The sinuses are hollow pockets in the face and head, which are lined with a thin mucosa. The main function of the sinuses is to humidify and filter air. In some people, the sinuses can become chronically blocked, leading to sinusitis. Sinus surgery may be needed when symptoms of sinusitis persist or sinus infections reoccur.
According to Cedars-Sinai Medical Center, sinusitis affects about 37 million people. Symptoms often include cough, fatigue, nasal congestion, headache and post nasal drip. Chronic sinusitis may be caused by the deviated septum and narrowing of the sinuses from inflammation or nasal polyps.
Indications For Sinus Surgery
Usually non-surgical treatment will be recommended first for people with sinus problems including sinusitis. When conservative treatment does not work, sinus surgery may be recommended. The goal of surgery is to widen and enlarge the sinuses, which helps the sinus cavity drain more efficiently and reduces sinus infections and chronic symptoms of sinusitis. Surgery also may make breathing through the nose easier.
A sinus surgery procedure may also be recommended for the removal of nasal polyps or to treat other anatomical abnormalities, such as a deviated septum. Additional reasons for sinus surgery, although not as common, include treatment of fungal infections and the removal of tumors.
Types Of Procedures
There are a few different types of sinus surgery procedures, which are available. The type of surgery recommended may depend on the problem being treated, the patient’s anatomy and any underlying risk factors for surgery. The types of sinus surgery procedures include:
- Endoscopic sinus surgery: This procedure is usually done under general anesthesia. It is the most common type of sinus surgery performed. A small scope is inserted in through the nose to view the sinuses. Instruments are also introduced into the nasal cavity, which are used to remove any blockages, such as polyps or scar tissue.
- Image guided surgery: Another option for sinus surgery, which uses an endoscope is image guided surgery. This procedure also includes the use of CT scans to provide a three dimensional image of the sinuses.
- Caldwell-Luc procedure: This procedure involves creating an opening between the maxillary sinus and the nose. This opening or window helps to improve draining in the sinuses.
- Balloon sinusplasty: Approved by the FDA in 2005, this relatively new procedure is another sinus surgery option. During the procedure a small catheter, which has a balloon attached, is inserted in through the nose. The balloon is slowly inflated, which enlarges the sinuses. The balloon catheter is removed, but the sinuses remain open.
After sinus surgery, certain restrictions may be recommended. Patients will usually be advised to restrict lifting and resume normal activities slowly. The length of time it takes to recover and return to normal activities may vary depending on the type of sinus surgery performed. Most sinus surgery is performed on an outpatient basis. Patients may be prescribed an antibiotic to reduce the risk of infection. Pain medication may also be needed.
Depending on the type of sinus surgery performed, the nose may be packed after surgery to control bleeding. The packing will likely be removed in a day or two. Patients may be instructed to avoid blowing their nose for about a week. Nasal irrigation may be recommended to flush old blood from the nose.
According to Medline Plus, sinus surgery is considered a safe procedure, although complications are possible. The risk of complications depends on the patient’s overall health and the type of sinus surgery procedure being performed. Although any type of sinus surgery can cause complications, surgery which includes cutting the skin is more invasive and carries a greater risk of complications, such as bleeding and infection.
Additional complications may include visual changes and numbness in the teeth. Although very uncommon, cerebral-spinal fluid may drain from the nose after the surgery.
Alternatives To Sinus Surgery
Prior to sinus surgery, conservative medical treatment may be used. In some cases, such as with nasal polyps or a deviated septum, surgery may be the only option to treat the underlying cause of sinus problems. In other instances, such as with sinusitis, medical management may be an alternative to sinus surgery.
Medical treatment may include antibiotics to treat an infection. Allergy medication may be used to reduce inflammation in the sinuses. Nasal washes or irrigation may help flush mucus from the sinuses and reduce symptoms of sinusitis.
Sometimes medical treatment is ineffective in treating chronic sinus infections and symptoms of sinusitis. In those instances, a surgical sinus procedure may be the last resort to reduce symptoms.
Although no one enjoys having surgery, sinus surgery appears to be safe and an effective way to treat sinus problems that do not respond to other treatments. There are several options when it comes to sinus procedures. Patients should discuss the risks and benefits of each procedure with their doctor to determine the best options.