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When Do You Need Sinus Surgery

What Happens Before This Procedure

How do I know if I need sinus surgery?

Your healthcare provider will do a pre-operation screening to be sure youre able to have the surgery. They may prescribe medications that prevent infection or swelling. Every persons situation is different, but most healthcare providers recommend the following:

  • If you smoke, please try to stop smoking at least three weeks before your surgery. Smoking can make your sinus symptoms worse. Ask your healthcare provider for advice or resources to help with this.
  • Dont take aspirin for at least seven days before your surgery. Even small amounts of aspirin can increase how much you bleed during and after your surgery.
  • If your surgery involves general anesthesia, dont eat or drink anything after midnight the day of your surgery.
  • You wont be able to drive for 24 hours after your surgery, so plan to have someone available to help you get home.
  • Your healthcare provider will administer general anesthesia just before your surgery begins.

When Is Surgery Needed

It depends on the cause.

Sinusitis is swelling in your sinuses that causes congestion and discomfort. Several things can cause your nasal passages to become blocked and lead to this condition. Some of these are:

  • Infections by bacteria, fungi or viruses
  • Small growths called polyps on the lining of your sinuses
  • A deviated septum, meaning a crooked wall in between your nostrils

If you donât get relief from your medicine, nasal rinses, or other treatments, tell your doctor. They may send you to a specialist.

Surgery may be an option if your sinusitis is due to a deviated septum, polyps, or other structural problems.

The main goals of sinus surgery are to relieve your symptoms and cut down on how many infections you get. If they keep coming back, chances are thereâs something in your nasal cavity that surgery could fix.

An operation should also help you breathe better through your nose. And if the chronic congestionhas affected your sense of smell or taste, surgery might help with that, too.

Signs You May Need Sinus Surgery

Lets help you figure out how to finally get those severe sinus symptoms under control.

At some point, most people will end up dealing with sinus problems. Luckily, they often just go away on their own without needing more than an over-the-counter medication to manage symptoms. Unfortunately, millions of Americans arent as lucky. They deal with severe and uncomfortable sinus symptoms that last more than 12 weeks. If you are dealing with chronic sinusitis or other sinus problems, our Sun City West and Sun City, AZ, otolaryngologists are here to tell you the warning signs that it might be time to consider surgery.

Okay, we know that no one wants to undergo surgery and luckily most people dealing with sinus problems wont ever have to. Our Sun City West and Sun City ENT doctor offers a lot of different ways to help get your symptoms under control. If medication is able to manage your symptoms than no other course of action is necessary however, if medication isnt working for you then its time to come in for further testing.

Further testing will often include imaging tests such as a CT scan to look for signs of a sinus blockage or other symptoms that might require surgery in order to alleviate the issue. You may require sinus surgery if:

What kinds of sinus surgery are available?

However, sometimes traditional surgery may be necessary to repair structural deformities, remove diseased tissue and even reconstruct certain areas of the sinuses.

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During Endoscopic Sinus Surgery

Endoscopic sinus surgery is usually performed as an outpatient procedure. It does not include cutting the skin, because it is performed entirely through the nostrils. Most people can return home the same day.

The sinus surgeon will use an endoscope a thin camera rod with a light at the end to magnify and better see the sinus tissues. Specialized instruments open the sinuses widely by safely and effectively removing causes of sinus blockage like mucous membrane swelling, nasal polyps and scar tissue. Specialized instruments are also used, if required, to straighten the septum and reduce the size of the turbinates .

Is A Sinus Operation Painful

Sinus Relief Center

Pain: You should expect some nasal and sinus pressure and pain for the first several days after surgery. This may feel like a sinus infection or a dull ache in your sinuses. Extra-strength Tylenol is often all that is needed for mild post-operative discomfort.

How long does sinus surgery take?

In general, surgery takes a few hoursenough time for the surgical team to place the patient under anesthesia, introduce the nasal endoscope and other necessary tools into the sinuses, remove the tissue that needs to be removed, and prepare the patient for recovery.

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When Is Sinus Surgery Necessary

Sinus surgery should always be considered a last resort.

There are instances where surgery can be quite helpful, especially in people with large nasal polyps. If your sinuses are filled with polyps or cysts that are blocking the ostia , then I would recommend surgery. But then to prevent them from recurring, which often occurs, begin the Sinus Survival Program following the sinus surgery, states Dr. Ivker.

Pros And Cons Of Sinus Surgery

Like any surgical procedure, there are pros and cons. The most obvious pro is that sinus surgery typically works. While it may take a while to heal, most patients report significant improvement post-operation. Some procedures, like an endoscopy, also come with little to no potential for complications such as pain during recovery. However, patients who opt for surgery bear the responsibility of post-operation sinus care, which is just as important as the surgery itself. Regularly having examinations and cleanings or irrigations afterward is crucial for the success of the procedure. Potential, and fairly common, complications include bleeding and infection. Though serious complications are rare, they do occur in some cases, which is why ENT doctors will only recommend surgery when all other options have failed.

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Who Needs Surgery For Sinusitis

Very few people need surgery to treat sinusitis. You may need surgery if you have been through the following steps:

  • You have been diagnosed with chronic sinusitis by an ENT doctor.
  • After being diagnosed, you have used the maximum medical treatment for sinusitis. Maximum medical treatment includes at least four to six weeks of antibiotics, a steroid medicine and other prescription medicines to clear up the infection and reduce the swelling in your sinuses.
  • You have had a CT scan of your sinuses after using the maximum medical treatment as prescribed by your doctor. It is very important to have the CT scan done after this treatment. By reducing swelling and infection as much as possible, this treatment lets your doctor see what could be causing the repeat infections.
  • You might need surgery if:

    • The CT scan shows that something is keeping the sinuses from draining properly.
    • Your doctor suspects that you have a sinus infection caused by a fungus. This may be the case if antibiotics have not cleared up the infection. Antibiotics work for bacterial infections but not for fungal infections.
    • You have a serious problem from sinusitis, such as the spread of the infection beyond the sinuses. This rarely happens if it did, more extensive surgery would be required.

    Surgery As A Last Resort

    Endoscopic Sinus Surgery: Ten Reasons to NOT have Sinus Surgery

    Patients who respond to other, non-invasive treatments do not usually need surgery. Like any surgical procedure, sinus surgery presents risks that are not necessary to take if other treatment methods are effective. Before resorting to sinus surgery, any and all medical therapies should first be explored. Of course, this varies on an individual basis, but surgery should always be a last resort. An effective treatment option that should be tried prior to surgery is the balloon sinuplasty.

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    Acute Or Chronic Sinusitis

    Acute sinusitisleads to breathing difficulties and disrupts mucus drainage as your sinuses are inflamed and swollen. Its usually caused by the common cold, and your symptoms will fade or grow easier to manage over time.

    However, if your sinuses remain inflamed and swollen for over three months, despite undergoing non-invasive treatments, it could indicate that you havechronic sinusitis.In such cases, you may have to undergo frontal sinus surgery to clear your sinuses and remove any abnormal growths that could be blocking them.

    What Is Sinus Surgery Or Endoscopic Sinus Surgery

    Sinus surgery, or FESS is a procedure where the sinus cavities are examined and opened to provide improved drainage. There are four paired sinus cavities . Surgery is only performed on the affected sinus cavities, and is usually performed through the nostrils.

    This procedure is typically performed an operating room under general anesthesia. Sometimes this procedure is performed in conjunction with other procedures to improve nasal breathing

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    Acute Severe Ethmoid And Frontal Sinusitis

    Pus from an acute ethmoid sinusitis may break through the lamina papyracea and cause a painful proptosed eye with a risk of loss of vision. If the response to intravenous antibiotics is not very rapid, urgent orbital decompression is required. Bleeding is likely to occur because of the acute inflammation, making endoscopic surgery extremely difficult. An ethmoidectomy via an external incision may be the preferable option.

    Severe frontal sinusitis may be associated with intracranial sepsis and under these circumstances, a direct trephine into the frontal sinus together with the appropriate neurosurgical intervention is the best option.

    Options For Sinus Surgery

    What you need to know before you have your Nose or Sinus Surgery job ...

    Dr. Marc Dean provides in-office Balloon Sinuplasty to patients throughout Fort Worth, Texas.

    The Balloon Sinuplasty procedure provides the following benefits to patients suffering from chronic sinusitis:

    • Patients are anesthetized with local anesthetics as opposed to general anesthesia
    • Shorter recovery time
    • Proven successful outcomes
    • More cost-effective due to avoiding facility fees and anesthesia

    Call 817-332-4060 to find out if youre a candidate for Balloon Sinuplasty or make an appointment

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    How Is Sinus Surgery Performed On The Face

    In sinus surgery, the physicians goal is to open sinuses that are blocked by inflammation in order to improve sinus drainage and airflow. As mentioned above, the surgery previously involved incisions on the face. Now, the surgery is generally performed using a nasal endoscope, a slim instrument with a tiny camera, inserted through the nostril.

    How does a doctor do endoscopic sinus surgery?

    During functional endoscopic sinus surgery a small scope with a high-definition camera is inserted into the nose. The camera will project an image onto a TV screen, which will allow your surgeon to see the blockage to or narrowing of your sinuses. Special instruments will be used to enlarge the openings.

    Surgical Treatment For Chronic Sinusitis

    At NYU Langone, doctors recommend sinus surgery only if over-the-counter or prescription medications and other therapies fail to relieve symptoms of chronic sinusitis.

    Our surgeons can correct structural problems within the nasal passages and sinuses and remove polyps or other tissue blocking the nasal passages. Clearing the nasal and sinus passages allows mucus to drain normally, reducing facial pressure and pain, restoring your sense of smell, and making it easier to breathe.

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    What Should I Expect On The Day Of The Procedure

    The childs procedure takes place in an operating room. The procedure usually takes about 1-2 hours, but can take much longer depending on the severity and any other additional combined procedures planned. The surgeon provides an idea of how much time is expected, but this may change during the procedure.

    Before and after surgery: a pediatric nurse prepares the child for surgery, assists the pediatric ENT surgeon during surgery, and cares for the child after the procedure.

    Anesthesiology: The child is placed under general anesthesia by a pediatric anesthesiologist. At Nationwide Childrens, subspecialty-trained pediatric anesthesiologists regularly provide pediatric anesthesiology services for patients undergoing surgical procedures. It is important that the parent meet with the anesthesiologist prior to the procedure.

    Surgery: A pediatric ENT surgeon may use specialized telescopes to systematically evaluate the nasal airway in conjunction with specialized nasal instruments. If additional procedures are needed, additional special instruments may be used to perform these procedures.

    What Should I Expect After My Child Has A Sinus Surgery

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    After Surgery: The surgeon may feel it is safe for the child to go home after the procedure, or may recommend that he/she be observed at the hospital for a period of time afterward. The surgeon discusses the postoperative plan with the parent after the procedure. Follow up plans are discussed as well.

    The child may be more sleepy than usual. Some additional nasal obstruction is normal after surgery. There are sometimes small plastic splints placed in the nose after surgery, to help with healing. These are usually left in place for 1-7 days. Some minor nosebleeds or nasal drainage is normal after the surgery. Antibiotics are typically prescribed while the splints are in place.

    A slightly increased temperature after anesthesia is normal. The child should be encouraged to drink plenty of liquids after the procedure. The surgeon will discuss when he/she should return to a normal diet.

    Tylenol or ibuprofen is typically appropriate for pain control. Sometimes stronger narcotic pain medications may be prescribed for additional pain control

    If the child develops any concerning symptoms after surgery, including pauses in breathing, color change of the skin , appearing lethargic or tired, severe bleeding or any other sudden change from his/ her normal behavior, please seek immediate medical attention.

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    You Are Dealing With Fungal Sinusitis

    Since most sinus infections are bacterial you may be surprised to discover that your sinus infection is actually due to a fungus. Fungal sinus infections cause the exact same symptoms as a bacterial or viral sinus infection however, your symptoms may be more severe. If you are dealing with severe sinus infection symptoms its a good idea to see your ENT doctor to confirm whether its bacterial, viral or fungal. Invasive or chronic fungal sinusitis will typically require surgery.

    How Do You Know What Type Of Surgery You Need

    Types of Sinus Surgery

    • Functional endoscopic surgery, where a small tube with an attached camera is used to look directly into the nose and sinuses. During an endoscopy, the doctor can remove tissue, clean out the sinuses and enlarge sinus openings for drainage.
    • Open sinus surgery, where in more complicated cases, an incision may be made directly over the sinus so it can be opened, diseased tissues eradicated and sinus reconstructed.
    • Balloon Sinuplasty, where a catheter with an inflatable balloon is inserted into the sinus and then inflated to widen sinus openings. Unlike traditional sinus surgery Balloon Sinuplasty require no cutting or removal of bone or tissue.

    If you arent sure if you are the right candidate for a sinus surgery, here is a quick checklist:

    1) These recurring symptoms:

    • Discharge of yellow or green mucus from the nose

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    How Long Does It Take To Recover From A Sinus Surgery

    September 1, 2021 Written by: Michael Menachof Categories: Sinus

    Dr. Menachof, MD, has specialized in conditions around the head, throat, ear, nose, neck and face for over 20 years, and was the first to bring sublingual allergy drops to Colorado in 2005. He has been recognized as a Fellow by multiple academies, named one of Americas Top Facial Plastic Surgeons continually since 2003 and is featured in multiple national publications.

    Learn more about the recovery process after sinus surgery and how long you can expect it to take.

    Sinus surgery has come a long way. With advancements in technology and techniques, recovery time from sinus surgery has decreased over the past decade. Most patients are able to return to work within a few days, but healing differs with each person for a few reasons, including:

    • Unique anatomy of the nose
    • Individual recovery speeds
    • Extensiveness of each sinus surgery

    Your doctor will help you determine exactly how long your recovery will take. While you can typically return to work within a few days, it can take a few months and up to a year to realize the full benefits and improvements from your sinus surgery.

    Candidates For Sinus Surgery

    Sinus Surgery

    FESS is most successful in patients who have recurrent acute or chronic infective sinusitis. Patients in whom the predominant symptoms are facial pain and nasal blockage usually respond well. The sense of smell often improves after this type of surgery.

    A CT scan before FESS is mandatory to identify the patient’s ethmoid anatomy and its relationship to the skull base and orbit. CT scanning also allows the extent of the disease to be defined, as well as any underlying anatomic abnormalities that may predispose a patient to sinusitis.

    Patient selection therefore involves a thorough history and physical examination, a trial with medical treatment and, finally, CT scanning. The result is a highly selected group of patients who can expect an improvement of up to 90 percent in their symptoms.

    In patients with nasal polyposis that is not controlled with topical corticosteroids, FESS permits the accurate removal of polyps using suction cutters.5 It is not known whether the disease-free interval is extended for patients having endoscopic ethmoidectomies for polyposis compared with conventional polyp surgery, but the postoperative discomfort is minimal.

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    Common Side Effects And Best Practices For Recovery

    Youll most likely have some nasal dripping or mucus that is bloody this is normal. But you will need to avoid blowing your nose for 4 to 7 days after surgery. Blowing could disrupt the delicate sinuses as they heal.

    Your doctor might insert nasal packs at the site of the surgery and remove them in the days afterwards. Your doctor will ask you to schedule a few postoperative appointments. They can clear your nasal passages safely and carefully.

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