Patients suffering from sinus diseases are usually confronted with the painful prospect of major sinus surgery. That means one to two days in the hospital and weeks of recuperation.

But now, those same people can often be treated as outpatients with new endoscopic instruments recently acquired by LDS Hospital for the Ear, Nose and Throat Division of the Department of Surgery. In addition to reducing surgery to a minimum, the same equipment can help identify minor sinus problems before they become major secondary diseases."These new scopes allow us to examine the sinuses under just a topical anesthesia," said Dr. R. Jon Ord, an ENT specialist at LDS Hospital. "With the endoscopes and computer tomography (CT scans), we can define the anatomy better, determine the pathology of the conditions we find, and more accurately diagnose the problems.

"Then if surgery is indicated, the endoscopes usually allow us to perform whatever procedures are necessary on an outpatient basis. The result is more specific, with reduced trauma to the sinuses and a shorter recovery time."

Ord said this minimalist approach to problems of the nasal sinus region results from three developments: improved diagnostic imaging, particularly high-resolution CT scans; endoscopic equipment with improved visualization and surgical capabilities; and the realization that 90 percent of recurring sinusitis can be traced to diseases beginning in the middle section of the sinus cavities.

Conventional X-rays usually do not show disease in this region, but by treating problems there endoscopically, surgeons can usually relieve the symptoms in the secondarily affected sinuses. Without the endoscopes, patients would need a total intranasal ethmoidectomy - an operation that exposes the nasal and sinus passages.

Ord said that with the endoscopes, surgeons can take biopsies, evaluate the sinus opening, remove polyps and cysts, examine and open the nasal passages, remove only diseased cells that are causing drainage and ventilation blockage, clean the operative site with the help of an aspirator and apply antibiotics or mycotic ointment if necessary.

During the postoperative period, the endoscope allows ENT specialists to assess the surgical results.

"With this new equipment, we can offer substantial relief from chronic sinus problems, which benefits the patient physically, psychologically and financially," Ord said.