WHAT IS A SINUS ?

Sinuses are air-filled spaces inside the skull that are located around the eyes, forehead, nasal bones, and cheekbones. They secrete mucus, which helps protect against infection and humidifies the air we breathe.

WHAT IS SINUS SURGERY ?

Sinus surgery is a medical procedure performed by a specialist to treat conditions that affect the sinuses, such as chronic sinusitis, nasal polyps, swelling, and blockage. The surgery is done to release any blockage or infection and to enable the normal functioning of the sinuses

INDICATIONS OF SINUS SURGERY / WHEN TO GET OPERATED ?

Sinus surgery is recommended when medications and other therapies fail to relieve the symptoms.
  • Sinus surgery can treat conditions such as chronic sinusitis, deviated nasal septum, nasal polyps, nasal cavity and paranasal sinus cavity tumors and cancer, enlarged adenoids, excessive growth or enlargement of the turbinates, and sleep apnea caused by obstructions in the airways.
  • Chronic sinusitis is a condition where there is inflammation or swelling that lasts for more than 12 weeks.
  • Deviated nasal septum is a condition where the nasal septum is deviated to one side due to injury
  • Nasal polyps are non-cancerous and painless growths that form in the nose or sinuses.
  • Sinus surgery can be an effective treatment to improve airflow and prevent interruptions to breathing during sleep for those with sleep apnea

TYPES OF SINUS SURGERIES:

  1. Functional Endoscopic Sinus Surgery (FESS)
  2. Balloon Sinuplasty
  3. Caldwell Luc Surgery
  • Functional Endoscopic Sinus Surgery (FESS) is the most commonly used procedure to treat sinus-related issues. It is a minimally invasive procedure that utilizes an endoscope, a thin device or tube with a small camera and light, to visualize the inside of the sinuses and nasal passage. The surgeon can remove any obstruction or tissue that is blocking the sinuses, such as swollen or infected tissue.
  • Balloon Sinuplasty is a minimally invasive procedure that is used to treat chronic sinusitis and recurrent infections. During this procedure, a surgeon inserts a catheter attached to a small balloon through the nose and inflates the balloon to dilate the sinus opening. This helps to improve the drainage and airflow.
  • Caldwell Luc Surgery is a less common and complex procedure that is carried out if there is any growth inside the nasal cavity. It involves making an opening from the maxillary sinus, which is the sinus cavity behind the cheek, to the nose

SINUS SURGERY PROCEDURE

1. PREPARATION BEFORE THE SURGERY
  • Your specialist will conduct a thorough physical examination before the surgery.
  • Certain investigations like an MRI and CT scan may be necessary to screen your condition.
  • The healthcare team will provide a set of instructions to follow before the surgery, which include.
    • Quitting smoking at least two weeks before the surgery
    • Avoiding certain medications like aspirin and ibuprofen
    • Disclosing any drug history to the specialist
    • Making transportation arrangements before and after the surgery
    • Discussing the anesthesia procedure with your surgeon and voicing any concerns you may have
2. WHAT HAPPENS DURING THE PROCEDURE ?

The surgical procedure used to treat sinus conditions depends on the severity of the condition. The most commonly used and reliable method is Functional Endoscopic Sinus Surgery (FESS). During FESS, the surgeon inserts an endoscope - a thin, tube-like device with a small camera and light - through the nostrils or nose to visualize inside the sinus and nasal passage. This allows the surgeon to remove any obstructions or tissue that may be causing the problem. Surgical tools are inserted alongside the endoscope to remove any bone, diseased tissue, or polyps that may be blocking the sinuses. If necessary, the surgeon may use instruments like a rotatory bur to scrape away any infected or overgrown tissue. After the procedure, the surgeon may cover your nose with material to absorb any blood discharge. FESS is considered an effective and safe treatment for sinus conditions.

Another method is Balloon Sinuplasty. This procedure is performed under local anesthesia or conscious sedation. The surgeon inserts a guide wire through the nostril to access the blocked sinus, then passes a balloon catheter along the guide wire for inflation. The balloon is inflated to dilate the sinus opening and improve drainage and airflow. After the procedure, the surgeon may cover your nose with material to absorb any blood discharge.

Caldwell Luc surgery is a more complex procedure and is only used in rare conditions. It is performed under general anesthesia, meaning you are entirely put to sleep. The surgeon makes an incision on your gums between your upper lip and gum tissue to access your maxillary sinus by making a small hole in the sinus wall. Any damaged or diseased bone or tissue is removed, and an endoscope is used to increase the size of the maxillary sinus opening. After the surgery, stitches are used to close the incision or cut made.

3. AFTER THE SURGERY
  • Your nose may be covered or packed with gauze to absorb any blood.
  • Your nose might feel stuffy or crusty.
  • You may experience mild to moderate pain for about a week after the surgery.

HOSPITAL STAY

  • If you had local anesthesia, you can leave the hospital right after the surgery.
  • If you had general anesthesia, you will need to stay in the hospital.

POST-OP CARE

  • Sleep with your head elevated, using an extra pillow if needed.
  • Avoid blowing your nose for a couple of weeks.
  • Sneeze with an open mouth to reduce pressure on your nose.
  • Take care of the gauze under your nose and replace it as necessary.
  • Drink plenty of fluids

Sinus surgery recovery may take up to a few days; most people recover within a few days.

FACILITIES REQUIRED FOR THE SINUS SURGERY

Here are the facilities and equipment required for sinus surgery in the operating theater:
  • Television monitor
  • Navigation system (if being used)
  • Camera
  • Sinus endoscopy tray including all sterile surgical instruments
  • Sinus forceps with different angulations
  • Punch instruments
  • Endoscopes (0, 30, 45, 70 degree scopes, and reverse scopes)

Personnel required in the room include a surgeon, typically an ENT Surgeon, technician, paramedical staff (nurses), and an anesthesiologist.

HOW TO CHOOSE A SURGEON AND HOSPITAL FOR SINUS SURGERY?

When choosing a surgeon and hospital for sinus surgery, it is important to consider the surgeon's experience, training, certification, positive reviews, and references. It is also important to choose a hospital that is well-equipped with state-of-the-art technology and is easily accessible to minimize travel time. Additionally, considering the experiences of individuals who have undergone treatment for a similar condition can help in making decisions about treatment or surgery options for better outcomes.

Skedoc can assist you in finding information related to the best ENT surgeon and best hospitals. It can also help you in selecting the right doctor for proper advice.

Top Surgeons for Sinusitis Surgery

Top Hospitals for Sinusitis Surgery

FAQ's Related to Sinusitis Surgery

A.
Functional Endoscopic Sinus Surgery abbreviated as FESS is one of the most routine surgeries performed to treat chronic sinusitis. It is a very less invasive procedure with fast recovery and a fewer risk for complications.

A.
Persistent and prolonged nasal symptoms like nasal congestion, loss of smell, nasal drainage, and post nasal drip, headaches, recurrent sinus infections; structural abnormalities as evidenced by imaging studies like nasal polyps and nasal obstruction due to deviated nasal septum and bony or tissue growths are the indications for sinus surgery.

A.
There is a significant improvement in managing the nasal symptoms secondary to sinus infections post operatively; however, it is directly related to patient's compliance with the instructed dietary changes and protective measures.

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There is a tolerable pain which may linger initially for 2 to 3 days after the sinus surgery, but it will eventually subside with pain management protocol.

A.
There is a chance for persistent bleeding, damage to underlying structures, recurrence of chronic sinusitis but usually the risk factor associated with sinus surgery is very low.

A.
Pediatric sinus surgery is indicated in children with chronic and severe sinus infections which can not be managed with medical therapy and protective measures.

A.
The post operative diet for patients who have undergone sinus surgery treatment will include bland food items which includes low fat, carbohydrates with protein and fluids for 1 to 2 weeks, which can be modified as the recovery progresses. However, avoidance of sinus triggering foods like sweets, ice creams/dairy rich products and hot spicy foods is deemed essential to manage the condition.

A.
During sinus surgery, there is a removal of nasal obstructions which faciliates increased efficiency in breathing capacity post-operatively.

A.
With proper adherance to the post surgery instructions, maintenance treatment and avoidance of potential triggers for sinus infections one can manage the sinusitis; however, there is a possible scope for re occurence.

A.
Yes, there is an elevated sensation of taste and smell in people who lost it after operating and clearing the sinuses.

A.
As the sinus surgery is very technique sensitive procedure requiring minimal incision and 100% accuracy, choosing a well established ENT speciality surgeon is the deciding factor for the success of the treatment. To choose such surgeons, any individual can simply utilize the features of Skedoc platform and search for the top-notch ENT specialty surgeon in their preferred locations and proceed with consultation and treatment planning.