Nasal PolypectomyWadie

Anatomy & Physiology Occur at any site in

the nasal cavity or paranasal sinuses but most often in the clefts of the middle meatus

Usually start at the osteomeatal complex of the nasopharynx (the sinus ostia)

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

Random Details Anesthesia: general or local with

vasoconstricting agents administered to the nasal cavity

Positioning: supine Supplies & Instruments: nasal set, nasal

speculum, rhinoscope (for endoscopic,) and surgeon’s choice for method of polyp removal

Procedure1. Time out2. After vasoconstricting agents have reached a

therapeutic level, the offending nasal cavity is retracted using a nasal speculum

3. The nasal canal is explored and polyps are removed (usually with a microdebrider)

4. Blood loss is checked, no suturing is required5. Packing depends on surgeon’s preference

Methods for Excising Polyps Lasers Polyp snare Polyp forceps Microdebrider

Ex: the Stryker “hummer”

Post-op Considerations Patient should be able to leave the

same day Corticosteroid nasal spray Saline rinses Polyps are very likely to reoccur

especially in patients with chronic rhinosinisitis

Complications include hemorrhage and damage to surrounding structures

http://www.entsurgery.net/nasal-polyps-removal.html