Sinus Surgery – Is it for Me?

By: Nona M. Lizada, PharmD Candidate 2022

Belmont University College of Pharmacy

What is Sinus Surgery?

Sinus surgery may be necessary when there’s blockage in your sinuses that prevent you from breathing well, persistent sinus infections and common medications don’t resolve the problem. Those with badly damaged sinus tissue, a fungal infection, benign growths (called polyps) or structural problems that prevent your sinuses from draining properly – sinus surgery might be for you! This type of surgery often involves enlarging the openings between the sinuses and inside the nose so air can get in and drainage can occur.

What are the different types of sinus surgery?

  • Functional Endoscopic Sinus Surgery (FESS): the most common type of sinus surgery done outpatient that involves inserting a nasal endoscope – a thin, lighted tube with a camera on the end looking through the nostril to view the inside of the nose and entrances of the sinuses. Tiny surgical instrumentals are inserted to remove any obstructive tissues. This type of surgery is minimally invasive and does not require any incisions since the procedure is performed through the nostrils. Advantages of FESS include shorter recovery time, reduced risk of infection, less scarring and decreased postoperative pain.
  • Image-Guided Surgery: combines endoscopic techniques with CT imaging scan for more precise results. During surgery, a CT scan is performed simultaneously to help guide the surgeon to the targeted area within your sinuses when infection or blockage occurs to clear any obstructions present within your sinuses.
  • Balloon Sinuplasty: involves inserting a thin endoscope into the nose without disrupting any surrounding bone and tissue and a small balloon is gently inflated to widen any blocked passageways to allow for proper drainage of sinus fluid.
  • Caldwell-Luc Operation: this procedure is ideal for clearing blockages primarily within the maxillary sinus by entering the sinuses through the mouth after an incision is made in the gums above the canine teeth. A small portion of the maxillary bone is removed during the surgery to improve drainage within the sinuses and is usually performed under general anesthesia and may cause swelling, bruising and numbness post-surgery.

Sinus Surgery Risks

Complications of sinus surgery are not common, but depending on the type of sinus surgery you have some risks may include:

  • Bleeding
  • Damaged eye or vision
  • Brian injury
  • Brain fluid leak
  • Infection

Sinus Surgery Recovery

Generally, sinus surgery is an effective treatment for those experiencing chronic sinus problems that do not respond to medication therapy. Most patients notice immediate improvements in their symptoms after surgery, while for others it may take a few weeks or even months. Common post-surgery symptoms: swelling, bruising, temporary numbness, crusting or stiffness of nose. Overall, sinus surgery recovery depends per person and the type of procedure done.

How can I prevent Sinus Surgery?

Most of the time you can treat your sinus problems with home care and medications:

Home Treatments

  • Drink plenty of fluids – helps keep the mucus thin.
  • Hold a warm, damp towel or warm gel pack to your face for 5 to 10 minutes several times a day.
  • Breathe warm, moist air from a steamy shower or hot bath. Avoid very cool and dry air. A humidifier can add moisture to the air in your home.
  • Use saline/saltwater nasal drops or washes/irrigations (i.e., Netipot, NeilMed – helps keep nasal passages open and to wash out bacteria and mucus.
  • If you need to blow your nose, blow gently. Blowing your nose too hard may force mucus back into your sinuses.

Medicines

  • Pain relievers – acetaminophen (Tylenol) or ibuprofen (Advil)
  • Steroid nasal spray or decongestant nasal sprays or pills – helps reduce swelling
  • Take antibiotics as directed by your doctor – can treat acute sinusitis cause by bacteria
  • Use mucolytics (i.e. guaifenesin/Mucinex) – helps thin the mucus in your sinuses

Frequently Asked Questions (FAQs)

Is sinus surgery painful?

You should expect some nasal and sinus pain and pressure for the first several days post-surgery. This might feel like a sinus infection or a dull headache in your sinuses.

How long does it take to recover from sinus surgery?

Patients will be able to return to work or school in about 1 week post-operation and be back to your normal routine in about 3 weeks. However, recovery varies per person and depends on the extent of your surgery. Most people feel normal in 1 to 2 months post-surgery.

What is the success rate of sinus surgery?

According to the American Academy of Family Physicians, most studies report an 80-90% success rate after FESS.

What is removed during sinus surgery?

It may involve removing infected sinus tissue, bone or polyps.

 References:

  • American Academy of Otolaryngology-Head and Neck Surgery. Nose Conditions. Updated August 2018. Accessed October 21, 2021. http://www.entnet.org/content/sinus-surgery
  • American Academy of Family Physicians. Functional Endoscopic Sinus Surgery. Updated September 1, 1998. Accessed October 21, 2021. https://www.aafp.org/afp/1998/0901/p707.html
  • Sinus Surgery. Vernick & Gopal. Updated 2021. Accessed October 22, 2021. https://www.vernickandgopal.com/our-services/nose-sinus/sinus-surgery
  • Sinus Surgery. Cleveland Clinic. Updated September 17, 2019. Accessed October 22, 2021. https://my.clevelandclinic.org/health/treatments/15854-sinus-surgery-overview#recovery-and-outlook
  • Sinusitis: Should I Have Surgery. HealthLinkBC. Updated April 15, 2020. Accessed October 22, 2021. https://www.healthlinkbc.ca/health-topics/tb1888
  • Sinus Center: Post Operative Instructions. Johns Hopkins Medicine. Updated 2021. Accessed October 22, 2021. https://www.hopkinsmedicine.org/otolaryngology/specialty_areas/sinus_center/post_operative_instructions.html
  • Endoscopic Sinus Surgery: What to Expect at Home. MyHealth Alberta. Updated December 2, 2020. Accessed October 22, 2021. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ug3524

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