Allergy affecting the nose may lead on soft tissue growth called polyps. This in turn can lead on to constant headache, fever, dimness of vision and rarely infection of the brain. The growth can spread on to the inside and to the upper aspects of the nose and this in turn can lead on to the closure of sinus openings. This can result in the loss of sense of smell and taste. Fungal infection (Fungal sinusitis) also may result. This can affect the surrounding bones, eyes, and brain and lead on to serious complications. Drugs can control allergy, but cannot eliminate it. FESS (Functional Endoscopic Sinus Surgery) is commonly done in the above condition.
Through this surgery, pus, fungus and polyps are removed and the sinus orifices are opened. This methodology has some limitations. The orifices which are opened by this method are likely to narrow by 35 to 50 % within a year . Douche (Mixture of saline and steroids ) and spray which are supposed to be used lifelong post surgically don’t reach all the sides of the sinus. In short, these medical applications can control the disease only to a certain extent in a person undergoing FESS .
A new type of surgery has been developed for the above mentioned pathological conditions ie. allergy , polyp and fungal sinusitis . This surgery is Total sphenoethnidectomy with Draf III ( Modified Lothrop procedure). Through this surgery sinus orifices are opened widely, so that the disease is removed to the very last bit and nasal washes with drugs reach all areas of the sinuses . Thus the polyps, and fungus resulting from allergy are effectively controlled.
Since brain, bones and soft tissues are situated around the frontal sinuses, this is a fine surgery and has to be done very carefully . If ethmoid and sphenoid sinuses which lie in between, and behind the eyes are opened up widely, it is called a full house sphenoethmoidectomy.
The Draf III procedure have so far not been done in large numbers in our country.
In the more commonly done FESS, liquid drugs cannot reach the inside , and interior of the sinuses, since the openings are less than 4 mm. But in the newer method, they reach through an opening which is 2cmX1.5cm in dimension.
The chance of recurrence( getting it back again) in the older type of surgery is 100 % whereas in the newer method , it is only 15 % .
By the new technique, revolutionary changes have been brought about in the treatment of nasal allergy and related conditions.
We are one of the pioneers in this surgery in the country.