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
Obstructing polyps
With polyps
Due to polyps
Multiple recurrences
Refractory to medications
Contraindications
Absolute Contraindications
Relative Contraindications
📋 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.