Dr David Chin

What is endoscopic sinus surgery? Endoscopic Sinus Surgery (ESS) is simply any surgical procedure for the sinuses performed through the nostrils and visualised with an endoscope. When sinus surgery is performed to treat a condition e. g. sinusitis (inflammation or infection of the paranasal sinuses), and we want to maximise the chance of the sinus returning to normal function, this is called Functional Endoscopic Sinus Surgery (FESS). FESS is thus the most common type of ESS. What is balloon sinuplasty?

Firstly, tonsillectomy is generally a safe procedure [1]. However, risks may often occur in the first 2 weeks after the surgery [2]. Unlike other surgeries, the throat muscles stay exposed after the surgery. That said, other surgeries will involve closing the wound to protect the delicate tissues that are not usually exposed to the air, causing the risk of bleeding to increase [3]. As the tonsils sit on the throat muscles, the surgery will definitely affect the control of these muscles.

When we exercise and we need more air, we open our mouths and indeed it is easier to breathe. When we sleep, however, the situation is totally different; breathing through the nose is a necessity, not an option. In research on normal patients, the upper airway resistance (and therefore the effort required to breathe) is much higher with mouth breathing compared to nose breathing. Why is this the case? The main reason is that when we sleep, the muscles of the throat and tongue are relaxed (especially during rapid eye movement -REM- sleep).

Like many other questions in medicine and health, the answer needs to be tailored to the specific circumstances for each patient. There are different subsites in the throat. Therefore the factors for risk assessment and symptoms are different. The ENT evaluation would include transnasal endoscopy and might require imaging (ultrasound, CT or MRI) of the neck.

Dear Sir, I suspect that everyone has experienced what you are experiencing and have probably asked the same question as you have at some stage in their life. Fever usually indicates that there is an infection. Thick phlegm is usually made up of mucus and inflammatory exudates. While any inflamed mucosal lining (nose, sinus, throat, and lower airways) may produce phlegm during inflammation and infection, the quantity and location of what is seen in the picture suggests that it comes from the nose, sinus, and nasopharynx (the uppermost part of the throat where there is adenoidal tissue).