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Sinus surgery

A rare, but effective, option to cure sinus infections

Sinus surgery is considered only if medical treatment has failed, if there are anatomic (physical) problems in the nose that medication will not correct, or if there have been complications due to the sinus infection. Rarely, sinus infections can spread to the eyes, causing loss or impairment of vision. Sometimes the sinus infections can spread to the spinal fluid space around the brain, resulting in meningitis, or rarely to the brain itself, resulting in abscesses (pus pockets).

Fortunately, these complications are rare, but they can be very serious. Sinus surgery is most often performed with fiberoptic scopes, called endoscopes, and tiny instruments. The procedure is performed through the nostrils, so there are no external scars or any external sign of surgery. The newer techniques are more effective at treating the chronic infections by re-establishing normal drainage pathways within the sinuses. This type of surgery is called functional endoscopic sinus surgery. 

What are the risks?

Fortunately, endoscopic sinus surgery is quite safe. However, there are rare complications that have been documented with any sinus operation. One significant complication that has been described is formation of a spinal fluid leak in the nose. Rarely, injury to the eye muscles or vision nerve itself has been described. These complications are similar to complications that may occur with untreated sinus infections.

The most common problem encountered after sinus surgery, however, is scar tissue formation in the nose and sinuses. Avoiding scar formation requires good surgical technique, regular visits to the office after surgery, and the patient performing care to the nose as directed after surgery. Sometimes, a sinus infection is so severe that several operations will be needed before the patient is free of infection. Fortunately, the need for a second sinus operation only occurs about seven to ten percent of the time. Mild nosebleeds after sinus surgery may occur, but are rarely serious. 

Getting ready for surgery

Before surgery, be sure you understand the treatment plan. Be realistic about your expected results and the recovery time. By the time a patient is seen by the ENT specialist they may have had sinus infections for months or even years. Severe infections do not resolve on the day of the procedure. Often several weeks of antibiotics, nasal steroid sprays, and nasal saline (salt water) irrigations are required. The body requires time to regenerate the "normal" function of the sinus membranes.

After surgery, it is recommended that patients arrange 3-4 days where they can be off of work or school. Sometimes patients feel well enough to return to work the next day. Avoid heavy lifting or straining for at least one week after the operation, and sometimes longer depending on the type of surgery required.

After surgery, patients are usually seen on a weekly basis for two weeks, then seen again two weeks later. Treatments to clean the nose and sinuses are performed on these visits. Usually after the first week, the sinus condition begins to improve rapidly and patients will often feel much better at that point.

Headaches and sinusitis

Most headaches due to sinus infections can be greatly improved with curing the infection. However, not all headaches are due to sinus infections. Other causes may also be present. For headaches that persist after the infection is gone, further treatment by a headache specialist may be required.