FUNCTIONAL ENDOSCOPIC SINUS SURGERY AS A TREATMENT OF NASAL POLYPOSIS

Nosna polipoza podvrsta je kroničnog rinosinusitisa, te je po Stammbergerovoj klasifikaciji možemo razdijeliti u 5 tipova. U prva dva tipa FEKS ima predstojeću ulogu u terapiji dok u ostalim tipovima FEKS služi kao potporanj medikamentoznoj terapiji. Dobra predoperativna priprema kao i postoperativna njega ključne su za uspjeh same operacije. Bolesnik koji ima odgovarajuću simptomatologiju mora biti obrađen endoskopski i CT-om. Te nam dvije tehnike daju uvid u anatomske varijacije i širinu patologije, te na temelju njih i svojeg iskustva kirurg odlučuje o opsegu zahvata. Revizijske su operacije često opsežnije od primarnih. Kirurg osim vrstan anatom, mora biti i realista te objektivno pacijentu prezentirati mogućnosti i očekivanja od predstojećeg zahvata. Napretkom tehnologije FEKS ima velike prednosti nad konvencionalnom kirurgijom jer ostavlja manju traumu i omogućuje brži i lakši oporavak pacijenta. FEKS je baziran na očuvanju zdrave sluznice i uspostavljanje fiziološke funkcije samih sinusa kroz njihova prirodna ušća. Komplikacije tijekom izvođenja FEKS-a, danas su izuzetno rijetke ukoliko zahvat izvodi iskusan kirurg.Nasal polyposis is a subtype of chronic rhinosinusitis, and according to Stammberger's classification it can be divided into 5 types. In the first two types, FESS has an upcoming role in therapy, while in other types, FESS serves as a support for drug therapy. Good preoperative preparation as well as postoperative care are the key to the success of the operation itself. A symptomatic patient must be evaluated endoscopically and by CT. These two techniques tell us the anatomical variations between patients and the width of the pathology, and based on them and the surgeon's experience, the surgeon decides how extent the operation will be. Revision operations are often more extensive than primary ones. The surgeon has to objectively present the possibilities and expectations from the upcoming procedure to the patient. With the advancement of technology, FESS has great advantages over conventional surgery techniques because it leaves less trauma and enables faster and easier recovery of the patient. With FESS maintaining a healthy mucosa and establishing the physiological function of the sinuses themselves through their natural openings can be achieved. Complications during the FESS are extremely rare today if the procedure is performed by an experienced surgeon