancy).
• Deviated septum, nasal trauma.
• One of the latest theories expressed in the domestic literature is a violation of the metabolism of arachidonic acid. Note. This compound is involved in the formation of substances that transmit signals between nerve cells. Products of arachidonic acid - prostaglandins, are responsible in particular for the regulation of the inflammatory process.
• Cysts in the nasal cavity and sinuses. They are small, fluid-filled formations.
• Hereditary diseases that lead to disruption of the normal functioning of the mucosa (for example, cystic fibrosis).
• Taking drugs or products with aspirin if you are intolerant to it.

Development of the disease

Despite the heterogeneity of the causes that cause polyps, the disease develops according to the same pattern. The mucous membrane of the paranasal sinuses or the ethmoid labyrinth has to function for a long time in conditions of increased activity. This is necessary to cope with allergies, inflammation or other adverse factors. At first, it performs this task, but gradually the reserves run out, and the effect of the factor does not stop.

Then the body tries to compensate for the insufficient efficiency of the mucosa by increasing its area. The tissue begins to grow, a polyp forms. At first, it is localized in the organ in which it was formed, but gradually, with an increase in its size, it begins to hang down into the nasal cavity. There he interferes with breathing, over time seriously complicating it.

The formed polyp looks like this: it is a mushroom-shaped formation on a stalk that hangs down into the nasal cavity with its wide part. The color of a polyp can vary from pearlescent to red, depending on how well the blood supply is developed in it. It is characterized by moderate growth, spherical or cylindrical shape.

The polyp does not affect other tissues, except for the mucous membrane and does not pose a serious danger to the body.

Symptoms of polyposis rhinosinusitis

The main symptom of the disease is nasal congestion. It does not go away after taking vasoconstrictor drugs, it gets worse over time. Patients may also complain about:

1. Sinusitis. Inflammation of the paranasal sinuses is often the cause or concomitant disease of polypous rhinosinusitis.
2. Rhinitis. Runny nose (allergic or otherwise) often provokes hypertrophic development of the mucosa.
3. Decrease or loss of smell. Due to changes in the size of the mucosa, sensitive areas cease to function properly, they become smaller relative to the total surface of the nasal cavity.
4. Headache. Violation of nasal breathing often results in problems with the regular supply of oxygen to the brain. Periodic hypoxia can cause migraines.
5. Voice disturbance. Due to the constant congestion of the nasal passages, the patient is forced to nasalize when talking.

Diagnostics

As a rule, polyps are easily detected during rhinoscopy. An important task of a specialist is the differential diagnosis of benign, malignant tumors and other diseases. To do this, research:

• Computed tomography of the nasal sinuses. It is carried out, as a rule, before the operation, in order to accurately identify the localization of the polyp.
• Biopsy. A piece of tissue that makes up a polyp is subjected to a comprehensive study, its structure, size and shape of cells are studied under a microscope.
• Serological study. It allows, in the absence of certain antibodies in the blood, to exclude scleroma, tuberculosis, syphilis, leprosy. These diseases sometimes produce similar tissue indurations (granulomas) that can be mistaken for polyps.

Diagnosis can be somewhat difficult in children, especially at a younger age, when they can't talk about their problems on their own. Parents should take their child to the doctor if:

1. He suffers from a prolonged runny nose, which then subsides, then resumes again.
2. The child's nose is stuffed up, he breathes mainly through his mouth.
3. The kid periodically rubs his nose, shows obvious discomfort.
4. Along with the above symptoms, the child's appetite has changed, he has become capricious and irritable.

Treatment of polyps and prevention of recurrence

In the treatment of the disease, the doctor should set the following goals:

• Elimination of the cause of the disease when it is detected.
• Restoration of normal nasal breathing.
• Polyp removal.
• Prevention of the emergence of a new formation.

Important! The combined measures of medical treatment of polyps (conservative therapy) and surgery are recognized as the most effective at the moment. Exclusively surgical intervention does not make it possible to achieve a stable remission (recovery).

Conservative treatment

The basis of the drugs taken are steroids. Along with them, antibiotics and antiseptic drugs, general stimulants and immunomodulators can be prescribed. In therapeutic practice, intranasal topical steroid sprays are commonly used:

1. Beclomethasone. The drug acts as an anti-inflammatory and antiallergic agent. It inhibits the work of certain parts of the immune system, therefore, with prolonged use, infection of the nasal cavity is possible (most often with fungi of the genus Candida). In this case, the reception is not stopped, but beclomethasone is combined with antimicrobial drugs. Also, the drug can affect the adrenal glands, slowing down the growth of the body in childhood. For this reason, it is contraindicated for use under 12 years of age.
2. Mometasone. The drug reduces inflammation, relieves swelling, itching, fluid accumulation in the nasal cavity. Mometasone reduces the production of arachidonic acid, which can presumably be involved in the formation of polyps. With prolonged use, control of adrenal function is necessary.
3. Fluticasone. The drug belongs to synthetic corticosteroids. Its use in the form of an intranasal spray is allowed from the age of 4. One of the frequent side effects from the use of the drug include: nosebleeds; sensation of dryness, unpleasant smell or taste; headache.

The impact of immunomodulatory drugs is currently being studied, but the work of recent decades shows their unequivocal effectiveness. They make it possible to treat diseases by influencing the mechanism of its development.

However, the results are highly dependent on the route of administration of drugs (preferably local). Often they are used along with surgery. Candidate of Medical Sciences Samolazova S.G. describes the results of the use of these drugs for polyps (2003): “Local immunocorrection with cycloferon and subsequent surgical treatment lead to an improvement in immunograms ... and an increase in the rate of mucociliary transport”.

The positive effect of recombinant human interferon 2a was also noted. This drug affects cells at the genetic level, preventing their proliferation (excessive growth and reproduction). Research has shown ( Miroshnenko A.P., 2004) that "recombinant a2 interferon should be used in addition to the traditional treatment of polypous rhinosinusitis".

Surgical removal of polyps

It is worth noting that it is quite difficult to get rid of a polyp without surgery; usually, conservative treatment is stopped only if there are serious contraindications to surgical intervention (asthma during an exacerbation, bleeding disorders, etc.).

There are three main operational methods:

• Laser removal.
• Endoscopic polypectomy.
• Removal with Lange's loop.

The laser is considered the least traumatic, but it is used only for single polyps. The operation lasts 15-20 minutes and is usually performed under local anesthesia. During the procedure, a device that emits laser beams is inserted into the nasal cavity. They cause coagulation of polyp cell proteins. As a result, they die. As such, no wound is formed in the process, which minimizes the risk of infection and subsequent complications. Scarring at the site of the former polyp also does not occur.

Due to the limitations of the method, endoscopic polypectomy is performed much more frequently. It allows you to remove any growth, even in hard-to-reach places in the body. The operation is performed under general anesthesia and is associated with a small risk of bleeding. A big plus of polypectomy is the low risk of recurrence. New polyps usually appear no earlier than 5-6 years after surgery.

The doctor observes the entire space in an enlarged view on the monitor screen, which allows him to act with great accuracy. The actual removal is performed using a special device - a rhinoscopic shaver. It resembles a pistol in appearance, but instead of a muzzle, it contains a hollow tube with cutting nozzles of various sizes. Depending on the volume of the polyp, the doctor chooses one or another knife. During the operation, the cutting nozzles rotate, and at the same time, excess tissue is captured. Removal with shaver is an excellent alternative to conventional surgery, because. the device acts pointwise, leaving healthy mucosa intact.

Video: removal of polyps in the nose, endoscopic surgery

The last method - polypotomy with a loop, is the oldest, "classic" way to get rid of growths in the nasal cavity. The operation is performed under general anesthesia and can take up to 1 hour. Important! Its main disadvantage is the high recurrence rate. After a few months, the polyps reappear. This is due to the fact that the surgeon removes only the visible part of the neoplasm, while the growth of the polyp from the sinuses or the mucosa of the ethmoid labyrinth begins. The advantages of the operation are its accessibility, the possibility of carrying it out without a highly qualified doctor or special expensive equipment.

Treatment of polyps with traditional medicine

At the moment, there is no encouraging data on the possibility of getting rid of the disease on their own. Although homeopathy and alternative medicine offer a wide range of methods, home treatment is unlikely to bring the desired recovery. However, folk remedies for dealing with polyps in the nose can be considered as maintenance therapy, which will alleviate the patient's condition before a medical examination or surgery.

For such purposes, you can use:

1. Celandine juice diluted with water 1:2. It is recommended to bury it in the nose for 10 days. First you need to make sure that you do not have an allergic reaction to the plant. Also, the solution can be laid in the nasal passages by moistening a cotton swab with it.
2. Hypericum juice mixed with sea buckthorn juice. This tool is used for long-term use. Homeopaths advise using it for instillation for at least 1 year. The main thing is to monitor the freshness of the solution. It must be stored in the refrigerator, but not more than 10-14 days.
3. Tui oil. It can be used in finished form or used as part of the homeopathic preparation of the same name. The oil is sold in specialized pharmacies or can be ordered from non-traditional practitioners.

Video: treatment of polyps in the nose with folk methods

Nasal hygiene

During illness and as part of its prevention, it is necessary to perform certain hygiene procedures:

• Frequent moistening of the nasal cavity.
• Washing the nose with sea water or iodine-salt solution.
• Inhalations with decoctions of herbs with anti-inflammatory properties: chamomile, calendula, sage, etc.
• Wetting the nasal mucosa with vaseline, almond, peach oil.

It is also desirable to protect the patient from the action of additional damaging factors:

1. Smoke from a fire or tobacco smoke;
2. Inhalation of poisons, including insecticides for private use;
3. dust;
4. Aroma and pollen of flowering plants.

A big plus will be the rejection of food allergens that can aggravate the situation: coffee, chocolate, citrus, spicy, salty or smoked foods.

Important! It is not possible to cure polyps with surgery or by taking steroid drugs. These methods are purely symptomatic. They are necessary because there is no other way to get rid of polyps. However, to prevent recurrence, it is important to identify the causes of neoplasms and eliminate them.

These are benign formations from the mucous membrane that gradually grow, making nasal breathing difficult. They are formed both in the nasal cavity and in the paranasal sinuses. Upon closer examination, they look like outgrowths in the form of peas or grapes of a grayish-pearl color. They can be either single or multiple. Depending on the localization, there are choanal polyps, which close the entrance to the nasopharynx from the side of the nasal cavity, and polyps, located directly in the nasal cavity and paranasal sinuses. Basically, polyps grow from the cells of the ethmoid labyrinth, which are located in the upper parts of the nasal cavity.

Polyposis rhinosinusitis (PRS) is a fairly common disease. According to world literature, its prevalence in the population is from 1 to 4%, according to European data (EPOS), it affects from 1 to 6% of the population. In Russia, according to some authors, up to 5 million people suffer from ORS and there is a tendency for the number of detected cases to increase annually.

The main reasons for the formation of polyps

The development of the polyposis process occurs with concomitant diseases:

• Bronchial asthma. In this disease, there is an "aspirin triad of symptoms":
  • bronchial asthma
  • intolerance to non-steroidal anti-inflammatory drugs.
• Cystic fibrosis and Kartagener's syndrome. With the course of these diseases, the movement of cilia located on the apical surface of the mucosal cells slows down. This changes the constant flow of mucus in the nose, causing congestion and chronic inflammation of the mucous membrane, changes in its structure and the formation of polyps.
• Chronic, bacterial and fungal rhinosinusitis. According to studies, with a fungal infection, polyps form in 85% of cases.
• Disturbed structure of the nasal cavity. With a curvature of the septum, chronic vasomotor or hypertrophic rhinitis, the patient's nasal breathing is incorrect: that is, something blocks the path for the air flow, and it changes its direction. There is a constant mechanical load on the areas of the mucous membrane, chronic inflammation occurs, and polyps are formed.

Stages of development of the polyposis process

Symptoms of polyp formation

The most obvious symptoms:

• difficulty in nasal breathing;
• discharge from the nose is mostly mucous, thick. If there is an interaction with an infectious agent and we are talking about purulent-polypous rhinosinusitis, then purulent discharge also occurs;
• headache;
• fast fatiguability;
• decrease in working capacity;
• sleep disturbance, snoring;
• sneezing and itching in the nose.

Methods for diagnosing nasal polyps

Diagnosis begins with an examination by a doctor, followed by video endoscopy. The endoscope allows you to visualize much more than is possible to see with a conventional illuminator. There are also X-ray methods of research: computed tomography, magnetic resonance imaging. They help to see polyps in the nasal cavity and paranasal sinuses.

Features of treatment in children

Polyps are more common in adults than in children. But in childhood, as in any pathology of a chronic nature, doctors show a minimum of radicalism in relation to treatment, surgical treatment is in the background. And if surgery is still required, then it will be minimally invasive. If the child is under 15 years old and he is shown polypotomy, it will be gentle - with a laser, radio waves, endoscope or shaver, without opening the paranasal sinuses.

Children are treated conservatively, in addition to the appointment of local and general drugs, the treatment includes washing the nasal cavity by the method of movement. In the process of washing, allergens, bacteria from the nasal cavity and paranasal sinuses are washed away, and inflammation is reduced.

Conservative treatment of nasal polyposis

Conservative methods of treatment are indicated for patients in the presence of the initial and second stages of polyposis or if there are contraindications to surgical treatment. In addition, after surgery, in order to prevent recurrence, it is necessary to conduct periodic courses of conservative therapy.

In case of illness in children, conservative treatment takes precedence over other methods.

Surgical treatment of polyposis

Polypotomy is an operation to remove polyps, which can be supplemented by surgery on the paranasal sinuses, depending on the indications.

The amount of intervention depends on the localization and prevalence of the process. In the case of the development of polyposis, polypotomy is sufficient only in the nasal cavity. But if there is localization in the paranasal sinuses, then in such cases we are talking about an extended surgical intervention - it is necessary to remove polyps from the paranasal sinuses, which increases the volume of the operation. Such a surgical intervention will be called polysinusotomy in conjunction with polypotomy. During the operation, the surgeon under the control of the endoscope will be produced:

• removal of polyps;
• expansion of fistulas of the paranasal sinuses;
• deleting content;
• opening of the cells of the ethmoid labyrinth.

Contraindications for removal of polyps

• pregnancy;
• severe general somatic condition of the patient;
• bleeding risks leading to profuse blood loss (coagulopathy).

Polyp removal methods

Removal of a polyp loop

The operation is performed under local anesthesia. The main tool is a metal Lange loop, adjustable in width. First, local anesthesia is done, then the loop is put on the polyp and cut off at the base of the leg.

A significant drawback of the operation is that the polyp is not completely removed, because of this there is a high probability of recurrence. Also, during this operation, bleeding is possible, and the operation itself is not painless: when the doctor inserts a loop into the nasal cavity and puts it on the polyp, the loop touches the other walls and nasal septum. For the patient, this can be quite sensitive, despite the effect of local anesthesia.

However, Lange's loop surgery also has advantages. It can be performed under local anesthesia, the operation is budgetary for both the patient and the clinic - hence the prevalence of this method in public health structures.

Radio wave method for removing polyps in the nose

This method of surgical intervention is close to the removal of the Lange loop. But, despite the similarity of the methods, radio wave removal of polyps in the nasal cavity has a greater advantage: at the time of cutting the polyp, the radio wave immediately coagulates the polyposis tissue and reduces the risk of bleeding to zero. Also, the advantages of this operation include the ability to perform it on an outpatient basis and avoid the installation of nasal tampons in the nasal cavity after the operation.

The disadvantage of removing polyps with a radio wave is the risk of recurrence - the polyp is also cut off at the base. Radio wave polypotomy implies the removal of only large and medium-sized polyps.

Laser removal

Laser polypotomy involves surgical intervention under the control of the endoscope. The operation is performed on an outpatient basis and, most often, under local anesthesia. This is the best method for removing polyps in children.

Under the control of the endoscope, a laser knife is brought to the place where the polyp needs to be removed. Further, under the action of a heating beam, it is evaporated and reduced in size.

The advantages of this method are in the speed, efficiency and accuracy of execution. Laser polypotomy has a minimum of contraindications and is available to almost everyone.

Difficulties may arise if there are many polyps and they vary in shape and size. In this case, it will be difficult to remove them all. Another disadvantage is that the impact of laser polypotomy is limited to the nasal cavity. That is, if the formations are in the paranasal sinuses, they are not removed with this method.

All methods are performed without intervention on the paranasal sinuses and their fistulas, but can be supplemented with endoscopic polysinusotomy.

Removal of polyps in the nose with a shaver (endoscopic method)

The endoscopic method is the latest technology. Endoscopy is performed under general anesthesia and, in addition to the thorough removal of polyps, it makes it possible to open all the cells and sinuses of the nose, from where they grow, prolonging remission for years. Before the operation, the patient undergoes computed tomography in order to accurately establish the localization of the process. Careful removal of polyposis tissue from the paranasal sinuses using the endoscopic method, supplemented by polysinusotomy, is a significant advantage over other methods. It allows you to extend the period of remission for years or even for life.

In endoscopy, a shaver polypotomy is used. A shaver or otherwise microdebrider is a tool that has a cutting and suction function. When removed, it cuts the polyposis tissue and sucks it up at the same time. This operation is much faster, since there is no need to evacuate the removed tissue from the nasal cavity. Shaver polypotomy allows you to remove the source of polyp formation. The endoscopic method is the least traumatic for the patient and the most convenient for the surgeon.

Comparative characteristics of methods for removing polyps in the nose

Local anesthesia

In children older than 7 years and adults, it is possible to perform polypotomy under local anesthesia. Before the operation, a sedative is administered intramuscularly to the child. An anesthetic solution (10% lidocaine solution), vasoconstrictor drugs are sprayed or applied to the nasal cavity to relieve swelling from the mucous membrane and better view. After that, a less concentrated anesthetic solution (2% lidocaine or ultracaine) is injected into the mucous membrane of the nasal cavity to enhance the effect of anesthesia. During the operation, the patient is conscious and perceives everything around. Local anesthesia is indicated only in the case of surgical interventions limited to the nasal cavity - polypotomy.

General anesthesia (narcosis)

In children under 7 years old, polypotomy is performed under general anesthesia, so the intervention takes place without pain and, which is especially important for a child, without psychological stress. The clinic uses drugs of a high safety class, they are non-toxic, do not give complications, so anesthesia is easily tolerated even in childhood and feels like normal sleep. Also, under anesthesia, endoscopic polysinusotomy (FESS) and polypotomy, in case of a large amount of intervention, are performed in children and adults. The type of anesthesia is chosen by the operating doctor together with the anesthesiologist according to indications.

Anesthesiologists

The clinic employs experienced anesthesiologists, specialists from the Children's Clinical Hospital. N.F. Filatov, who have scientific degrees of candidates and doctors of medical sciences. Our specialists use the German Drager anesthetic apparatus, the latest generation of medicines. All this allows for removal under general anesthesia (anesthesia) that is safe for the patient's health with a quick recovery in the postoperative period.

Anesthetics

Anesthesiologists use Sevoran, Diprivan, Esmeron, Enfluron, Isofluran, Dormicum and others. The choice of a specific drug is at the discretion of the anesthesiologist and depends on each specific case, test results and other factors.

Choice of method of removal and anesthesia

The choice of method for removing polyps depends on the indications and contraindications. Before surgery is scheduled, the patient undergoes an examination and does a computed tomography. Next, the doctor carefully examines the location of the process. If it is limited to the nasal cavity and the cells of the ethmoid labyrinth, polypotomy is prescribed under local anesthesia, along with hormonal preparations necessary for remission. If the process is in all paranasal sinuses, a polysinusotomy is performed under general anesthesia.

With contraindications to anesthesia, the volume of the operation is reduced. Surgical intervention will only be aimed at removing polyps from the nasal cavity and improving nasal breathing.

Contraindications may be:

• pregnancy;
• severe chronic (congenital or acquired) somatic diseases.

The decision to perform the operation under anesthesia is made after a thorough examination of the patient together with the therapist and anesthesiologist.

The operation time is interconnected with the prevalence of the process. If this is a single polyp, then under local anesthesia the operation will take no more than 15 minutes, and if the polyposis process is localized not only in the nasal cavity, but also in the paranasal sinuses, the duration of the operation can be one hour or more.

Our clinic uses the best methods of surgical interventions for nasal polyposis and polypous rhinosinusitis:

• radio wave polypotomy
• laser polypotomy
• endoscopic shaver polypotomy (using a microdebrider), if necessary, supplemented by interventions on the paranasal sinuses and their anastomoses (polysinusotomy, FESS-functional endoscopic sinus surgery).

The clinic employs otorhinolaryngologists who are proficient in all methods of surgical interventions. The volume of surgical intervention and the method of anesthesia is chosen by the doctor after examination and careful examination of the patient.

Rehabilitation after polypotomy

The postoperative period depends on the amount of surgical intervention performed on the patient. If a polysinusotomy was performed, then the patient's nasal cavity is plugged to avoid postoperative epistaxis. In the case of endoscopic shaver or laser polypotomy without opening the sinuses, tampons are not needed.

Rehabilitation takes up to one week, with any type of intervention.

With minimally invasive interventions, this period is reduced to 2-3 days, until the convergence of reactive postoperative mucosal edema. After surgery, it is recommended to limit physical activity for 2-3 weeks.

After the operation, topical steroids are prescribed, as a prevention of the resumption of growth of polyposis tissue. Patients with polypous rhinosinusitis should undergo a course of topical steroids several times a year.

Complications due to delayed treatment of polyps

First, complications are possible with bronchial asthma. If polyposis is actively developing and polyps grow, asthma attacks become more frequent and are much more difficult to bear. Secondly, it is a violation of nasal breathing, which adversely affects the entire body. Lack of oxygen leads to the development of chronic diseases. In this case, the person will develop problems with the heart and lungs faster. Also, lack of oxygen leads to chronic fatigue and developmental delay (if the patient is a child).

Polyps contribute to chronic inflammation in the nasal cavity, the rapid penetration of infection into the lower respiratory tract, and even a common cold for a person with polyposis can cause complications.

Very rarely, polyps may degenerate into malignant tumors. But in addition, there are diseases, such as inverted papilloma or other neoplasms of the paranasal sinuses, the symptoms of which pass under the guise of a polyposis process, carrying a significant threat.

Prevention of the polyposis process

The best prevention is a timely visit to a doctor and a comprehensive treatment of diseases that contribute to the possible appearance of polyps. If a person has the slightest violation of nasal breathing, this should be a signal for action. Any violation of the structure of the nasal cavity and a violation of the air flow in it can contribute to the development of polypous rhinosinusitis. People with asthma should visit an ENT doctor at least once a year, undergo an endoscopic examination and, if necessary, have a computed tomography of the sinuses.

The cost of removing polyps in the nose

The cost of removing nasal polyps in our clinic using local anesthesia is from 18,000 rubles beforeRUB 35,000 depending on the complexity of the operation.

Removal of nasal polyps under general anesthesia fromRUB 70,000. The doctor can tell the final cost of the operation by evaluating the amount of work and taking into account the peculiarities of the course of the polyposis process in the patient.