Removal of nasal polyps in the hospital. Nasal polyps

Polypotomy is a manipulation that allows you to get rid of polyps, restore normal nasal breathing, and also get rid of associated unpleasant symptoms(loss of smell, hearing, sleep, etc.)

Contraindications:

• bronchial asthma;
• poor blood clotting;
• cardiovascular diseases.

Equipment used:

• polyp loops for the nasal cavity;
• radio wave loop for removing nasal polyps;
• rhinoshaver (microdebrider).

Polyps are formations that arise in the paranasal sinuses and descend into nasal cavity, interfering with normal air circulation and proper breathing. Outwardly, they look like small bunches of grapes. When they grow, they not only make breathing difficult, but can cause unpleasant symptoms that cause discomfort and interfere with normal life: loss of smell, hearing, and sleep. People go to the clinic for the removal of nasal polyps only when signs of the disease appear, such as:

• difficult to breathe through the nose; vasoconstrictor drops do not make life easier, and you have to breathe through your mouth;
• due to poor air circulation in the nasal cavity develops pathogenic microflora, causing frequent viral diseases, accumulation of mucus and pus;
• the patient has the feeling that there is a presence in the nose foreign body;
• frequent headaches.

How to delete?

There are three methods of getting rid of polyposis: laser removal nasal polyps, removal under the control of an endoscope and a loop. The operation itself is called polypotomy.

1. Laser removal is the most delicate and safe method. It is performed under local anesthesia and lasts about 20 minutes. Suitable for those patients who cannot undergo general anesthesia and for children. The only disadvantage of the procedure is that only single polyps can be removed using this method; it is not possible to remove them inside the sinuses. The price for laser removal of nasal polyps in Moscow clinics depends directly on the degree of polyp growth and pricing policy clinics.
2. Using an endoscope, you can see polyps in the most inaccessible corners, including in the sinuses. Moreover, the risk of recurrence of polyposis is sharply reduced. The image from the endoscope camera is displayed on the monitor, and it becomes possible to see the number of polyps and their size. The operation is performed both under local anesthesia and general anesthesia.
3. If the formations are large, they need to be removed with a loop. The loop can be tearing and cutting. The first is used when endoscopic polypotomy is performed for the first time, the second - for repeated surgery. You can use the loop of the Surgitron device - this is a more gentle method. First, local anesthesia is performed with a lidocaine solution, then an injection with an anesthetic. The whole procedure lasts about an hour. Using this method, you can get rid of multiple tumors, but only those located in the nasal cavity. The method is contraindicated in patients with bronchial asthma, poor blood clotting and cardiovascular diseases. An unpleasant consequence surgery is the possibility of re-formation of polyps within a year.

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Forecast

After the intervention it is necessary great attention pay attention to nasal hygiene. You can't blow your nose sharply. Crusts in the nose must be removed very carefully. You should not eat very hot food. Breathing returns to normal within a few days after endoscopic polypotomy, and the sense of smell returns within 30 days. At home, you need to rinse your nose with products like Aquamaris, Aqualor, etc. and take allergy medications. And of course, observation by an otolaryngologist is necessary.

We have endoscopic polypotomy

The price of surgery to remove nasal polyps depends on several factors. First of all, it depends on the degree of growth of formations. The more advanced the disease, the longer, more severe and more expensive it will cost this operation. The cost in Moscow of this operation also depends on the chosen removal method. Thus, the cost of laser nasal polypotomy in Moscow will be more expensive than conventional polypotomy.

The cost of removing nasal polyps with a laser, loop or endoscope in our clinic has remained unchanged for 3 years.

To find out the exact cost of manipulations, you need to contact the specialists of our clinic for an initial diagnosis. ENT doctors will conduct a comprehensive examination, the results of which will reveal the extent of the disease, the number of formations, their size, and suggest one of the surgical methods. After the examination, the ENT specialist will announce the exact price for nasal polypotomy with a laser, using a loop or an endoscope.

You can find out how much a procedure costs in a clinic on the website or at an appointment with an ENT specialist

Consultation with an ENT doctor

* - the cost of admission is included in the cost of the operation

ENT diagnostics

ENT manipulations

Possible ENT procedures in the postoperative period

Medical service	price, rub.
Removing tampons from the nasal cavity with treatment of the nasal cavity	500
Sanitation of the nasal cavity	500
Nasal cavity toilet	500
Session of laser photodynamic therapy of the nasal cavity and nasopharynx	1000
Pawning medicinal ointment into the nasal cavity	500
Ultrasonic medicinal irrigation session (TONZILOR-M device)	1000
Session of infrared laser therapy of the nasal cavity and nasopharynx	200
Ultraviolet irradiation session of the nasal cavity and nasopharynx	200
Vibroacoustic therapy session in the projection of the maxillary sinuses	200
Magnetic therapy session with the “POLYUS – 2D” device	200
Percutaneous infrared laser treatment using the RVB device (Italy)	200

** - discount is provided for complex treatment of the disease

Polyps in the nasal cavity are almost impossible to remove conservative method. Surgery to remove nasal polyps is the only way to radically solve the problem. Treatment of nasal polyps without surgery does not exclude further growth of pathological tissue, which has a bad effect on nasal breathing and leads to brain hypoxia. Surgical treatment helps restore natural ventilation and prevents complications of polyposis.

Indications for use

Polyps not only create a mechanical obstacle to air circulation, they change the structure of the nasal mucosa. If the formations are small, then they try to cure nasal polyps using a conservative method. They use antihistamines and antiallergic drugs, macrolide antibiotics, and physiotherapy.

Polyposis can be cured without surgery if it is allergenic or fungal in nature. Medicines can stop the growth of pathological tissue and reduce existing formations. In case of gross violations respiratory function It will not be possible to restore the functionality of the nose without surgery.

Indications for surgical treatment are:

• snoring during sleep, risk of respiratory arrest;
• progressive deformation of the nasal septum;
• inability to restore nasal breathing using other methods;
• purulent-inflammatory processes of the paranasal sinuses;
• loss of smell and impaired sense of taste;
• nasal discharge mixed with blood.

Surgery is not always possible. In this case, the doctor will tell you how to treat nasal polyps without surgery. But one cannot count on significant improvements. Refrain from surgical intervention will be necessary for oncological diseases, serious cardiovascular pathologies, and blood diseases. Doctors of various specializations will decide together how to restore nasal breathing without surgery and avoid complications. Therapy is selected taking into account minimal harm to the patient.

Preoperative preparation

If the decision to undergo surgery is made, the patient must be examined by a specialist and undergo tests. During the examination, the ENT doctor identifies complicating factors: chronic diseases, allergic reactions, other pathologies in the functioning of the respiratory system. If a person is taking blood thinning drugs, they should be stopped.

Mandatory research methods include:

• clinical blood and urine tests;
• blood biochemistry;
• computed tomography of the nose;
• X-ray examination if necessary;
• video endoscopic examination of the nasal cavity and sinuses.

A week before the operation, a chest X-ray, electrocardiography, and blood donation are done to check for markers of dangerous viruses. The patient is prescribed decongestants. 6 hours before the procedure, the patient is prohibited from eating and drinking.

Types of surgical treatment

You can remove nasal polyps various methods. The choice of surgical treatment is determined by individual characteristics and the need for additional operations.

In case of a deviated septum, polypotomy is performed simultaneously with surgery to correct the nose. Conchotomy or drainage of the paranasal sinus may also be required if it is chronically inflamed.

The doctor selects a treatment method based on the patient’s age, concomitant diseases, and predicted complications. There are five main surgical methods treatments that allow you to remove polyps with minimal risk.

Classic polypotomy

Surgery to remove nasal polyps using a loop is considered obsolete. But it can be performed in any conditions with minimal cost. The disadvantages of the method are high trauma, pain and the risk of re-formation of polyps. The loop encircles the polyp and literally cuts it off, but the deep areas remain untouched. As a result, the nasal passages are cleared, but the polypous tissue is not completely removed.

As for the advantages of the method, there are several:

• speed of implementation;
• minimum contraindications;
• no need for anesthesia.

An experienced doctor can remove polyps painlessly and efficiently, which reduces the risk of tissue regrowth.

Endoscopic removal of polyps

How to remove growths more accurately? In this case, you cannot do without an endoscope. It allows you to monitor the progress of the operation on the monitor. The camera is located at the tip of the surgical device and transmits images in real time.

During the operation, it is possible not only to get rid of growths, but also to straighten the nasal septum. In case of congenital anomalies of the nose, this particular treatment method is recommended.

Endoscopy is good because it allows you to remove even the smallest tissues of a pathological nature. At the same time, the risk of injury is minimal. In the case of deep polyps or multiple formations, surgical removal using an endoscope allows the procedure to be performed as accurately as possible.

No long recovery after surgery is required. The tissues heal quickly, nasal breathing returns to normal within 24 hours. Swelling subsides within a few hours, and complications practically do not occur. If, after removal with a loop, polyps grow again after a year and a half, then after endoscopy, relapses occur after 6-7 years and only in half of the cases.

The cut tissue is sent for histology. If malignancy is suspected, the patient is sent to the oncology center. If the operation is successful, the nose is plugged for a day. You should not blow your nose or sniffle for 48 hours. Do not touch the formed crusts until they peel off on their own.

Shaver polypotomy

Endoscopic surgery for nasal polyps can be performed with a shaver. Unlike a conventional scalpel, this device is equipped with additional suction. The device cuts off the formation along with the stem and draws it into a special compartment. Indications and contraindications for this method the same as with conventional endoscopy.

The advantages of the shaving operation include ease of execution and high accuracy. In rare cases, treatment is carried out without video navigation. But then the accuracy of the operation decreases. Without an endoscope, it is allowed to remove only nearby polyps, whose location does not need to be clarified.

The relapse rate will be slightly lower than after traditional endoscopic polypotomy. Regarding complications and side effects treatment, then in rare cases it is prolonged rhinitis and adhesions.

Laser removal

Treatment of nasal polyps using laser is the most reliable and modern. The method is recommended for elderly people and children, as well as those who have chronic ENT diseases. Nasal polyps are treated with a high-precision laser. As a result, the pathological tissue literally “burns out.” Bleeding during this procedure is excluded, and the nasal passages are quickly restored.

The method has several undeniable advantages:

• painlessness;
• lowest risk of complications;
• high accuracy;
• minimum recovery period;
• speed of the operation.

No nasal packing is required. Nasal breathing is restored almost immediately. It avoids swelling and secondary infection. But laser therapy not always effective. The method is not used for multiple polyposis, as well as for deep formations in the sinuses. The disadvantages of the method include high cost. Laser surgery will cost several times more than classical polypotomy.

Radio wave surgery

The operation is performed using the Surgitron apparatus. Long-term postoperative treatment is not required. The tissues are quickly restored, infection is excluded. The rehabilitation period is minimal. But, despite the advantages of the method, it is not as widespread as those described above.

Rehabilitation

For 10 days after surgery, it is necessary to monitor the condition of the nasal cavity and carry out anti-relapse therapy. Just as you cannot do without surgery in case of large-scale tissue proliferation, you cannot neglect postoperative therapy. A mandatory component of treatment is rinsing the nasal cavity. But it must be done by a doctor. This is why it is recommended to stay in the hospital for several days after surgery.

To treat the nasal cavity, use saline solution or pharmaceutical drugs– “Aquamaris”, “Aqua-Rinosol”, “Morenazole”. Postoperative therapy is determined by the reasons for the formation of polyps. If these are allergic reactions, then you cannot do without antihistamines. Moreover, they are taken not only immediately after the operation, but also in preventive courses. It is advisable to take drugs such as Loratadine, Lomilan, Claritin.

Observation after surgery continues for a year. Rhinoscopy is recommended to be performed every 3 months even in the absence of complaints from the patient.

Possible complications

If the growths are not removed in time, irreversible processes may develop. One of the complications of polyposis is the complete loss of smell. It cannot be restored even after removing the growths.

Brain hypoxia is considered a dangerous complication of progressive polyposis. The inability to breathe freely through your nose can cause sleep apnea. Prolonged hypoxia causes problems with memory, concentration and attention. Such phenomena are especially dangerous in childhood. Polyposis, accompanied by hypoxia, inhibits mental development in young children.

Due to difficulties with nasal breathing, the risk of inflammation of the paranasal sinuses increases. The maxillary sinuses are the first to be affected. Any cold can cause sinusitis. The infection takes root in maxillary sinuses oh, what complicates the course of polyposis. Subsequently, the inflammatory process rises upward, covering the frontal sinuses and tissues of the ethmoidal labyrinth.

If the growth of pathological tissue does not stop, then bone deformities cannot be ruled out. Resorption of cartilaginous structures occurs. Pressure on the nasal septum provokes its destruction. If the polyp penetrates the nasolacrimal duct, persistent lacrimation occurs.

Prognosis and prevention

How to prevent the appearance of pathological formations, and how to treat nasal polyps without surgery? Unfortunately, there are no universal methods with proven effectiveness. Radical therapy is inevitable when natural air exchange is disrupted. But even after removing the formations, it remains high risk relapses. In this case, you should stop it in time respiratory infections, moisturize the nasal mucosa when it dries out, treat dental diseases.

To prevent the growth of polyps, macrolides are prescribed in short courses, as well as nasal corticosteroids. Physiotherapy plays an important role in the prevention of polyposis. Patients who have undergone surgery are advised to:

• electrophoresis – procedures with calcium preparations have proven the most effective. According to the results of therapy, the patient experiences an improvement in general well-being, nasal breathing is completely restored, and the nutrition of the nasal tissues is enhanced;
• UHF therapy – consists of 7-10 sessions. Aimed at stimulating blood circulation, improving the outflow of lymphatic fluid, preventing inflammatory processes, preventing exacerbation of chronic ENT diseases;
• Magnetic therapy – starts regeneration processes, enhances capillary blood supply, strengthens superficial vessels.

All methods of physiotherapy are good because they not only improve the condition of the nose, but also increase the body’s overall resistance to infections. A visit to the physiotherapy room is recommended for those who have concomitant chronic illnesses. The otolaryngologist can additionally refer the patient to Spa treatment. Homemade herbal remedies help enhance the effectiveness of physiotherapy.

Traditional medicine methods can stop the growth of polyps. They are practically ineffective in terms of treatment, but are considered the safest and most affordable preventive agents.

Using homemade rinsing solutions and homemade drops can eliminate swelling, cleanse the nasal passages, and reduce the risk of infection. Among the most popular recipes:

• sea ​​buckthorn oil - it is instilled into each nostril daily in short courses. The product has antiseptic properties, softens the mucous membrane and prevents respiratory diseases;
• horsetail decoction - used for nasal rinsing. Brew 2 tbsp. l. herbs 500 ml boiling water. The product perfectly removes swelling, stimulates regenerative processes, normalizes cellular metabolism;
• white lily tincture - seven large bulbs are placed in a three-liter jar, filled with alcohol and left for 14 days. Cotton pads are moistened with the product and placed in the nasal passages. The procedure is carried out once a week, and the turundas themselves are changed up to 3 times during the day.

Nasal polyps- These are round, benign, painless to the touch formations that are the result of proliferation of the nasal mucosa. Externally, 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 susceptible to it 3-4 times more than women. Antrochoanal polyps are more common in children, while ethmoidal polyps are more common in adults.

The disease is manifested by nasal congestion and mucous discharge. Unlike a common runny nose, after use vasoconstrictor drops breathing does not improve. A person is forced to breathe through his mouth. As a result, dry air enters the lungs, not sufficiently purified from dust and allergens. This causes frequent respiratory diseases and asthma. As a result, polyposis reduces a person’s life expectancy by 6 years.

Anatomy of the nose

The human nose is quite complex design. The part we see is called the external nose. It includes: frontal process upper jaw, lateral cartilage and greater pterygoid cartilage of the nose. The lateral surfaces - the wings of the nose - consist of cartilage and connective tissue; from below they open with the nostrils. All this is covered on top with muscles and skin rich in sebaceous glands.

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. Many people have a deviated septum. Minor changes are considered normal.

The nasal cavity has four walls:

• lateral
• internal
• top
• lower

The most complex structure is the lateral wall, on which the upper, middle and lower nasal turbinates are located. It is formed by the nasal bones, the upper jaw, the lacrimal bone, the ethmoid bone, pterygoid process sphenoid bone, inferior nasal concha (independent bone) and vertical plate of the palatine bone.

Between the nasal septum and the nasal turbinates there is a space called the common nasal meatus. 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 duct opens in the inferior nasal meatus.

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

All this a complex system performs a number of vital functions.

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

But all these functions of the nose would be impossible without the special mucous membrane that lines the nasal cavity. On top it is covered with pseudostratified epithelium. Below is loose connective tissue, beneath it is a layer of glands and perichondrium ( upper layer cartilage).

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

The protective function of the inner lining of the nose is provided by ciliated cells ciliated epithelium. Each of them has 250-300 cilia several microns long. Cilia trap the smallest particles of substances contained in the air. Vibrating movements of the cilia send these substances into 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 sticking to it. Then this contaminated mucus is pushed out by the movement of the cilia and natural cleansing of the respiratory tract occurs.

Causes of nasal polyps

During infectious diseases, microorganisms multiply on the mucous membrane. This process leads to the detachment of the upper layer of mucosal cells. At this time, we feel a burning sensation in the nose, stuffiness, and voice changes. Mucus flows from the nose, which is the result of increased work of the mucous glands and exudate, a liquid that is formed during inflammation. At proper treatment and normal immunity, recovery occurs after 7-10 days. The mucous membrane is restored and is again able to perform its functions.

If the disease is not treated, it may drag on and develop into chronic form. A prolonged inflammatory process undermines local immunity and the strength of the mucous membrane. But it is trying to fulfill its functions by increasing the area. As a result, it begins to grow rapidly and thicken due to the growth of connective tissue. This often occurs in the paranasal sinuses. At a certain point, hyperplastic (overgrown) mucous membrane emerges from the sinus opening into the nasal cavity - this is usually called a polyp.

The cause 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 house and library dust, plant pollen, fungal spores, animal hair, particles of household chemicals, chromium compounds
• severe curvature of the nasal septum, causing breathing problems and proliferation of the mucous membrane
• hereditary tendency to form polyps
• pathological reaction immune system

A number of diseases can affect the occurrence of polyps: asthma, cystic fibrosis, aspirin intolerance, nasal mastocytosis, Young's syndrome.

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

• Antrochoanal – most often arise from the mucous membrane of the maxillary sinus. Located on one side. More common in children.
• Ethmoidal– develop from the mucous membrane lining the ethmoid labyrinth. They occur on both sides of the nasal septum. It affects people in adulthood.

Based on the size of the polyp and the changes it causes, polyps are divided into three stages:

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

Symptoms of nasal polyps

A nasal polyp is a round formation ranging from a few millimeters to 3-4 centimeters. It is painless, insensitive to touch and easy to move.

Symptoms of nasal polyposis include:

• Prolonged difficulty breathing through the nose, feeling of nasal congestion. This is caused by the fact that the overgrown mucous membrane partially or completely blocks the lumen of the nasal passage.


• Runny nose, mucous or mucopurulent discharge. These are signs of a secondary infection and intensive work 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.


• Smell disorders, up to complete loss of sensitivity to odors. When connective tissue grows, the functioning of receptor cells in the polyp that perceive odors is disrupted.


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


• Voice disorders, nasal sound. The nose is an organ that takes part in the formation of the voice. With polyposis, the passage of air is disrupted and this causes the person to speak “through the nose.”

Treatment of nasal polyps

Treatment of polyps depends on the stage of the disease and the cause that caused the growth of the nasal mucosa. If the size of the polyps is small, the doctor will prescribe medication.

For 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 the allergy. After this, 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 case where polyps are caused by aspirin intolerance, it is necessary to exclude from the menu all foods rich in salicylates (strawberries, gooseberries, cherries, currants), some nutritional supplements and dyes. Also stop taking all non-steroidal anti-inflammatory drugs that contain acetylsalicylic acid.

Treatment with topical steroids (Beclomethasone, Mometasone, Fluticasone) helps reduce the size of nasal polyps, relieve inflammation and swelling of the mucous membrane. They provide a good therapeutic effect, but have a significant drawback. Treatment requires taking large doses of steroids for a long time, and this can cause serious side effects.
Membrane stabilizers are used for treatment mast cells– cromoglycates (Ketotifen, sodium cromoglycate), which can stop the release of histamine in the body. This substance causes allergies, swelling of the mucous membranes and increased activity of the respiratory tract.

IN last years Immunotherapy has become widespread. To restore the functions of the immune system, immunocorrective drugs are used bacterial origin(Ribomunil, Polycomponent vaccine VP-4). They contain bacterial antigens and nonspecific immunomodulators in the form of lipopolysaccharides. These drugs cause the body to produce special antibodies that increase immunity.

In the event that the patient consults a doctor at a late stage or when drug treatment does not produce results, surgery may be prescribed to remove polyps.

Indications for carrying out surgical removal polyps are:

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

Preparing for surgery necessarily starts with full examination patient. This is necessary in order to determine the state of health and identify possible contraindications. You need to tell your doctor:

1. What medications the person is taking (for example, anti-inflammatory birth control pills)
2. About the presence of chronic diseases
3. About problems with cardiovascular system
4. About cases of allergies to medications and other substances

To determine the structural features of the nose, diagnose inflammation in the sinuses, and identify a deviated nasal septum, radiography or computed tomography is performed.

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

Medication preparation for surgery:

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

Methods for removing nasal polyps. Types of operations

Conventional polypotomy

Polypotomy is an operation that allows you to get rid of polyps using a cutting loop or Lange hook. Its advantage is that in one procedure you can get rid of numerous polyps.

On the day of surgery, you must refrain from eating. The procedure is performed under local anesthesia. 2 ml of a 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 stalk of the polyp and cut off. The Lange hook is used when it is necessary to remove a polyp arising 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 basin. His head is covered with a sterile sheet. After surgery, the mucosal surface is disinfected. If necessary, the nose is swabbed. Turundas soaked in Vaseline are inserted into the nose and secured with a sling-shaped bandage. This procedure leaves no scars and usually very little bleeding.

After the operation, the patient remains in the hospital for several days. The tampons are removed the next day and lubricated with synthomycin ointment. As prescribed by the doctor, the patient goes for nasal rinsing. 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: acute period colds, blood clotting disorders, heart problems. In bronchial asthma, conventional polypotomy can cause status asthmaticus. Therefore, it is advisable for such patients to choose another method of polyp removal.

A significant disadvantage of this intervention is that the polyp grows again in 70% of cases. And the patient may need repeat surgery after 6-12 months.

Endoscopic surgery

The procedure is performed under local anesthesia. An endoscope with a camera is inserted into the nasal cavity through the nostril. The image is displayed on the computer screen. This allows you to accurately determine the size and number of polyps and eliminate them without affecting important structures of the nose. By using endoscopic equipment All altered tissues are removed and the structures of the nose are corrected. With this method of treatment, there are no traumatic scars left.

After the operation, there is a feeling of discomfort that goes away quite quickly. The patient feels significant relief in breathing. For 2-3 days, bloody or mucous (not purulent) discharge is possible. Within 24 hours 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 Nasonex spray.

Contraindications: exacerbation of bronchial asthma and chronic bronchitis, the period of flowering of plants, if they cause an allergic rhinitis. For women, the operation is planned so that it does not coincide with menstruation.

Shaver removal

One of the types endoscopic surgery, when the doctor sees everything that is happening on the monitor screen and is in complete control of the situation. The procedure is carried out under general or local anesthesia.

A shaver or microdebrider removes polyps as accurately as possible until healthy tissue. It kind of crushes the tumors and absorbs them. The operation is low-traumatic and allows maximum preservation of healthy mucous membranes. 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 recurrent polyps.

After the operation, the patient remains in the hospital for 3-5 days. During this period, saline rinses are prescribed to remove tissue debris and antibiotics to prevent secondary infections. Local steroids are prescribed to prevent re-growth of connective tissue.

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

Removal of polyps with laser

This procedure can be performed on an outpatient basis, meaning you do not have to go to the hospital. It is better not to eat on this day. The patient is injected into the area of ​​the polyp with an anesthetic drug. An endoscope with a camera and laser equipment are inserted into the nasal cavity. By using laser beam the doctor heats the cells that make up the polyp, and they evaporate. During the operation, the laser seals the vessels, and bleeding does not occur. Also, with this procedure, the possibility of infection is completely eliminated. This is the least traumatic procedure and is suitable for people with asthma and children.

After the operation, the patient must visit a doctor for several days to monitor the condition of the mucous membrane. It is not recommended to drink alcoholic beverages, visit the bathhouse or play sports. This may cause bleeding. Special aerosols are often prescribed to prevent the reappearance of polyps.

Pregnancy is a contraindication to the procedure. 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 treating polyps with folk remedies?

Treatment of polyps with folk remedies is used quite widely and dates back hundreds of years. But official medicine does not recognize the effectiveness of using herbs. Doctors warn that nasal polyposis is often caused by allergic reactions. And many traditional medicine recipes are based on products such as honey, propolis, essential oils various plants. They can intensify the manifestations of allergies and worsen the situation.
At the same time, traditional medicine has not yet fully studied the problem of the occurrence of polyps and cannot guarantee that after treatment with medications or surgery, polyps will not reappear.

Treatment of polyps with folk remedies eliminates the very cause of the disease. Natural components have a comprehensive effect on the body. They help restore 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 large sizes, then with the help of natural remedies it will not be possible to get rid of it. In this case, it is necessary to remove the tumor. And after the operation, folk remedies are used to prevent recurrent polyps.

Treatment of nasal polyps with folk remedies

Nasal drops

1. Recipe from the series
   The stem and flowers of the fresh string 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, instill 2-3 drops into each nasal passage, 2 times a day. The course of treatment lasts 20 days.


2. Anise drops
   You need to take 15-20 g of dry anise and grind it. Pour 100 ml of alcohol over the herb and let it brew for 8 days in the refrigerator. Shake the tincture thoroughly before use. Then dilute with boiled water room temperature in a ratio of 1:3. The resulting composition must be instilled 3 times a day, 10 drops into each nostril. Continue the course for 15 days. If the polyps do not go away, take a break for 2 days and continue treatment.


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


4. St. John's wort and celandine drops
   Take dry St. John's wort powder 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. Drip 2 drops 4-5 times a day. The course of treatment is 10-15 days.

Ointments for the nose

1. Propolis ointment
   To prepare this medicine you need to take 15 grams. homemade propolis, 10 gr. Vaseline and 25 gr. butter. Mix the ingredients thoroughly until a homogeneous consistency is obtained. Then cotton swabs are soaked in 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 in it cotton swab and anoint problem areas in the nose. Perform 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.

Nasal inhalations

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


2. Inhalation of chamomile and celandine
   You need to take 2 tbsp. spoons of crushed chamomile and celandine. Pour boiling water and put on low heat. After the broth boils, remove from heat and carefully inhale the steam. It is advisable to do the procedure 2 times a day for 10-15 days. Then take a break for 5 days and repeat the treatment for another 10 days.

Using celandine to treat nasal polyps

Celandine is one of the most popular plants, which is used in both 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. The stem, roots and flowers of celandine are used for medicinal purposes. This medicinal plant collected during the flowering period. The root is cleaned from the ground and stored in a cool, dark 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. Celandine drops
   To prepare the drops, you need to take fresh celandine roots and flowers. Rinse them thoroughly with running water. Then grind in a blender or meat grinder. Squeeze the resulting mass through cheesecloth, expressing the juice into a clean glass container. Then let it brew for 5 days in a cool, dark place. After this, the drops are ready for use. Using a dropper, place 2-3 drops into each nostril daily, 3 times a day. The duration of the course is 10 days.
   Juice from freshly picked stems is also used as drops. Instill 1-2 drops of pure juice, 2 times a day, for 10-15 days. After which you need to take a break for 10 days. Repeat the course 3-5 times.


2. Infusion of celandine
   Take 1 tsp. crushed dry celandine, place in an enamel container and pour 200 ml. boiling water Cover with a lid and let sit for half an hour. Strain the resulting infusion through cheesecloth. Soak cotton swabs in the product and insert one by one into each nasal passage for 15 minutes, 2 times a day. The course of treatment is 2 months. After which you need to take a break for 1 month and repeat the course.
   An infusion of celandine is also used to rinse the sinuses. This method is most effective in treating nasal polyps. The infusion is poured into each nostril one by one and spat. The procedure must be done 2-3 times a day for 15 days.

How to treat nasal polyps in a child?

Polyposis is considered an adult disease, but can also develop in children. Usually in teenagers over 10 years of age. Most often, antrochoanal polyps develop from the mucous membrane of the maxillary sinuses. The main reasons for their occurrence in childhood are frequent, prolonged runny noses and allergic reactions to dust particles, animal hair or fungal spores. Treatment of polyps in a child is related to the causes of inflammation.

It is necessary to conduct allergy tests to determine what exactly causes irritation of the mucous membrane. If you eliminate the patient's contact with this allergen, then there is a chance that the polyps will stop growing and begin to shrink.
After you find out what foods you are allergic to, you can begin treating polyps in your child. traditional methods.

The safest procedures for the baby are salt rinses. You can purchase a saline solution at a pharmacy or make it yourself. To do this, you will need a liter of boiled water and two teaspoons of sea or regular salt. Rinse your nose with a warm mixture 4-5 times a day using a 5 ml syringe.

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

Small polyps in children are treated with medications:

• antibiotics (Augmentin, Azimed)
• antiallergic drugs (Cetrin)
• mast cell membrane stabilizers (Ketotifen)
• steroid drugs (Beclomethasone)

In order to stop the growth of polyps, it is necessary to increase immunity. This can be done through hardening and taking vitamins, immunomodulating drugs and special bacterial antigens (vaccines).

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

• nasal congestion for several weeks
• smell disturbances
• headache
• copious mucopurulent discharge
• hoarseness of voice

A laser is suitable for removing single polyps in a child. This procedure is the least traumatic and does not require a long hospital stay.

How are nasal polyps removed?

In the event that there are indications for surgical removal nasal polyps and the doctor insists on surgery, then the patient can choose the removal method.

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. A device that directly removes polyps is called a shaver. It crushes the polyp tissue and removes it from the nose. The shaver penetrates the paranasal sinuses through natural openings and removes polyps there. Thus, it is possible to completely get rid of the changed tissue and prevent relapse of the disease.


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

What to do after polyp removal?

After removal of polyps, antibiotics must be taken and steroid drugs, which prevent the occurrence of inflammation and complications.

It is necessary to instill oil drops into the nose: Pinosol or sea ​​buckthorn oil. This will speed up healing. They are used for 3-5 days 3-4 times a day.

In order to wash away germs and allergens from the mucous membrane, salt sprays are used. They can be used for a long time and are a prophylactic against ARVI.

Assign local remedies based on steroids. They do not cause systemic side effects. The drugs are intended to prevent the regrowth of polyps. They have antiallergic and anti-inflammatory properties. Most effective means is Nasonex spray.

You need to be attentive to your health. If measures are not taken, polyps can reach large sizes and lead to sinusitis, otitis media, deviated nasal septum, and even the development of a cancerous tumor. If, upon examination by a doctor, you were diagnosed with polyps, do not despair. Modern traditional and folk medicine offer many options for treating this problem.

Polyps of the nasal cavity and nasopharynx- This benign formations, which are a pathological growth of the mucous membrane of the nose and paranasal sinuses, similar in appearance to bunches of grapes. Polyps can interfere with breathing and become injured, so it is recommended to remove them. If you need a clinic in Moscow where they perform nasal polyp removal, contact Family Doctor JSC.

Causes of formation of nasal polyps

The main reasons for the formation of nasal polyps are:

allergic diseases: allergic rhinitis, bronchial asthma;

chronic inflammatory diseases paranasal sinuses (sinusitis);

anatomical disorders of the structures of the nasal cavity.

Polyps are capable of growing. As it grows, the body of the polyp fills the surrounding free space, partially or even completely blocking the nasal passages. As a result, nasal breathing is impaired.

If nasal breathing is impaired, the polyp must be removed. Surgery to remove polyps is called polypotomy.

Preparation for polypotomy - operations to remove nasal polyps

A referral for polypotomy is issued by an ENT doctor based on an examination. It will be necessary to undergo general clinical and biochemical blood tests. It is good if a computed tomography scan of the paranasal sinuses is done first.

Removal of nasal polyps (polypotomy)

At Family Doctor, polyps of the nasal cavity and nasopharynx are removed using high-tech equipment - a medical laser or a Surgitron radio wave surgery device.

Removing nasal polyps using high-tech equipment has the following advantages:

Pathological mucosal tissues are completely removed, which significantly reduces the risk of polyp re-formation;

the operation takes place with minimal blood loss;

short recovery period after surgery (3-4 days);

• The sterility of the procedure is ensured, which minimizes the possibility of infection during surgery.

You can find out prices for nasal polyp removal services below.

These are benign formations from the mucous membrane that gradually grow, making nasal breathing difficult. They form both in the nasal cavity and in the paranasal sinuses. Upon closer examination, they look like outgrowths in the form of peas or a bunch of grapes of a grayish-pearl color. Can be either single or multiple. Depending on the location, 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 cells of the ethmoid labyrinth, which are located in the upper parts of the nasal cavity.

Polypous rhinosinusitis (PRS) is a fairly common disease. According to world literature, its prevalence in the population ranges 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 PRS 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 polypous process occurs when concomitant diseases:

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

Stages of development of the polyposis process

Stage	Stage I	Stage II	Stage III
Size	Closes only top part nasal septum.	Closes the common nasal passage to the lower border of the middle turbinate.	Covers the entire space.
Complaints and signs	The patient is concerned about a decrease in sense of smell or loss of it. Polyps do not interfere with breathing and are discovered by chance.	Polyps are visible during endoscopy or rhinoscopy. The patient is concerned about slight difficulty breathing through the nose and mucous discharge from the nose.	The patient stops breathing normally, vasoconstrictor drops do not help him, and a nasal sound develops.

Symptoms of polyp formation

The most obvious symptoms:

• difficulty in nasal breathing;
• Nasal discharge is mostly mucous and thick. If there is interaction with an infectious agent and we are talking about purulent-polyposis rhinosinusitis, then purulent discharge occurs;
• headache;
• fast fatiguability;
• decreased performance;
• sleep disturbance, snoring;
• sneezing and itchy nose.

Methods for diagnosing nasal polyps

Diagnosis begins with an examination by a doctor, followed by video endoscopy. An endoscope allows you to visualize much more than is possible with a conventional illuminator. There are also X-ray methods 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 with any chronic pathology, doctors show a minimum of radicalism in relation to treatment; surgical treatment takes a back seat. And if it is still required surgery, then it will be minimally invasive. If the child is under 15 years of age and polypotomy is indicated for him, it will be gentle - with a laser, radio waves, endoscope or shaver, without opening the paranasal sinuses.

Children are treated conservatively; treatment, in addition to the prescription of local and general medications, includes rinsing the nasal cavity using the displacement method. During the rinsing process, allergens and bacteria from the nasal cavity and paranasal sinuses are washed away, and inflammation is reduced.

Conservative treatment of nasal polyposis

The first place in conservative treatment is occupied by hormonal drugs: local - topical steroids, and systemic. Systemic hormonal drugs are used mainly in patients with moderate to severe bronchial asthma. They reduce the intensity and frequency of asthma symptoms, and also counteract the growth of polyposis tissue. Conservative treatment includes mast cell membrane stabilizers and antihistamines. If the polyposis is of an allergic nature or if we are talking about a purulent polyposis process, then antibacterial medications are used. In the case of a fungal process, antifungal agents are prescribed.

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

When the disease occurs 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 volume of intervention depends on the localization and extent of the process. If polyposis develops only in the nasal cavity, polypotomy is sufficient. But if the localization is also in the paranasal sinuses, then in such cases we are talking about 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 polysinsotomy together with polypotomy. During the operation, the surgeon under endoscope control will be produced:

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

Contraindications to polyp removal

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

Polyp removal methods

Removal of a polyp with a loop

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

A significant drawback of the operation is that the polyp is not completely removed, which creates a high probability of relapse. Also, during this operation, bleeding is possible, and the surgical intervention 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 septum of the nose. This may be quite sensitive for the patient, despite the action local anesthesia.

However, surgery with a Lange loop also has advantages. It can be performed under local anesthesia; the operation is inexpensive for both the patient and the clinic - hence the prevalence of this method in public healthcare structures.

Radio wave method for removing nasal polyps

This method of surgical intervention is close to removal with a Lange loop. But, despite the similarity of methods, radio wave removal polyps in the nasal cavity has a greater advantage: at the moment of cutting the polyp, the radio wave immediately coagulates the polypous tissue and reduces the risk of bleeding to zero. Also, the advantages of this operation include the ability to carry it out in outpatient setting and avoid inserting nasal packs into the nasal cavity after surgery.

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

Laser removal

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

Under the control of an endoscope, a laser knife is brought to the place where it is necessary to remove the polyp. Then, under the influence of a heating beam, it evaporates and decreases in size.

The advantages of this method are 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 effect of laser polypotomy is limited to the nasal cavity. That is, if the formations are located in the paranasal sinuses, they are not removed with this method.

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

Removal of nasal polyps using a shaver (endoscopic method)

Endoscopic method - latest technology. Endoscopy is performed under general anesthesia and, in addition to thoroughly removing polyps, 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 a computed tomography scan in order to accurately determine the localization of the process. Careful removal of polypous 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.

During endoscopy, shaver polypotomy is used. A shaver or in other words a microdebrider is a tool that has a cutting and suction function. When removed, it cuts the polyp tissue and sucks it in 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 nasal polyps

	Removal of a polyp with a loop	Radio wave method	Laser removal method	Endoscopic removal method
What is used	Metal Lange loop	Surgitron device (with a radio wave polyp loop or knife attachment) Video endoscope	Laser radiation Video endoscope	Microdebrider (a tool with a blade at the end) Video endoscope
Anesthesia	Local anesthesia	children under 7 years old - general anesthesia children aged 7 years and older - local anesthesia; if the process is widespread, it can be performed under general anesthesia.	children under 7 years old - general anesthesia children aged 7 years and older - local anesthesia; if the process is widespread, it can be performed under general anesthesia.	children under 7 years old - general anesthesia children aged 7 years and older - local anesthesia; if the process is widespread, it can be performed under general anesthesia; for interventions on the paranasal sinuses - only under general anesthesia.
Advantages	Common and affordable	No bleeding, the ability to perform surgery on an outpatient basis	High speed, minimal contraindications	Removal of the focus of polyp growth, prolongation of remission, high speed execution.
Flaws	The likelihood of relapse, bleeding and discomfort.	Probability of relapse, removal of only large and medium-sized polyps	If there are many polyps and they differ in size, removal will be difficult. It is carried out only in the nasal cavity.	No

Local anesthesia

In children over 7 years of age and adults, polypotomy can be performed under local anesthesia. Before the operation, the child is given a sedative intramuscularly. An anesthetic solution (10% lidocaine solution) and vasoconstrictor drugs are sprayed or applied into the nasal cavity to relieve swelling from the mucous membrane and provide better vision. Afterwards, a less concentrated anesthetic solution (2% lidocaine or ultracaine) is injected into the nasal mucosa to enhance the analgesic effect. During the operation, the patient is conscious and perceives everything around him. Local anesthesia is indicated only in the case of surgical interventions limited to the nasal cavity - polypotomy.

General anesthesia (anesthesia)

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

Doctors anesthesiologists

The clinic employs experienced anesthesiologists, specialists from the Children's Clinical Hospital named after. N.F. Filatov, having academic degrees candidates and doctors of medical sciences. Our specialists use an anesthetic apparatus from the German company Drager, medications latest generation. All this allows removal under general anesthesia (anesthesia) that is safe for the patient’s health. fast recovery in the postoperative period.

Anesthetics

Anesthesiologists use the drugs Sevoran, Diprivan, Esmeron, Enfluron, Isoflurane, 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.

Selection of removal method and anesthesia

The choice of polyp removal method depends on the indications and contraindications. Before surgery is scheduled, the patient undergoes an examination and undergoes a computed tomography scan. 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 drugs necessary for remission. If the process is in all paranasal sinuses, a polysinusotomy is performed under general anesthesia.

If there are contraindications to anesthesia, the scope of the operation is reduced. Surgical intervention will be aimed only 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 an operation under anesthesia is made after a thorough examination of the patient together with the therapist and anesthesiologist.

The operation time is related to the extent 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 polypous 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 polyposis 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 surgical techniques. The volume of surgical intervention and the method of anesthesia are selected by the doctor after examining and thoroughly examining the patient.

Rehabilitation after polypotomy

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

Rehabilitation takes up to one week for any type of intervention.

With minimally invasive interventions, this period is reduced to 2-3 days, until the reaction converges postoperative edema mucous membrane. After surgery, it is recommended to limit physical activity for 2-3 weeks.

After surgery, topical steroids are prescribed to prevent the regrowth of polypous tissue. Patients with polypous rhinosinusitis should undergo a course of topical steroids several times a year.

Complications due to untimely treatment of polyps

Firstly, complications are possible with bronchial asthma. If polyposis actively develops and polyps grow, attacks of bronchial asthma become more frequent and are much more difficult to tolerate. Secondly, this is a violation of nasal breathing, which has a bad effect on the entire body. Lack of oxygen leads to the development of chronic diseases. In this case, a person will quickly develop problems with the heart and lungs. Also, lack of oxygen leads to chronic fatigue and developmental delays (if the patient is a child).

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

Very rarely, polyps can transform 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 polyposis process

Most the best prevention is to consult a doctor in a timely manner and complex treatment diseases that contribute to possible emergence polyps. If a person experiences the slightest disturbance in nasal breathing, this should be a signal to action. Any disturbance in the structure of the nasal cavity and disruption of the air flow in it can contribute to the development of polypous rhinosinusitis. People with bronchial asthma should visit an ENT doctor at least once a year, undergo an endoscopic examination and, if necessary, have a computed tomography scan of the sinuses.

Cost of nasal polyp removal

The cost of removing nasal polyps in our clinic using local anesthesia is from 18,000 rub.before RUB 35,000

depending on the degree of complexity of the operation. Removal of nasal polyps under general anesthesia costsfrom RUR 70,000