RESEARCH PAPER
A 5-year experience in functional endoscopic sinus surgery under local anaesthesia
 
More details
Hide details
1
Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine and Health Sciences, University Malaysia Sarawak (UNIMAS), Malaysia
 
2
Otorhinolaryngology-Head and Neck Surgery Department, Sarawak General Hospital, Malaysia
 
 
Submission date: 2020-04-09
 
 
Final revision date: 2020-05-05
 
 
Acceptance date: 2020-05-05
 
 
Online publication date: 2020-10-15
 
 
Corresponding author
Boon Han Kevin Ng   

Boon Han Kevin Ng, University Malaysia Sarawak (UNIMAS), Jalan Datuk Mohammad Musa, 94300 Kota Samarahan, Sarawak, Malaysia. Tel.: +60 82 58 1000.
 
 
Pol. Ann. Med. 2021;28(1):17-20
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Functional endoscopic sinus surgery (FESS) under local anaesthesia performed as an office-based procedure is an alternative to general anaesthesia. It is gaining popularity among otorhinolaryngology – head and neck surgeons.

Aim:
This study assesses the outcome of FESS performed under local anaesthesia in a tertiary centre over a 5-year period.

Material and methods:
A retrospective data collection was conducted. All adults who underwent FESS under local anaesthesia for a 5-year period from June 2014 to June 2019 in Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) Department, Sarawak General Hospital, Malaysia were included in this study. Data and information on preoperative assessment, surgical indication, sinuses operated on, intraoperative findings and postoperative complications and follow up were recorded.

Results and discussion:
A total of 150 patients met the inclusion criteria. The most common indication was chronic rhinosinusitis with nasal polyp (78%). All paranasal sinuses were operated on. In 43% of cases local anaesthesia was used alone, while 57% received both local anaesthesia and intravenous anaesthesia. Majority of patients (90%) were discharged home the next day. Four patients (2.7%) developed epistaxis postoperatively which did not require surgical intervention.

Conclusions:
FESS under local anaesthesia is a safe and feasible alternative to general anaesthesia and is well tolerated by patients. Complications of general anaesthesia can be avoided.

FUNDING
None declared.
CONFLICT OF INTEREST
None declared.
 
REFERENCES (10)
1.
Lee JT, DelGaudio J, Orlandi RR. Practice Patterns in Office-Based Rhinology: Survey of the American Rhinologic Society. Am J Rhinol Allergy. 2019;33(1):26–35. https://doi.org/10.1177/194589....
 
2.
Varshney R, Lee JT. New innovations in office-based rhinology. Curr Opin Otolaryngol Head Neck Surg. 2016;24(1):3–9. https://doi.org/10.1097/moo.00....
 
3.
Prickett KK, Wise SK, DelGaudio JM. Cost analysis of office-based and operating room procedures in rhinology. Int Forum Allergy Rhinol. 2012;2(3):207–211. https://doi.org/10.1002/alr.21....
 
4.
Fedok FG, Ferraro RE, Kingsley CP, Fornadley JA. Operative times, post anesthesia recovery times, and complications during sinonasal surgery using general anesthesia and local anesthesia with sedation. Otolaryngol Head Neck Surgery. 2000;122(4):560–566. https://doi.org/10.1067/mhn.20....
 
5.
Unsal AA, Gregory N, Rosenstein K. Current opinions in office-based rhinology. Curr Opin Otolaryngol Head Neck Surg. 2018;26(1):8–12. https://doi.org/10.1097/moo.00....
 
6.
Armstrong M. Office-based procedures in rhinosinusitis. Otolaryngol Clin North Am. 2005;38(6):1327–1338. https://doi.org/10.1016/j.otc.....
 
7.
Gittelman PD, Jacobs JB, Skorina J. Comparison of functional endoscopic sinus surgery under local and general anaesthesia. Ann Otol Rhimol Laryngol. 1993;102(4 Pt 1):289–293. https://doi.org/10.1177/000348....
 
8.
Scott JR, Sowerby LJ, Rotenberg BW. Office-based rhinologic surgery: A modern experience with operative techniques under local anesthetic. Am J Rhinol Allergy. 2017;31(2):135–138. https://doi.org/10.2500/ajra.2....
 
9.
Radvansky BM, Husain Q, Cherla DV, Choudhry OJ, Eloy JA. In-office vasovagal response after rhinologic manipulation. Int Forum Allergy Rhinol. 2013;3(6):510–514. https://doi.org/10.1002/alr.21....
 
10.
Thamboo A, Patel ZM. Office procedures in refractory chronic rhinosinusitis. Otolaryngol Clin North Am. 2017;50(1):113–128. https://doi.org/10.1016/j.otc.....
 
Journals System - logo
Scroll to top