Endoscopic sinus surgery

Treating sinusitis can be a quick and simple solution.

If you have been suffering from sinusitis for a while, you should not wait to visit your doctor and get it treated.

What is sinusitis?

Endoscopic sinus surgery

Your sinuses are air-filled spaces at the front of your skull, between your eyes and above your upper jaw, that are connected to the inside of your nose. Sinusitis is an infection of the mucous membrane that lines your sinuses. It causes symptoms of pain, a blocked nose, discharge, reduced sense of smell and the feeling of mucus at the back of your nose or throat.

The mucous membrane that lines your sinuses produces mucus, which helps to keep the air you breathe clean, warm and moist. If the opening between a sinus and the inside of your nose gets blocked, the mucus gets trapped and can become infected. 

This can cause the mucous membrane to become inflamed, causing it to swell and form extra folds in your nose and sinuses. These are called polyps (small growths) and usually make the symptoms worse.

What are the benefits to surgery?

The aim is to widen the passage between the sinus and your nose so that mucus no longer becomes trapped. This should prevent the sinusitis from coming back but your sense of smell may not improve.

Are there any alternatives to surgery?

Antibiotics may help to clear the infection. If your sinusitis is caused by an allergy, you may be able to prevent sinusitis by avoiding the ‘triggers’ of your allergy or by taking medication such as antihistamines or a nasal steroid spray. If you use a nasal steroid spray for a long time, you can reduce the size of polyps, which may mean that you do not need surgery.

What does the procedure involve?

The operation is usually performed under a general anaesthetic, but a local anaesthetic can be used. The operation usually takes 1 to 2 hours. Endoscopic sinus surgery is performed through your nostrils and does not result in any facial scars or change to the outside shape of your nose.

Your surgeon will use a small telescope (endoscope) to examine your nasal passages. They will use instruments to remove any polyps and to widen the passages from your sinuses into your nose.

What complications can happen?

Like all surgical procedure, some complications can be serious and can even cause death. However, speak to your doctor if you have any concerns regarding this procedure.

General complications of any operation

It is good for patients to be aware of the possible complications that could occur:

  • Pain
  • Bleeding
  • Infection of the surgical site (wound)
  • Blood clot in your leg
  • Blood clot in your lung

Specific complications of this operation

In addition, it is important for patients to be aware of more specific complications that could occur:

  • Adhesions, where scar tissue forms deep inside your nose
  • Leak of fluid from your brain
  • Damage to the orbit (the bone around your eye)
  • Double vision
  • Blindness
  • Toxic shock syndrome, which is an infection of your bloodstream
  • Damage to your tear duct
  • Reduced sense of smell

How soon will I recover?

You should be able to go home the same day. If you had non-dissolvable packing in your nose, you will need to stay overnight, and the packing will be removed the next morning. Do not blow your nose for at least a week. Your nose will continue to feel blocked for a few weeks. Your surgeon will give you a nasal spray or drops for you to use. You may be given a course of antibiotics to reduce the risk of infection. Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice. Most people make a good recovery.

Summary

Sinusitis is not usually serious, but it can cause unpleasant symptoms. If medication does not help, endoscopic sinus surgery should help prevent the sinusitis from coming back.


Acknowledgements

Author: Miss Ruth Capper MD FRCS (ORL-HNS)

Illustrator: Medical Illustration Copyright © Medical-Artist.com

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