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Sinus Surgery

Dr. Nick Debnath

Question:Debnath N

After years of sinus infections, I am considering sinus surgery: What should I expect and will surgery cure my sinus problem?

Sinus surgery is usually indicated for chronic sinus infections that persist despite medical therapy. The sinuses are air-filled cavities of the bones around the nose, and any cause of swelling such as an infection, can cause sinusitis by blockage of their drainage pathways. Common symptoms include pain, congestion, drainage or post-nasal drip. A physician should take these symptoms into account when diagnosing, along with physical and radiographic findings such as signs of pus or sinus blockage.

The main treatment for chronic sinusitis is medical management. Conventional therapies include antibiotics, topical or oral steroids, allergy medications and saline rinses, to name a few. When medications fail, surgery may be a reasonable option for treating chronic sinusitis. Other indications, nasal polyp disease, sinus cysts or mucoceles, tumors or discrete anatomic abnormalities.

Using the newest techniques, sinus surgery is usually performed without incisions and with minimal packing, pain and a faster recovery. Endoscopic sinus surgery is generally performed through the nostrils using specialized instruments and small telescopes called endoscopes. The goals are to enlarge the natural drainage pathways of the sinuses, remove polyps and fix anatomic structural problems that contribute to sinus blockage. Sinus surgery has potential risks that you should consider in order to make an informed decision. Adverse events may include complications from general anesthesia, post-operative bleeding, infection, scar tissue formation, tear duct injury, and the need for further surgery. Since the sinuses are near the eyes and brain, surgery puts these areas at risk, but problems such as vision loss or spinal fluid leakage are exceedingly rare in experienced hands.

Surgery is not a cure for sinusitis, but most patients who have sinus surgery report an improved quality of life and a decrease in medication usage. Recent studies suggest that surgery not only alleviates chronic sinusitis symptoms but also improves fatigue, sleep and sexual function. Consult with an ENT (Otolaryngology) specialist to see if sinus surgery is right for you, if all reasonable medical options have been considered. If you questions about surgery are still not answered, you should feel comfortable seeking a second opinion.