Nasal Surgery in Gandhinagar & Ahmedabad | Niraaya Hospital

Functional Endoscopic Sinus Surgery is a minimally invasive surgical procedure to open blocked sinus drainage pathways, remove diseased sinus tissue, and restore the natural ventilation and mucociliary clearance function of the paranasal sinuses. It is the gold-standard surgical treatment for chronic rhinosinusitis (sinusitis lasting more than 12 weeks despite maximal medical therapy), nasal polyposis, recurrent acute sinusitis, sinus mucocoeles, and selected orbital and intracranial complications of sinus disease.

Patients who have failed at least 12 weeks of maximal medical treatment for chronic sinusitis (appropriate antibiotics, intranasal corticosteroid sprays, nasal saline irrigation, and treatment of underlying allergy), or those with symptomatic nasal polyps not adequately controlled by steroids, are candidates for FESS. A CT scan of the paranasal sinuses is an essential pre-operative investigation - it provides a detailed anatomical "roadmap" of the sinus drainage pathways, any anatomical variations, and the extent of disease. FESS without a pre-operative CT is inadvisable.

Performed entirely through the nostrils using a rigid Hopkins rod nasal endoscope (a thin illuminated telescope) and fine endoscopic instruments, FESS opens the natural ostia (drainage openings) of each diseased sinus - typically beginning with the anterior ethmoid and maxillary sinus and extending posteriorly to the sphenoid and frontal sinuses as indicated. Nasal polyps are removed under direct endoscopic visualisation. No external incisions are made. No nasal bones are broken. In most cases, nasal packing is not required or is very limited. The procedure is performed under general anaesthesia and takes 45-90 minutes depending on the extent of disease.

Hospital stay: 1 day. Nasal congestion and minor blood-tinged discharge for 1-2 weeks. Nasal saline rinses (large volume, high-pressure) are the most important aspect of post-operative care and must be performed 2-3 times daily from day 2 onwards to remove crusts and keep the sinus openings patent. Nasal steroid sprays are restarted once initial healing is established. Follow-up nasal endoscopy is performed at 1 week and 4 weeks to clear debris and monitor healing. Return to office work: 5-7 days. Full recovery: 3-4 weeks.

Rhinoplasty is the surgical reshaping of the external nose. At Niraaya Hospital, rhinoplasty is offered for two distinct indications:

Addresses nasal deformity that impairs breathing - for example, a post-traumatic crooked nose with resulting nasal obstruction, internal nasal valve collapse causing significant breathing difficulty, or nasal deformity following previous surgery. Functional rhinoplasty is often combined with septoplasty (septorhinoplasty) and is medically indicated - improving breathing rather than primarily altering appearance.

Addresses concerns about the external appearance of the nose - size (a large nose), the bridge (dorsal hump), the tip (wide, bulbous, or drooping nasal tip), the nostrils (flaring or asymmetric), or overall facial harmony. Cosmetic rhinoplasty is an elective procedure and requires careful, realistic pre-operative expectation counselling.

At Niraaya Hospital, rhinoplasty consultations begin with a detailed discussion of your specific concerns, followed by clinical photography and where available, digital imaging to simulate potential outcomes. Dr. Patel takes a conservative, harmony-focused approach - the goal of rhinoplasty is a natural-looking result that enhances facial balance, not a dramatic transformation that looks operated-upon.

• Closed (Endonasal) Rhinoplasty: All incisions inside the nostrils; no visible external scar. Suitable for limited modifications.
• Open Rhinoplasty: A small incision across the columella (the narrow skin bridge between the nostrils) provides wider access. The scar is typically barely visible after healing. Used for more complex modifications.

A cast or splint is worn on the nose for 1 week. Swelling and bruising around the eyes and nose peak at days 2-3 and significantly reduce by 2 weeks. Presentable (swelling no longer obvious to strangers) by 3-4 weeks. Final result - with full resolution of residual subtle swelling - fully apparent at 9-12 months. No strenuous activity or contact sport for 6 weeks.

DCR (Dacryocystorhinostomy) is a surgical procedure to bypass a blocked nasolacrimal duct - the narrow channel that drains tears from the inner corner of the eye (lacrimal sac) down into the nasal cavity. When this duct is blocked - by chronic infection, scarring, trauma, or congenital narrowing - tears cannot drain and overflow onto the cheek (epiphora, or watering eye). If the lacrimal sac becomes infected (dacryocystitis), a painful, red swelling develops at the inner corner of the eye, which may discharge pus.

Traditional DCR requires an incision on the side of the nose near the inner corner of the eye - leaving a visible scar. Endonasal DCR achieves the same result entirely through the nostril using a nasal endoscope - creating a new drainage window directly from the lacrimal sac into the nasal cavity, with no external incision and no visible scar on the face.

Under general anaesthesia, the nasal endoscope is introduced through the nostril. A window is created in the nasal bone and lacrimal bone opposite the lacrimal sac, and the lacrimal sac is opened directly into the nasal cavity - creating a new, large opening for tear drainage. A silicone stent (a small tube) is passed through the tear drainage system and tied in the nose to keep the new opening patent during healing. The stent is removed in clinic at 3-6 months.

Dr. Patel performs endonasal DCR in collaboration with ophthalmologists - providing a co-ordinated, one-stop solution for patients with blocked tear ducts in Gandhinagar and Ahmedabad.

Day care procedure (no overnight admission in most cases). Mild nasal congestion for 1-2 weeks. Watering from the eye reduces progressively over weeks as the new drainage pathway establishes. Avoid nose blowing for 2 weeks.

A nasal mass is any growth within the nasal cavity or sinuses that is not normally present. Nasal masses vary enormously in their nature - from very common benign inflammatory nasal polyps to uncommon but important tumours - and accurate diagnosis is essential before any treatment decision.

Inflammatory Nasal Polyps: Pale, oedematous, grape-like soft tissue outgrowths from the sinus lining - the most common nasal masses. Usually bilateral, associated with allergic rhinitis, asthma, or aspirin intolerance. Removed endoscopically during FESS. Require long-term steroid spray and allergy management to minimise recurrence.

Angiofibroma (Juvenile Nasopharyngeal Angiofibroma): A highly vascular benign tumour occurring almost exclusively in adolescent males, arising from the nasopharynx and typically extending into the nasal cavity and sinuses. Presents with recurrent severe nosebleeds and progressive nasal obstruction. Requires pre-operative embolisation (to reduce vascularity) followed by endoscopic or open surgical resection.

Inverted Papilloma: A locally aggressive benign tumour arising from the lateral nasal wall or sinus mucosa. Unlike simple polyps, inverted papilloma has a strong tendency to recur after removal and a small but significant risk of malignant transformation (to squamous cell carcinoma). Complete excision with clear margins - usually endoscopically - and meticulous long-term follow-up are essential.

Sinonasal Malignancies: Squamous cell carcinoma, adenocarcinoma, esthesioneuroblastoma, and other malignant tumours of the nasal cavity and sinuses are rare but serious. Biopsy and staging with CT and MRI are the first steps, followed by multi-disciplinary treatment planning.

All excised nasal masses are sent for histopathological examination - the microscopic diagnosis guides further management.