PIC

 

 

Chronic sinusitis, recurrent infections, and polyps impeding nasal breathing and causing chronic pain, drainage, loss of smell, fatigue, and malaise can be an awful thing to suffer from on a daily basis.  When medications and non surgical remedies fail to sufficiently control the problem, surgery can be a good option. 

 

Sinus surgery has evolved tremendously over the years and what used to be a painful, highly invasive operation often requiring external incisions, routine packing and long recovery has been transformed to a far better experience.  With modern techniques and instrumentation, surgery is done through the nostrils using endoscopic visualization and highly specialized instrumentation with no need for external incisions.  It's not uncommon for patient to have such little pain that no prescription pain medications are needed.  Bleeding is minimized and there is no need for packing for routine cases.  The overall experience is far safer and generally well tolerated with much faster recovery and return to normal activities. 

It's important to understand that most people with chronic sinus problems have multiple issues that predispose them to develop sinus infections including their immunologic makeup, allergies, environmental issues, and compromised anatomy.  Therefore, medications, surgery, and other care strategies are not mutually exclusive, rather they are complementary as they treat different components of a person's cause of sinus troubles. 

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Benefits of endoscopic sinus surgery (and polypectomy if applicable)

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The main goal of sinus surgery is to improve compromised drainage pathways in the sinuses.  By widening the drainage paths, severity and frequency of sinus infections are expected to improve.  Other benefits may include

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• Improved nasal breathing

• Improved efficacy of nasal sprays and irrigation.  This is one of the biggest benefits of sinus surgery in allowing for better control of chronically inflamed tissues in the sinuses.

• Decreased need for systemic antibiotics and steroid treatments.

• Improved quality of life and energy.

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Requisites

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Endoscopic sinus surgery (with polypectomy if polyps are present) may be an option for you.

Following requisites are important prior to undergoing the procedure.

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• You are in reasonably good health with no critical unstable medical condition.

• You have tried medical management of your sinus problems but medical therapy alone has failed to sufficiently control your symptoms.

• You have had a CT scan of your sinuses. 

• You have had an evaluation with a qualified surgeon to determine appropriateness of the procedure. 

• You have discussed the procedure with your surgeon and understand potential risks & benefits of the procedure.

• Be able to stop blood thinning medications prior to the procedure.

 

 

Risks of Endoscopic Sinus Surgery

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Although every surgery and treatment has risks, sinus surgery can be very safely performed.  Risk of serious complications are very small.   Risks include the following.

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• Bleeding and infection.  Universal risk with all surgeries.  Some blood tinged nasal drainage is typical during recovery.  Severe bleeding and infection are rare.  Bleeding impairing sufficient visualization may necessitate stopping the procedure to avoid unnecessary risk.

• Pain.  Typically the pain is mild to moderate.

• Injury to the eye or the brain.  A thin bone separates the brain and the eye from the sinus cavities.  Fracture may lead to brain fluid leak and will need further surgery.  More significant injury to the brain and eye is possible.  Fortunately, these complications are very rare in the hands of a skilled surgeon.

• Need for further treatment.  Remaining sinus problems due to allergies or other problems will need continued treatment.  Other unexpected outcome may require additional treatment. 

• General Anesthesia if applicable.  Although risk is not zero, modern anesthesia is overwhelmingly safe.  Nausea and other anesthesia related problems may occur and may need further treatment. 

 

What to expect

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• Surgery is typically performed under general anesthesia in the operating room.  Certain patient's maybe treated in the office under local anesthesia.    

• Most patients are discharged home the same day to convalesce at home.

• No packing is used unless problematic bleeding is encountered during the procedure.

• Light physical activity (walking) is encouraged during the recovery period. 

• You should avoid blowing your nose, heavy lifting, strenuous activities, and contact sports.

• Keeping the head of the bed elevated during sleep can help manage secretions..

• You will be using nasal saline irrigation to wash the nasal and sinus area clear of mucus and debris. 

• Followup appointment will be 1-2 week after surgery. 

• Average time off work is 3-7 days. 

• Regular followup visits are required for the first 6-8 weeks after the procedure. 

• On call physician is available 24-7 for any post surgery emergencies.  On call MD can be contacted 24-7 by calling our office.