Overview

Nasal polypectomy is a surgical procedure to remove nasal polyps, commonly performed endoscopically for chronic rhinosinusitis with polyps.

Nasal polypectomy is crucial for treating nasal obstruction, improving breathing, and reducing recurrence of polyps.

Learn more in our comprehensive RxDx ENT Course

Indications

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Nasal Polyps

Obstructing polyps

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Chronic Rhinosinusitis

With polyps

✓
Nasal Obstruction

Due to polyps

✓
Recurrent Polyps

Multiple recurrences

✓
Failed Medical Therapy

Refractory to medications

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Uncontrolled bleeding
✗ Severe coagulopathy

Relative Contraindications

✗ Active infection
✗ Recent surgery
✗ Poor general health

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient assessment, imaging review, equipment setup, and understanding contraindications.

Step-by-Step Procedure

Step 1: Patient Preparation

Position patient, administer anesthesia.

⚠️ Common Mistakes to Avoid:

  • Poor positioning
  • Inadequate anesthesia

💡 Pro Tip:

Use proper positioning.

Step 2: Nasal Preparation

Decongest and anesthetize nasal cavity.

⚠️ Common Mistakes to Avoid:

  • Inadequate preparation
  • Poor visualization

💡 Pro Tip:

Ensure proper preparation.

Step 3: Polyp Removal

Remove polyps using endoscope and microdebrider.

⚠️ Common Mistakes to Avoid:

  • Incomplete removal
  • Bleeding

💡 Pro Tip:

Use careful technique.

Step 4: Hemostasis

Control bleeding.

⚠️ Common Mistakes to Avoid:

  • Inadequate hemostasis
  • Post-op bleeding

💡 Pro Tip:

Ensure complete hemostasis.

Step 5: Closure

Pack nasal cavity and provide instructions.

⚠️ Common Mistakes to Avoid:

  • Inadequate packing
  • Poor instructions

💡 Pro Tip:

Use proper technique.

Step 6: Post-procedure Care

Monitor and provide instructions.

⚠️ Common Mistakes to Avoid:

  • Poor monitoring
  • Inadequate instructions

💡 Pro Tip:

Provide clear instructions.

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Post-procedure Care

Post-procedure care involves nasal care, monitoring for complications, and long-term follow-up.

Complications & Management

Complication Incidence Signs Management Prevention
Bleeding 2-5% Active bleeding Packing, cautery Proper hemostasis
Infection 1-2% Fever, pain Antibiotics Sterile technique
Recurrence 10-20% Recurrent polyps Revision surgery Complete removal
Synechiae 1-2% Nasal obstruction Lysis of adhesions Proper technique

Clinical Pearls

💡

Use image guidance when needed.

🎯

Ensure complete polyp removal.

⚡

Avoid excessive tissue removal.

🔍

Check for complications.

📊

Document procedure details.

🎨

Provide clear post-op instructions.

⚠️

Monitor for complications.