Facing the first general anesthesia operation in my life, like all fans of Guoke, my first thought was whether it is possible to contribute to the patients of Guoke… (On the basics of Guoke powder)
When I was young, I was relatively thin. Although I had a bigger appetite than boys and had perfect sports scores, in the eyes of the people around me, I always looked weak and lethargic.
On weekdays, what bothers me the most is that I do everything in one go, then decline, and exhaust three times. Not to mention physical work, even if I was talking normally, I would lose my strength while talking, and my head would break out in sweat.
After I went to college, I began to go to various departments to explore my body. I did a lot of tests, including lung function, blood vessel examination, various blood tests, ultrasound, electrocardiogram, sinus CT, nasal endoscopy, etc., and got insulin resistance, Polycystic Ovary Syndrome, Allergic Rhinitis, and Results of “Maxillary Sinus Cyst” .
It was the problem on the nose that made me undergo the first general anesthesia operation in my life.
Nasal endoscopy丨Photo courtesy of the author
“Early start and early birth”
After two months of delay, I finally made an appointment for surgery
One month after the “maxillary sinus cyst” was discovered, one night, I had a nosebleed from the left nostril for an hour and a half for no reason. Frightened, I quickly found a time to report to the ENT department of a well-known tertiary hospital in Shanghai.
I had another CT scan of the sinuses. The doctor looked at the results and made a diagnosis of sinusitis, suggesting surgery . I don’t know why, the sinus CT this time did not suggest “maxillary sinus cyst”. At that time, I didn’t know about “sinusitis”, had doubts about the operation, and was busy with work (actually it was an excuse for procrastination), so I didn’t report to the hospital immediately according to the doctor’s order.
Sinus CT丨Photo courtesy of the author
Sinus CT report丨Photo courtesy of the author
I continued to be tortured for two months. Apart from occasional headaches, the biggest pain was that every day I woke up feeling as tired as sleepwalking all night. Also, there is always a constricted feeling in the back of the nose that makes me nauseous. As a timid person, I was more and more afraid that there would be a lump in my nose, and it would become bigger and bigger. Thinking of “doing it early and giving birth early”, I finally made up my mind and made an appointment with the doctor for surgery.
I would like to thank the doctor for reserving the hospitalization form and contact channels for me early, which saved me from running around repeatedly. After another month or so, I got into bed.
It seems to be preparing for an autumn outing丨Photo courtesy of the author
“It’s just a blockage of pus, not a tumor”
I feel relieved
One Friday, I reported to the inpatient department, and the surgery was scheduled for the next Monday afternoon.
Patients in the Department of Otorhinolaryngology have very different surgical sites, but most of them are minimally invasive operations through the mouth, nose and ear openings, without any wounds on the skin surface, so people can’t tell where the problem is at a glance…
After being admitted to the hospital, I had nasal endoscopy and other examinations again, and I also used antibiotics, glucocorticoids, and anti-allergic drugs. During the examination, my right nostril was “punched through” by the endoscope, and I was happy to mention the good news that “it was just blocked by pus, not a tumor” , which reassured me a lot. After taking the medicine, the inflammation in the nasopharynx also subsided. The doctor said that the scope of the operation could be smaller than expected, but it depends on the situation during the operation.
It seems that re-examination after hospitalization can help doctors adjust the surgical plan according to the current situation. In addition, I also thank the doctor for leaving me a public consultation (liao) consultation (tian) channel, and I can communicate online for anything.
The humble brick-moving dog who can’t get under the fire line丨Photo courtesy of the author
The doctor said that my surgical plan is mainly to open the sinus opening slightly to make the internal secretions flow smoothly to solve the nasal congestion . Since I am also accompanied by part of the turbinate hypertrophy, some turbinates may be removed according to the intraoperative situation (I hope it will not affect the postoperative appearance, huh).
I was scheduled to be on stage at two o’clock in the afternoon, and the fasting before the operation began at 6:00 in the morning. Before fasting, the doctor advised me to eat lotus root starch and pulsation. What kind of magic recipe is this?
The surgical location should be marked丨Photo courtesy of the author
At 14:15, I was pushed into the operating room. 6~7 people circled around me, asked me about my physical condition, asked me to sign, put electrodes on my chest, connected my ankles, wrists, and fingers to the instrument, and gave me a large indwelling needle.
Afterwards, the doctor gave me an oxygen mask, asked me to take a few deep breaths, and then injected a cooling liquid. Me: “Ah, my wrist hurts so much!” Doctor: “It’s normal…” Then I lost consciousness, and when I woke up, I was pushed back to the ward.
A stream of heat rushes out
20 hours of “big aunt” coming to my nose
It took me about 3 hours for the operation. When I came out, I felt a bit of an inflammation-like pain in my nose, which I could bear, but my whole head was swollen into a “pig’s head”.
My adverse reaction after general anesthesia was quite small, and I woke up quickly without vomiting. I heard that my sister on the opposite bed vomited for a full 6 hours. I feel very good, and I can move freely on the bed in the ward, so I started to work on my mobile phone (don’t follow me, I still have to lie down for enough time as prescribed by the doctor).
But at night, I start to suffer. In fact, the wound itself did not hurt very much, but I had a low-grade fever for 2 days, a sore throat, and ear pain radiating to the back of the head. These medications can still relieve it, but the most unbearable thing is the nasal discharge.
In the middle of the night after the operation, I sat up for a while and felt a hot stream rushing out of my nose, which was very similar to the monthly “blood collapse” of girls. Since then, I have started a 20-hour nose “aunt”. Fortunately, the amount of bleeding was not large, and after 7 hours of bleeding, 80% of it was transparent exudate. After the doctor took the oppressive tampon away at noon, my nose “aunt” got better.
Sliver over 20cm long. The sourness when it is pulled out and the amazing size of the sliver, what the patient said is not exaggerated, and I am not deceiving… | Photo courtesy of the author
Due to oozing, swelling, my nose could hardly be ventilated, breathing through my mouth was difficult, and most troublesome, swallowing was also affected. I want to suck the secretion in my nose into my mouth and swallow it myself, but I can’t suck it in. Instead, the water I drink will invade the nasal cavity in reverse, which is a bit bullying…
The nose exudates a lot, so put (yi) gauze (ma) cloth (jin) on it, and change it too frequently, the doctor sent gauze and medical tape to change it yourself丨Photo courtesy of the author
After taking the tampon, my left nasal cavity opened up, but the hot feeling in the inner wall went straight to the top of the sky and radiated to the back of my head , making me feel like my whole brain was throbbing. In the evening, the doctor came and rinsed my nasal cavity. After washing, half of the blood tank recovered.
The doctor said that I can rinse my nasal cavity myself, so I ordered a takeaway nasal wash in the ward and started washing it at night! When you rinse your nose, the salt water travels down your throat, making you gag. Flushing the nasal cavity can flush out many indescribable objects of various shapes, such as jelly-like blood clots, which shows that the inner space is too good for hiding things. That night, I slept soundly.
I swept the “locusts” in the cafeteria before the operation
Turned into the most wilted cabbage after surgery
Before the operation, I was the happiest “locust” in the whole ward (the nurse joked that I ran to the cafeteria to scour the delicious food, who made the hospital cafeteria really good), but after the operation, I became the happiest in the whole ward of a small cabbage. On the first day after the operation, I lived on 3 cups of milk tea, 2 cups of soup and 1 cup of pudding; on the second day, I felt that there was no problem with my throat, so I picked soft and glutinous food to increase nutrition for my body to “fight”.
On the 7th day of hospitalization, I finally went home —with my head so greasy, I dragged my pickled flesh.
The time to return to the hospital for dressing changes after surgery is once a week for 1 to 3 weeks after surgery, and the fourth time in 4 to 8 weeks depending on the situation. The process of changing the dressing is to clean out the blood clots and secretions under the nasal endoscope . Although the doctor thoughtfully applied a topical anesthetic to the inner wall of the nose, the first two times were quite sore… Unfortunately, I really didn’t have the opportunity to take pictures of the blood clots that were so large that they almost blocked the pipeline of the machine.
During the back-and-forth follow-up visits, I finally ate up the “one sack” of glucocorticoids, antibiotics, and mucus excretion drugs, which came with my 2-month sideline experience: “hair soaking” hormones The full moon face does not need to be oiled, the mental hunger is full of hunger and the hardware has no stomach power to torture each other, and the switch between lethargy and short sleep from time to time.
Fortunately, the result of hard work is still pretty good so far. For the first time, I feel that the nasal cavity is so unobstructed, and I can feel it in all parts of the nose. I have also obtained a special skill: when rinsing the nasal cavity, I can freely control the salt water by turning my head to different angles internal orientation.
The turbinate tissue I removed was also submitted for pathology examination. According to the report, the amount of resection was small, and the pathological results were normal.
Oh, by the way, my full moon face is gone now, and the good news is that my nose has hardly changed in shape~
Three debridement endoscopic photos, the longer the visible to the naked eye, the better丨Photo courtesy of the author
doctor review
Cheng Xiaoxue | Attending Physician, Department of Otorhinolaryngology, People’s Hospital of Inner Mongolia Autonomous Region
Sinusitis is a sinus infection caused by viruses, bacteria or fungi. It is a general term for sinus mucosal inflammatory diseases. It is a common disease in rhinology. With hyposmia or loss , generally non-infectious and hereditary.
There are four pairs of symmetrical sinuses in our maxillofacial region, namely the maxillary sinus, frontal sinus, ethmoid sinus, and sphenoid sinus. Among them, the maxillary sinus is the largest and has the highest incidence of inflammation, followed by the ethmoid sinus. The results of nasal CT and nasal endoscopy provided by the author showed that he suffered from the most common bilateral maxillary sinus and ethmoid sinusitis in sinusitis, as well as mild rhinitis and deviated nasal septum.
According to the description in the article, the author’s diagnosis is likely to be chronic sinusitis. Chronic sinusitis is often protracted. When conservative treatment is not effective, accompanied by persistent nasal congestion, headache and other symptoms , which affect work and life, surgical treatment can be considered.
Sinuses丨Tencent Medical Dictionary
The author has sinusitis combined with allergic rhinitis. Repeated stimulation of inflammation leads to degeneration and edema of nasal sinus mucosa. Therefore, preoperative anti-allergic and hormone drugs can improve the environment of nasal mucosa, which is beneficial to surgical operations and reduces surgical risks; preoperative prophylactic use of antibiotics can reduce inflammation , conducive to postoperative recovery.
The operation plan is not specified in the article, but the opening of the ethmoid sinus and maxillary sinus should be done to remove the pus, and part of the turbinates hypertrophied due to allergic rhinitis and swelling of the nasal mucosa should be removed, so as to improve ventilation.
Although this type of open sinus surgery under laparoscope is minimally invasive, it is very easy to damage the adjacent eyes and skull base. The operation is delicate and belongs to medium operation. It takes longer than other oropharyngeal operations . The author performed the whole operation It took 3 hours and basically the process went smoothly.
The most difficult stage of sinusitis surgery is 1 to 3 days after surgery . On the day of the operation, the nasal cavity is filled with stuffing, which makes it impossible to breathe through the nose, and the surface of the stuffing will leak bloody secretions intermittently. In addition, there are often post-anesthesia reactions ranging from mild to severe after general anesthesia. Difficult night. Change the dressing regularly a few days after the operation, and the doctor will gradually remove the stuffing in the nasal cavity, and the patient will feel that the ventilation has improved significantly.
The experience described by the author is basically the same as that of many rhinology patients, but each person has a different degree of pain tolerance, and there are individual differences in specific manifestations. In addition, the author’s sinusitis is bilateral maxillary sinus and ethmoid sinusitis, and the postoperative pain of bilateral sinusitis is usually heavier than that of unilateral sinusitis.
After discharge, in order to observe the recovery of the nasal cavity, the doctor will regularly change the dressing for the patient and carry out nasal endoscopy to remove the mucous purulent secretions and blood clots in the nasal mucosa and keep the nasal mucosa smooth to promote recovery.
In this article, the author followed the doctor’s advice to start washing the nose regularly after removing the stuffing, which is very desirable. Sinusitis is prone to relapse, and postoperative medication and nasal irrigation are very important, which can greatly reduce the recurrence rate and determine the success or failure of 50% of the treatment process. Here is a special reminder for patients suffering from similar diseases, remember to follow the doctor’s advice to take medication regularly and rinse the nasal cavity after surgery to reduce the probability of sinusitis recurrence.
Here, I particularly appreciate the author’s practice of giving full play to his subjectivity and actively cooperating with doctors in the treatment of nasal cavity diseases. When we face various diseases, we should not panic. Maintaining a good attitude and optimistic mood is also a good medicine for treating diseases.
Maxillary sinus cyst is a benign lesion that occurs in the maxillary sinus. It is formed by mucus retention in the sinus mucosa. It grows slowly and has no obvious discomfort in the early stage.
When the cyst is small and has no obvious clinical symptoms, it is usually not necessary to deal with it, and the small cyst may absorb itself, and regular observation is enough. The author found a cyst in the maxillary sinus in the first inspection, but there was no indication in the re-examination of sinus CT, which may be due to self-absorption.
Surgical treatment is only considered when the cyst is huge and causes discomfort. Common symptoms include headache, nasal congestion, runny nose, visual impairment, and tenderness.
In addition, epistaxis caused by maxillary sinus cysts is rare, and the authors have no direct connection between left epistaxis and maxillary sinus cysts.
The sharing of personal experience does not constitute a diagnosis and treatment recommendation, nor can it replace a doctor’s individualized judgment on a specific patient. If you need to see a doctor, please go to a regular hospital.
Author: Pu Man
Editor: Zi Yi, Dai Tianyi
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