Sinus surgery

Overview

Doctors use sinus surgery to treat chronic sinusitis, remove sinus polyps, and address related conditions that haven’t improved with medication. People with severe sinus issues often opt for this procedure, which may involve removing infected sinus tissue, bone, or polyps. There are minimally invasive sinus surgeries designed to facilitate quick recovery.

Types of sinus surgery

Multiple variations of sinus surgeries exist:

• Functional Endoscopic Sinus Surgery (FESS): This common sinus surgery method involves widening the drainage passages connecting the nose and sinuses. It entails the removal of bone or infected tissue, enabling trapped mucus in the sinuses to be released. Doctors utilize endoscopes, which are slender tubes equipped with lights, to visualize the interior of the nose and sinuses and guide the procedure. Image-guided systems may also be employed, utilizing Computed Tomography (CT) scans for enhanced visualization of the sinuses.
• Balloon sinuplasty: This minimally invasive approach to treating sinusitis employs an endoscope and catheter to guide a small balloon into the nasal passage. Once in place, the balloon is inflated, expanding the passageway to the sinuses.
• Caldwell Luc surgery: Reserved for cases where conventional methods have proved ineffective, this surgery involves creating a new opening from the maxillary sinus, located behind the cheek, to the nose. This facilitates drainage of mucus from the sinus cavities.

Risks

Although all surgical procedures carry inherent risks, complications from sinus surgery are rare. It is important to consult your doctor to fully understand the potential complications and the steps they will take to address any issues that may arise during or after sinus surgery. These complications might include:

• Abnormally heavy bleeding: Although the likelihood of significant bleeding after sinus surgery is low, it is possible to bleed more than usual. In that case, your doctor might put packing in your nose and advise you to stay in the hospital so they can keep an eye on your condition.
• Tearing eyes: Surgical procedures or sinus inflammation can cause an increase in tear production in your eyes.
• Cerebral Spinal Fluid (CSF) leakage: This infrequent issue impacts the fluid surrounding your brain. If this fluid leaks, you could get meningitis or inflammation of the brain.
• Visual issues: Following sinus surgery, some patients experience vision loss in one eye or double vision.
• Numbness: People may experience a partial numbness in their face following Caldwell Luc surgery if there is a minor nerve damage.
• Empty nose syndrome: Although nasal passages are clear, some patients report feeling congested or blocked in their noses, or finding it difficult to take a full breath.

Before the procedure

Prior to undergoing surgery, your doctor will conduct a pre-operative screening to ensure your suitability for the procedure. They may prescribe medications aimed at preventing infection or reducing swelling. While each individual’s circumstances vary, most doctors typically recommend the following:

• If you smoke, please make an effort to give it up at least three weeks prior to your procedure. Smoking may exacerbate sinus symptoms. Consult your doctor for guidance or helpful resources in this regard.
• For at least seven days before to your procedure, avoid taking aspirin. Even tiny doses of aspirin can increase bleeding during and after your surgery.
• If your surgery requires general anesthesia, avoid eating or drinking anything after midnight on the day of the procedure.
• After your surgery, you won’t be able to drive for 24 hours, so make arrangements to have someone drive you home.
• Just prior to your operation, your doctor will give you general anesthesia.

During the procedure

Functional endoscopic sinus surgery and balloon sinuplasty involve the insertion of surgical instruments into the nasal passages. In contrast, Caldwell-Luc surgery accesses a sinus cavity through the mouth to create a passage between that sinus and the nasal passage.

Functional Endoscopic Sinus Surgery (FESS)

FESS is the primary procedure used to address severe sinus conditions. Here is an outline of the process:

• Decongestant medicine is applied directly intoyour nose.
• A follow-up nasal endoscopy is performed by your doctor.
• A numbing agent is injected into your nose. They carefully insert the endoscope into your nose. In order to utilize the endoscope to remove bone, sick tissue, or polyps that might be obstructing your sinuses, they introduce surgical instruments next to it. They might also remove tissue with a small rotatingburr.
• Lastly, in order to absorb any blood or discharge, your doctor may stuff material up your nose.

Balloon sinuplasty

This presents an alternative to FESS. Here is information regarding this procedure:

• A local anesthetic will be injected into the tissue lining your nose by your doctor.
• They’ll use an endoscope to guide the catheter as they enter it into your nose.
• After that, they’ll insert a little balloon into your sinuses using the catheter.
• To unblock your sinuses, they will gradually inflate the balloon.
• The balloon will be taken out.

Caldwell Luc surgery

Doctors generally opt for this surgery when previous procedures have failed to address your sinus issues. During this surgery, providers access your maxillary sinus, situated behind your cheek, and establish a new pathway connecting your sinus to your nose. Typically, any damaged tissue or bone is removed as part of the procedure. Here is further information regarding this surgery:

• A general anesthetic will be administered.
• To access the wall of your maxillary sinus, your doctor makes an incision in your gums between your upper lip and gum tissue.
• To remove any diseased or damaged bone or tissue, they create a tiny hole in your sinuswall.
• An endoscope is utilized to enlarge the opening of your maxillary sinus.
• The gum incision is closed with sutures (stitches).

After the procedure

After receiving general anesthesia, you’ll remain in a recovery area until its effects diminish. If you had local anesthesia, you can leave immediately. Before you go home, your doctor will provide instructions for self-care during recovery. You might be given pain medication to ease mild to moderate discomfort expected in the next week. Antibiotics may also be prescribed to lower the risk of infection.

Outcome

The majority of individuals typically recuperate from sinus surgery within a few days. Here are some recommended measures to aid in your recovery:

• To catch drainage, you’ll have gauze under your nose, which you’ll need to replace when it gets wet.
• Sleeping with your head up is recommended.
• Aim to consume a lot of liquids.
• You might feel stuffy or gritty in your nose.
• For roughly a week following your procedure, you can experience mild to moderate pain.

Sometimes, sinus issues may improve immediately after surgery for certain individuals. However, others may need several weeks or even months before they notice relief from their symptoms.