FESS Quiz

Which of the TWO following anesthetic techniques provides the best intraoperative conditions for FESS when utilizing a Total Intravenous Anesthesia (TIVA)? (Select Two)

• Propofol

• Sevoflurane

• Nitrous oxide

• Remifentanil

Which of the following is the most appropriate intraoperative positioning for a patient undergoing FESS?

• Prone with the head flexed

• Reverse Trendelenburg with head slightly elevated

• Supine with the neck extended

• Lateral decubitus with slight head rotation

Which TWO reasons would be contraindication for the  utilization of  nitrous oxide (N2O) during a FESS procedure? (Select all that apply)

• Increasing sinus pressure

• It promotes vasodilation, increasing surgical bleeding

• Diffuses into closed air spaces

• It reduces MAC requirements, leading to hypotension

What is the primary concern when extubating a patient with Kartagener’s Syndrome after FESS?

• Severe laryngospasm due to retained secretions

• Hypotension from residual anesthetic effects

• Severe PONV

• Postoperative cerebrospinal fluid leak

Which TWO ventilation strategies would optimize your patient during the most for KS patients undergoing FESS?

• Low tidal volume (6 mL/kg)

• High tidal volume (10-15 mL/kg)

• High respiratory rate

• Low respiratory rate

How should neuromuscular blockade be reversed in KS patients undergoing FESS?

• Neostigmine with glycopyrrolate

• Sugammadex

• Atropine only

• Atropine only

In KS patients with situs inversus, which ECG abnormality is commonly seen?

• Left bundle branch block

• Atrial fibrillation

• Inverted P waves in lead I

• ST-segment elevation in inferior leads

What is the purpose of posterior pharyngeal packing in FESS?

• To maintain an open airway

• To prevent aspiration of blood

• To provide additional surgical exposure

• To prevent sinus pressure buildup

Answer explanation

Posterior pharyngeal packing prevents blood from entering the airway, reducing the risk of aspiration and laryngospasm.

Which of the following is NOT a concern in the postoperative period after FESS?

• Airway obstruction from blood and secretions

• Pneumothorax

• PONV

• Severe postoperative nasal pain

What is the most common indication for FESS?

• Epistaxis

• Deviated nasal septum

• Obstructive sleep apnea

• Chronic rhinosinusitis refractory to medical therapy