Sinus Surgery

Overview

Why is sinus surgery performed?

Sinus infections are usually treated with medication rather than surgery. Sinus surgery may be necessary when those infections are recurrent or persistent. Sinus surgery is most commonly used to treat chronic sinusitis (inflammation of the nose and sinuses), but may be needed for other sinus problems.

Surgery involves enlarging the openings between the sinuses and the inside of the nose so air can get in and drainage can get out. It may involve removing infected sinus tissue, bone or polyps. Modern sinus surgery has less post-surgical bleeding, is less invasive and involves a shorter recovery time than sinus surgery in the past.

What are the types sinus surgery?

  • Functional endoscopic sinus surgery (FESS): This is now the most common type of sinus surgery. It can be done on an outpatient basis. It is done by looking through the nostril with a nasal endoscope (a small telescope) to see the inside of the nose and the entrances to the sinuses. Other instruments are used through the same nostril to perform the procedure
  • Image-guided surgery: FESS is often done with an image-guided system that uses computed tomography (CT) scans to aid the surgeon in identifying the anatomy and removing as little tissue as necessary. This system helps the surgeon to know when they are getting close to the margin of the sinus and thus improves safety as well.

Other procedures may be used for more serious sinus problems, including the Caldwell Luc operation and endoscopic skull base surgery.

Procedure Details

What happens before sinus surgery?

Your doctor will do a preoperative screening, and may prescribe medicines to prevent infection, swelling or other complications during the procedure. You will not be able to eat or drink anything after midnight the night before the surgery. Your doctor should let you know all medications or supplements to avoid before the surgery that may lead to bleeding, such as aspirin and ibuprofen. You must not drive for at least 24 hours after anesthesia.

What happens during sinus surgery?

You will receive local or general anesthesia (most often general anesthesia) for the procedure. The surgery may last from 1 to 3 or more hours depending on the type of surgery being performed. When the surgery is finished you will be taken to a recovery room to wake up from the anesthetic. Before leaving the surgery center you will be given instructions on what to do at home to help speed up your recovery and healing.

What happens after sinus surgery?

You should be able to return to your normal routine a number of days following the surgery. You may experience crusting or stuffiness in your nose for several weeks after the surgery. For the first few days you may need to change the gauze placed under your nose as needed. Your doctor may recommend that you sleep with your head elevated and to drink plenty of fluids. If needed, you may be prescribed pain medicine or antibiotics.

You will be asked to schedule follow-up visits with your doctor to ensure the sinuses are healing properly, and to clean out any excess blood or mucus. It is important that you do not blow your nose when recovering from sinus surgery. This can cause excess bleeding. The details will be in your post-operative instructions.

Risks / Benefits

What are possible complications of sinus surgery?

Complications of sinus surgery are not common, but your surgeon will talk about them with you. Be sure to ask ANY questions you have. Depending on the type of sinus surgery you have, complications may include:

  • Bleeding.
  • Damaged eye or vision.
  • Brain injury.
  • Brain fluid leak or infection.

Recovery and Outlook

What is the outlook for sinus surgery?

Sinus surgery is an effective treatment for those experiencing sinus problems but it is only done on patients who have not responded to medical treatment. Some people notice immediate improvement in their symptoms after surgery, while in others it may take a few weeks or months. Some patients require ongoing care even after recovering from surgery.

Last reviewed by a Cleveland Clinic medical professional on 09/17/2019.

References

  • American Academy of Otolaryngology-Head and Neck Surgery. Nose Conditions. (http://www.entnet.org/content/sinus-surgery) Accessed 10/8/2019.
  • American Family Physician. Functional Endoscopic Sinus Surgery. (https://www.aafp.org/afp/1998/0901/p707.html) Accessed 10/8/2019.
  • Dalziel K, Stein K, Round A, et al. Systematic review of endoscopic sinus surgery for nasal polyps. (https://www.ncbi.nlm.nih.gov/books/NBK62206/) 2003. In: NIHR Health Technology Assessment programme: Executive Summaries. Southampton (UK): NIHR Journals Library; 2003. Accessed 10/8/2019.
  • Tajudeen BA, Kennedy DW. Thirty years of endoscopic sinus surgery: What have we learned?. World J Otorhinolaryngol Head Neck Surg. 2017;3(2):115–121.

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