Sinus Surgery

Sinus surgery treats ongoing sinus issues, like chronic sinusitis or nasal polyps. Healthcare providers may recommend a procedure when medication isn’t effective. Sinus surgery is treatment for:

• Chronic sinusitis
• Fungal sinusitis
• Nasal polyps and swelling

Types of sinus surgeries

There are three types of surgeries. The most common ones are less invasive, so you recover quickly. The types are:

• Functional endoscopic sinus surgery (FESS): This is the most common type. Your surgeon opens blocked sinus passages and removes tissue or bone blocking your sinus. It’s also a way to remove a nasal polyp. They’ll use an endoscope to see inside your nose and sinuses and guide the surgery.
• Balloon sinuplasty: This procedure treats sinusitis. Healthcare providers use a thin flexible tube and a catheter to guide a small balloon into your nose. They inflate the balloon to enlarge your sinus so mucus can drain more easily.
• Caldwell-Luc surgery: Healthcare providers may do this procedure when other treatments aren’t effective. With this surgery, providers make an opening in your maxillary sinus — the sinus cavity behind your cheek — so mucus can drain from it.

What are the risks and benefits of sinus surgery?

These procedures may cure or ease symptoms of severe sinus issues. They’re an option when medication isn’t effective. Complications are rare, but may include:

• Unusually heavy bleeding: Rarely, you may bleed more than usual after surgery. Your healthcare provider will put material (packing) in your nose to slow the bleeding. They may recommend you stay in the hospital so they can manage any unusual bleeding.
• Tearing eyes: Surgery or sinus inflammation may make your eyes tear up.
• Leaking cerebrospinal fluid (CSF): This rare complication happens when the thin barrier between your sinuses and brain opens during surgery. It may increase your risk of meningitis or inflammation of your brain.
• Loss of vision: Very rarely, the surgery may cause sudden loss of vision or double vision.
• Numbness: Part of your face may feel numb if Caldwell-Luc surgery causes minor nerve damage.
• Breathing issues: This can happen if there’s scarring in your sinuses.
• Infection: Facial swelling, fever or pus coming from your nose may be infection symptoms.
• Recurring symptoms: The conditions that cause your symptoms may come back.

What happens during sinus surgery?

With FESS and balloon sinuplasty, healthcare providers insert small surgical tools into your nose to remove infected tissue and bone. With Caldwell-Luc surgery, your provider makes a cut (incision) in your upper gum to make a hole in the sinus wall.

Functional endoscopic sinus surgery

FESS is the standard procedure to treat serious sinus conditions. During the procedure, your healthcare provider will:

1. Put decongestant medication in your nose.
2. Check inside your nose again with a camera.
3. Inject numbing medication into your nose.
4. Use an endoscope to insert surgical tools in your nose. They’ll use the tools to remove bone, diseased tissue or polyps that block your sinus.
5. Pack your nose with material to absorb any blood or discharge.

Balloon sinuplasty

This is an alternative to FESS. Your provider will:

1. Inject local anesthetic into tissue lining your nose.
2. Place an endoscope and a catheter in your nose.
3. Use the catheter to place a small balloon in your sinuses.
4. Slowly inflate the balloon to unblock your sinuses.
5. Remove the balloon.

Caldwell-Luc surgery

This procedure is an option if other procedures don’t work. Your provider will:

1. Give you general anesthesia so you won’t feel any pain during the procedure.
2. Make a cut (incision) in your upper gum to reach your maxillary sinus.
3. Make a small hole in your sinus wall and take out damaged or diseased bone or tissue.
4. Use an endoscope to make the sinus opening larger.
5. Use sutures (stitches) to close the incision.

Is sinus surgery very painful?

Your healthcare providers will use general or local anesthesia to prevent pain during surgery. General anesthesia means you’re unconscious and don’t feel any pain. With local anesthesia, you may feel pressure, but the procedure won’t cause pain.

Sinus surgery recovery

Recovering from FESS, balloon sinuplasty or Caldwell-Luc surgery involves rest and caring for your nose. You should:

• Always open your mouth to sneeze. It’s normal to have bloody mucus.
• Don’t blow your nose. Your healthcare provider may say it’s OK to blow your nose two days after a balloon sinuplasty. But you should avoid blowing your nose for seven days after FESS, and at least two weeks after Caldwell-Luc surgery.
• Rinse your nose with saline or use saline spray.
• Use an extra pillow to lift your head while you rest or sleep. This eases congestion.
• Take a break from strenuous activity. Your provider will explain when it’s safe to be more active.
• Limit what you lift. Don’t try to lift anything weighing more than 10 pounds for at least two weeks after surgery.
• Eat soft foods for about a week after Caldwell-Luc surgery. Using ice packs will help with pain and swelling.

Your recovery time will vary depending on the sinus surgery type:

• FESS: Plan to take a week away from work and most daily activities. A complete recovery may take a month.
• Balloon sinuplasty: You can get back to your daily routine within 48 hours. It takes about two weeks for complete recovery.
• Caldwell-Luc surgery: It takes more time to recover from this procedure. It may be two weeks before you’re back to work or daily activities. It will take several months to completely recover.

When should I call my healthcare provider?

You should contact your provider if you have:

• Bleeding that is heavier than you expected
• Pain that medication doesn’t ease
• Fever

Is sinus surgery worth it?

Persistent sinus pain and stuffiness aren’t life-threatening medical conditions, but they can affect your quality of life. Minimally invasive sinus surgery, like FESS and balloon sinuplasty, can often help ease these symptoms and provide long-term relief. Caldwell-Luc surgery may help if other treatments aren’t effective.

Talk to a healthcare provider if you’re weighing the risks and benefits of sinus surgery. They’ll ask about your sinus symptoms and past treatments so they can recommend the treatment that’s right for you.

What’s the difference between turbinate reduction and sinus surgery?

Turbinates are small bony structures inside your nose. Like the name sounds, a turbinate reduction makes them smaller. Sinus surgery removes damaged or infected tissue and bone in your sinuses.