Endoscope Procedure May Be a Boon to Nasal Surgery

Surgery for sinus problems and nasal polyps is becoming easier, thanks to a special endoscope that allows physicians better access and visibility in problem areas.

With the new surgical method, patients often lose less blood, take fewer pain pills and return to work more quickly than patients who undergo traditional surgery, said Dr. Bruce Jafek, professor and chairman of otolaryngology at the University of Colorado School of Medicine, Denver. Endoscopic nasal surgery can usually be done on an outpatient basis, he added, and often with local, not general, anesthesia.

Proponents say the new endoscope (a cylindrical instrument for examining the inside of the nasal and sinus cavities) promises to do for certain types of nasal surgeries what the arthroscope has done for knee surgeries.

“Many times, endoscopic sinus surgery eliminates the need for a mouth incision to remove diseased sinus tissue,” said Dr. Sidney M. Fishman, a Lakewood otolaryngologist and assistant clinical professor of head and neck surgery at the UCLA School of Medicine. “It also permits the surgeon to leave greater amounts of normal tissue intact than traditional methods.”

The endoscope, now used by about 10% of ear-nose-throat specialists, also allows doctors access to the ethmoid sinus. “That’s the one all the other sinuses seem to drain through,” said Dr. Paul H. Toffel, chairman of the department of otolaryngology at Inglewood’s Daniel Freeman Memorial Hospital and associate clinical professor of otolaryngology at the USC School of Medicine.

However, surgeons agree that endoscopic nasal surgery is not ideal for all conditions. In cases of extreme sinusitis, Toffel said, traditional surgery is recommended. Massive nasal polyps are also better treated by traditional surgery, Fishman added.

Aspirin and Bruises

Consumers taking aspirin to ward off heart disease may discover a nuisance side effect: frequent bruising.

“People who take aspirin and other medications, especially nonsteroidal anti-inflammatory drugs (such as ibuprofen) will tend to bruise more easily,” said Dr. Jack Braunwald, a hematologist at Kaiser-Permanente, Los Angeles. “These drugs can prevent platelets from clumping together normally. The main function of platelets is to clump together and prevent bleeding from small blood vessels.”

Other little-known facts about bruises, according to Braunwald:

-- If you bruise easily, it usually doesn’t point to a vitamin deficiency. You don’t need extra Vitamin C to prevent bruises, he added, though others disagree and recommend boosting Vitamin C intake.

-- Fair-skinned people probably don’t bruise more easily than those with darker skin. “It just shows up more on the fairer skinned.”

-- The tendency to bruise increases with age. “As people get older, sometimes capillaries are more likely to tear. It’s not usually a sign of a serious condition.”

-- Most bruises should disappear in two to three weeks, larger ones in a month. “The blood has to be reabsorbed.”

-- “Ice doesn’t help a bruise but helps the swelling associated with a fall,” he added.