Idowu Sowunmi
Four months after it successfully performed three open heart surgeries/interventions, Afe Babalola Multi-system Hospital in Ado-Ekiti has again successfully carried out its first Functional Endoscopic Sinus Surgery (FESS).
The procedure was carried out on a young lady with recurrent growth in the nostrils with an extension to all the sinuses. She was diagnosed as a case of Antrochoanal Polyp with Pansinusitis.
According to a statement by the Head of Corporate Affairs of Afe Babalola University, Ado-Ekiti, Mr. Tunde Olofintila, the patient had a successful surgical procedure arising from the use of minimally invasive technique called FESS with the advantage of short hospital stay and with minimal intra operative blood loss.
“The beauty of the treatment was that the patient was discharged after an overnight admission for recuperation. By this successful FESS, ABUAD Multi System Hospital, a new generation tertiary health centre with a mission to reverse the direction of medical tourism in Nigeria, has positively demonstrated its ability and capability to use this technique as a result of which Nigerians no longer need to travel abroad for the sake of undergoing FESS.
“FESS is a procedure for the treatment of sinus disease and restoration of the functions of the paranasal sinuses using tiny telescopes mounted on cameras and tiny instruments. The development of high-resolution telescopes, camera systems, medical imaging systems and instrumentations has propelled FESS to the gold standard in the management of sino-nasal diseases.
“The paranasal sinuses are air filled spaces lined by mucosa within the bones of the face around the nose. They help to keep the skull light and assist with nasal breathing and smelling. Diseases of these sinuses often lead to head or facial pains, facial congestion and heaviness, loss of sense of smell and impaired taste among others,” the statement said.
FESS has been available in a few government hospitals and a handful of high-end private hospitals in Nigeria for about a decade now. Most of these centres offer various degrees of basic and advanced FESS based on their equipment levels and expertise.
However, FESS remains a major reason for medical tourism outside Nigeria.
Prior to the advent of Endoscopic Sinus Surgery, patients having sinus surgeries have had to undergo extensive surgeries involving incisions through the face or oral cavities.
These surgeries are associated with extensive tissue dissection, significant blood loss, and the attendant post-operative pains, prolonged hospitalisation and facial scars.
However, current knowledge and skills have shown that these traditional surgeries leave the paranasal sinuses in an abnormal physiological state resulting in frequent recurrence of sinus diseases and need for further surgeries.
But, FESS is based on current knowledge and it relies on precise identification of disease sites and meticulous precise surgery to reverse the disease process. This is based on the knowledge that with precise extirpation of disease, there is improved ventilation and drainage of the paranasal sinuses resulting in reversal of pathologic process leading to restoration of sinus function without a significant change in sinonasal anatomy.
Cure is achieved without facial scars and with minimal risks of recurrence.
Although FESS costs much more than traditional sinus surgeries, the reduced post-operative pains and swellings and the lack of facial scars more than compensate for the increased cost.
The primary indication for FESS is chronic rhinosinusitis unresponsive to maximum appropriate medical treatment. Such patients will often have had multiple causes of antibiotics and steroids without resolution of symptoms. Other indications include nasal polyps, antrochoanal polyps, endoscopic dacrocytorhinostomies, benign sinonasal neoplasia and transphenoidal pituitary surgeries among others.
