1. Nasal Polypectomy Wadie

2. 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)

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

4. 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

5. Procedure 1. Time out • After vasoconstricting agents have reached a therapeutic level, the offending nasal cavity is retracted using a nasal speculum • The nasal canal is explored and polyps are removed (usually with a microdebrider) • Blood loss is checked, no suturing is required • Packing depends on surgeon’s preference

6. Methods for Excising Polyps • Lasers • Polyp snare • Polyp forceps • Microdebrider • Ex: the Stryker “hummer”

7. 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

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