Sinus Surgery
The sinuses are air spaces that are inside the skull and face. They moisten and filter the air we breathe in, produce mucus to trap dust and allergens, and help resonate our voice. There are four categories of sinuses:
- Frontal sinuses – Located in the forehead
- Maxillary sinuses – found in the cheeks
- Ethmoid sinuses – Eye space
- Sphenoid sinuses – Found behind the eyes and nose
When sinuses are blocked or inflamed, they cause sinusitis, which results in pain, breathing, and infection.
If you have chronic throat issues, a tonsillectomy is the best method to achieve long-term relief.
Conditions That May Require Sinus Surgery
Sinus surgery is normally recommended when treatments do not work. Some conditions are as follows:
1. Chronic Sinusitis
- Sinusitis that lasts for longer than 12 weeks
- Nasal stuffiness, pain in the face, postnasal drip, and decreased ability to smell
2. Nasal Polyps
- Benign tumors in the nasal cavity
- May cause acute blockage, breathing difficulties, and recurrent infections
3. Deviated Nasal Septum
- A deviated nasal septum that obstructs breathing and causes sinus problems
- Usually managed with septoplasty, sometimes with sinus operation
4. Sinus Tumors or Growths
- Occasionally, but in certain situations, require surgery to remove benign or malignant tumors
5. Fungal Sinus Infections
- Fungal infections that lead to severe inflammation, occasionally requiring surgery to drain
6. Sinus Complications from Allergies
- Allergies may lead to chronic inflammation and stuffy sinuses
If you have chronic throat issues, a tonsillectomy is the best method to achieve long-term relief.
Types of Sinus Surgery
There are different sinus surgeries, and the appropriate one depends on the condition to be addressed. The most common are:
1. Functional Endoscopic Sinus Surgery (FESS)
- Minimally invasive technique with an endoscope (slender tube with camera)
- Removes blockages, polyps, or inflamed tissue
- Used in chronic sinusitis and nasal polyps
- Short healing time compared to traditional surgery
2. Balloon Sinuplasty
- Least invasive of the surgical options; uses tiny balloon to open blocked sinus passages
- Does not involve tissue removal
- Appropriate for patients with mild to moderate chronic sinusitis.
- Short recovery period with fewer aches
3. Septoplasty (Corrective Deviated Septum)
- Straightens the nasal septum to improve breathing
- Traditionally followed by sinus surgery for additional gain
4. Turbinate Reduction Surgery
- Reduces swollen turbinates (tissues within the nose that control breathing)
- Aids in decongesting and easing breathing
5. Caldwell-Luc Procedure
- A more invasive surgery to remove tumors or drain maxillary sinuses
- Less common due to the efficacy of the endoscopy intervention
6. Open Sinus Surgery (Traditional Surgery)
- Employed in complex situations such as tumors or faulty sinus blockages
- Requires bigger incisions and a longer recovery time
Preparing for Sinus Surgery
1. Preoperative Tests
- Nasal endoscopy to inspect the sinus passages
- CT scan or MRI to ascertain the extent of sinus disease
- Allergy testing to determine if allergies are causing sinus problems
2. Medications Before Surgery
- Antibiotics if there is a current infection
- Steroid nasal sprays to reduce swelling
- Do not take blood thinners (aspirin, ibuprofen) to prevent more bleeding
3. Lifestyle Changes
- Avoid smoking and alcohol use as they are likely to interfere with healing.
- Keep yourself hydrated to ensure open nasal passages
4. Fasting and Anaesthesia
- General anaesthesia is commonly used, with 6-8 hour fasting before surgery
The Sinus Surgery Procedure
1. Anesthesia Administration
- General anesthetic (patient is under anesthetic)
- Local anesthetic (numbing of the nasal passage, used in minor surgery)
2. Surgical Process
- A thin endoscope is inserted through the nostrils
- The physician eliminates inflammation, polyps, or obstructions
- Sinuses are enlarged to ensure better drainage
- During balloon sinuplasty, the sinuses are dilated with a balloon catheter
3. Closure and Recovery Room
- No extra cuts needed for balloon sinuplasty and FESS
- Patients monitored for a few hours post-surgery
Recovery After Sinus Surgery
1. Postoperative Care Immediately
- Most patients go home the same day
- Mild bleeding and congestion are expected during the initial few days
- Pain management using acetaminophen (dose aspirin/ibuprofen)
2. Nasal Care and Cleaning
- Saline nasal sprays flush out mucus and protect against infection
- Nasal sprays (as instructed) decrease swelling
3. Activity Limitations
- Avoid vigorous activities for 1-2 weeks
- Sleep with your head elevated to reduce swelling
4. Follow-Up Appointments
- The initial follow-up after surgery is within a week
- The surgeon may have stitches or packing removed if used
Potential Risks and Complications
Although sinus surgery is generally safe, there can be complications:
1. Bleeding
- Minor bleeding is frequent, but significant bleeding can necessitate medical attention
2. Infection
- Rare but may be necessitated; antibiotics may be necessary
3. Scar Tissue Formation
- At times, tissue growth may result in recurring obstruction
4. Damage to Adjacent Structures
- Rarities include trauma to the eye or brain by virtue of the sinus proximity
5. Transient or Permanent Change in Smell
- There is reversible anosmia in other patients, usually resolving
Long-Term Health and Prevention Strategies
1. Sinus Health Maintenance
- Use a humidifier to keep nasal passages moist
- Stay hydrated and have a balanced diet
- Avoid allergens and irritants (dust, smoke, pet dander)
2. Allergy Management
- Daily use of antihistamines or nasal steroids if allergy is a causative factor
3. Daily Sinus Rinses
- Daily saline rinses avert mucus buildup
4. Identifying Symptoms of Relapse
- If congestion, headache, or sinus infection recurs, seek medical attention
5. When to Have Revision Surgery
- If the symptoms persist even after the first surgery, revision sinus surgery can be needed
FAQs
No, it is performed under anesthesia, and there is minimal pain afterwards and this is regulated by medication.
Surgery drastically improves sinus infection and breathing, but maintaining success long-term depends on treating allergies and sinus maintenance.
The duration of the operation is usually between 30-90 minutes
There is bound to be some congestion during healing, but very noticeable improvement happens within two days.
The majority of insurance policies do cover sinus surgery when it is medically necessary. We can assist with insurance verification.
