Rhinology

Rhinologist in Bangalore

Rhinology and Sinus Surgery is a sub speciality to manage nasal and sinus problems. Dr Gaurav Medikeri has three international fellowships in Rhinology and Anterior Skull Base Tumor Surgery. He specializes in Advanced Sinusitis Surgery, Rhinoplasty and Skull Base Tumor Surgery.

We treat common problems such as allergies, nasal obstruction, and sinusitis. Less common conditions such as tumors of the Sinuses or Anterior Skull Base are also treated at Medikeri’s ENT Super Speciality Center.

Sinusitis

Sinuses are four pairs of air-filled cavities in the bones surrounding the nose and eyes. The sinuses work together to warm or cool inhaled air, humidify it and remove dust and allergens.

Several factors can inflame or block the sinuses. They include:

Allergies

Cold and Respiratory Infections

Nasal Polyps

Bacterial Infections

Anatomical Problems

Edoscopic Sinus Surgery

Is Endoscopic Sinus Surgery painful? How do they perform it? – Dr. Gaurav Medikeri

Endoscopic sinus surgery is not a very painful condition. We have performed many extensive procedures on the nose without much pain. Pain is usually minimal and controllable with medication. The procedure involves inserting a 4 mm telescope into the nose and operating with certain instruments inside where we open all the paranasal sinuses and make them open for drainages and washes.

What is the recovery time post Functional Endoscopic Sinus Surgery? – Dr. Gaurav Medikeri

Recovery time depends on the recovery time that he patient has and the type of procedure that has been performed.

A simple endoscopic sinus surgery would take about 2 to 3 weeks for the sinus cavities to heal completely.

But in terms of post-operative times the patient is back on their feet on the same day. They can go back to work within about 2 or 3 days of surgery.

Whereas if a more extensive surgery like a lothrops is performed the healing time is about 4 to 5 months for the sinus cavity, but still the patient will be back on the feet on the same day and they can go to work within about 4 or 5 days.

Do’s and Don’t after Endoscopic Sinus Surgery

1. Take Prescribed Medication:

Post endoscopic sinus surgery the patient will be put on a certain set of medications, which they have to take for about 7 days to 10 days.

2. Wash Your Sinus Cavities Thoroughly.

The most important things after an endoscopic sinus surgery would be to wash their sinus cavities thoroughly because during the surgery and after the surgery, there will be small capillaries which will ooze into the sinuses. This will create clots within the sinus which will be washed put to allow better breathing for the patient.

3. Do Not Drink Alcohol

Things that the patient should not do is to drink alcohol because it induces more bleeding into the sinuses.

4. Do Not Have Spicy Food

To have more spicy food because they are already on certain medications which can induce gastritis.

5. Do Not Blow your Nose Heavily:

The patient should not blow their nose heavily because that can increase the amount of bleeding.

6. Regular Follow up If Required

Most patients who undergo endoscopic sinus surgery are the ones who have allergy problems. So they require long term follow up even after surgery to inspect their sinus cavities and to make sure that their disease is under control.

Take a Look at our successful surgeries

At Medikeri’s ENT Super Speciality Center, we treat conditions such as complex disorders of the nose and sinuses such as sinus tumors, cerebrospinal fluid leaks, recurrent nasal polyps and complicated chronic sinusitis (i.e., sinusitis associated with cystic fibrosis, auto-immune disease, immune deficiency and damage from prior surgery).

Lateral wall Sphenoid Meningoencephalocele (Brain Herniation into the Sinus).

This is a patient with an active leak of fluid around the brain into the nose. This was due to raised intracranial pressure which led to herniation of the brain into the sphenoid sinus. The herniated part of the brain was hugged by the optic nerve above and the Carotid artery behind. The herniated brain was removed and the defect was closed in multiple layers with dural substitute, bath plug fat graft, fascia lata and a gasket seal with sliced cartilage. We offer some of our unaffordable patients the choice of allowing us the rights to use their case as a teaching and training tool. We love training young ENT surgeons and help these poor patients get the quality treatment they deserve.

Brain herniating into nose – Meningoencephalocele posterior table frontal sinus.

We offer some of our unaffordable patients the choice of allowing us the rights to use their case as teaching and training tools. We would love to train young ENT surgeons and help these poor patients get the quality treatment they deserve. This is a lady with herniation of part of her brain into her frontal (forehead) sinus through the posterior table. She was slightly obese and had fluid from her brain (CSF) leaking into her nose. This increases her risk of developing meningitis which is infection of the coverings of the brain. We were able to identify the site of leak and successfully repair the defect. Patient has been followed up and is completely rid of the CSF leak. She has no complaints and is very happy.

Frontal sinus pyocele surgery (PUS IN THE FOREHEAD)

This is a patient who underwent sinus surgery 2 years ago in a different hospital. She then developed a painful swelling over the supero-medial quadrant of the orbit. The eye had developed ptosis , but vision was still normal. Scan showed erosion of the bone between the orbit and the frontal sinus with erosion of the anterior and posterior table of the frontal sinus. The pyocele was in contact with the orbit and brain. This happened because during the previous surgery, the frontal sinus was not opened correctly and the mucosa wasn’t spared, leading to circumferential scarring. This lead to mucous retention and subsequent infection. Frontal sinus is one of the most difficult sinuses to master and we have quite a series of such cases with us at Medikeri’s superspeciality ENT center. For further details or appointments please contact us on +917349304672.

Nasastent results – 15 days post endoscopic sinus surgery

This is a case of bilateral comprehensive endoscopic sinus surgery done for a case of eosinophilic CRS wherein the middle turbinates were stabilized with NASAL STENTS to maintain the access to sinonasal corridoor. 15 days later they were removed & a beautiful mucosalized cavity was seen with all sinuses being wide open & the corridoor being open too. Floppy middle turbinates prevent access to topical steroid medication in the nose which can defeat the purpose of surgery itself. This is one of the ways to keep the cavity widely patent & prevent adhesions.

Importance of Sino Nasal Access

This is a case of fungal sinusitis with posterior septal perforation operated at Medikeri’s ENT Super Speciality Hospital.

The patient didn’t follow up regularly and turned upon 2 months after the surgery was conducted. MT had lateralised & wasn’t allowing Irrigant Solution to reach the sino-nasal cavity.

Here is how we dealt with it. Lower part of MT was mobilised medially. THRU Cut used to cut Adhesions and to create space.

Watch how bleeding was controlled and gentle medial mobilisation of MT is done at 1:05.

Observe the polyps due to lack of access to irrigant solution. Observe the posterior or septal perforation of DT fungal mass.

At 2:02 Surgicel and gelform are placed to avoid re-adhesion. At 2:07 observe how Gentamicin + Dexamethasona is instilled into the Gelfoam and cavity.

Observe the before and after pictures of the surgery. Patient continued nasal douching daily after the surgery was conducted. Oral steroids were not used. He was reviewed after 3 weeks.

This video highlights the importance of access to the sinonasal cavity during and post operative period. It also shows the effectiveness of nasal irrigation post surgery.

Nasastent results – 15 days post endoscopic sinus surgery

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Phone

+91-7349304672

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Location

#9/91, Govindappa cross, RV Road

Near lalbagh metro station,

Basavanagudi, Bangalore – 560004

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Email

info@enthospital.org
medikerihospital@gmail.com

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Store Hours

Mon to Sat:

10:00 AM – 4:00 PM

Sun: Closed

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