Endoscopic Sinus Surgery Overview

By:    Published: March 13, 2012

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Endoscopic sinus surgery is a very common surgical procedure done to treat chronic sinusitis. Although other types of sinus surgery are also available, endoscopic sinus surgery is often the procedure of choice. It is considered less invasive than traditional open sinus surgery because it does not involve external incisions. The sinuses are viewed through the endoscope, which is inserted through the nose. According to the Cleveland Clinic, the majority of patients who undergo the procedure have improvement in their symptoms.

Why Is It Done?

The goal of surgery is to reduce symptoms of sinusitis. Sinusitis is a very common condition that occurs when the sinuses become inflamed. The inflammation prevents proper mucus drainage and infection can also develop. Medical treatment may be used as the first line of treatment for chronic sinusitis, but if it does not cure the problem endoscopic sinus surgery may be recommended.

The procedure helps open the sinus cavities and allows mucus to drain better. By allowing mucus to drain properly from the sinuses, the number of sinus infections usually decreases. Widening the sinus cavity may also improve a person’s sense of smell.

Procedure

Endoscopic sinus surgery is often performed under general anesthesia, but can also be done using a local anesthetic. If the patient chooses the option of only having a local anesthetic to numb the area, medication may also be given to sedate and relax the patient.

An endoscope, which has a small camera on the end of it, will be inserted into the nose to allow the physician to view the inside of the nasal cavity. The surgeon will use additional instruments inserted into the nose to remove excess tissue, which may be obstructing the flow of mucus from the sinuses. Nasal polyps may also be removed during the procedure.

After the procedure, patients will generally be monitored until they are fully awake. If general anesthesia was used, it may take a little longer for the effects of the anesthetic to wear off. If complications do not occur, most patients can go home the same day as the surgery.

Patients will be given instructions for post-operative care. Usually patients are advised to refrain from blowing their nose for a week or two after surgery. Heavy lifting, which may result in straining, should also be avoided, since it may increase bleeding.

Side Effects

According to the Cleveland Clinic, some bleeding from the nose for about two weeks is normal after endoscopic sinus surgery. The bleeding generally decreases over time. Sinus pain or pressure may also be felt for a few days after surgery.

Pain is usually not severe and can be treated with over-the-counter pain medication, such as those containing acetaminophen. According to The John Hopkins Sinus Center, pain relievers containing aspirin and non-steroidal anti-inflammatory medication (NSAIDs) should not be taken for two weeks after the surgery to prevent an increase in bleeding.

Additional side effects that can occur after endoscopic sinus surgery include mild fatigue and nasal congestion. Fatigue usually improves in a few days. Nasal congestion may last for a few weeks post-operatively.

Risks

As with all types of surgery there are risks with endoscopic sinus surgery. Although it is considered a safe procedure, risks include infection and swelling or bruising around the eyes. A small number of people experience numbness in the upper teeth, which improves over time.

Although very rare, patients should still be made aware of additional risks, such as vision problems, which may occur. A very small number of people may develop vision loss in one eye or double vision. Another rare risk with endoscopic sinus surgery is leakage of spinal fluid. If this complication does develop, it can lead to a serious infection, such as meningitis.

Patients should be educated to watch for signs of infection after surgery and spot any complications quickly. Signs may include a fever, sudden vision disturbances, severe headache and heavy bleeding from the nose.

Benefits

There are several advantages of endoscopic sinus surgery over conventional sinus surgery.

  • Endoscopic sinus surgery is considered less invasive than open sinus surgery, which usually allows for a quicker recovery.
  • The procedure is quick and done on an outpatient basis.
  • The procedure may be performed with general anesthesia or with a local anesthetic and sedation.
  • If the patient is awake during the procedure, complications associated with general anesthesia are eliminated.
  • The procedure does not involve external cutting through the nose, which reduces the risk of excess bleeding and infection.
  • Scarring is also very minimal.
  • After the procedure, pain is often mild and well controlled.

Chronic sinus problems, such as sinusitis, can interfere with quality of life and lead to additional health problem. If sinus surgery is recommended, endoscopic sinus surgery may be a good option. Recovery is usually quicker than traditional sinus surgery, and complications are often reduced. Consult with your doctor when deciding if endoscopic sinus surgery is the appropriate procedure for you.

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