Do I need sinus surgery?

Healthy sinuses are lined with a layer of tissue and very fine hair-like cells (cilia), producing mucus that adds moisture to the nasal passages. The mucus provides a protective layer to help keep out unwanted particles like pollutants, dirt, and infectious organisms. The cilia help to drain mucus through the sinuses and out into the nose. When infected, the airway in these sinuses is blocked, and they drain into the nose, leading to the sinuses and airway blockage.

What is sinus surgery?

Surgery is performed to open the sinus pathways and clear blockages. It is an option to treat people with ongoing (chronic) and recurrent sinus infections, nasal polyps, and other related conditions. Untreated sinusitis is the most common cause of upper respiratory tract infections and their complications.

An ear, nose, and throat specialist (ENT) will often attempt medication and other treatments before resorting to surgery. If these don’t work, surgery may be carried out. Nowadays, various types of sinus surgeries that are less invasive, have few complications, and require shorter recovery periods are available.

What conditions are treated with sinus surgery?

Sinus surgery may be used to treat many conditions, including:

• Chronic sinusitis (sinus infection or allergies)
  
• Deviated nasal septum
  
• Nasal polyps
  
• Nasal cavity and paranasal sinus cavity tumours and cancer
  
• Enlarged adenoids
  
• Enlarged turbinates
  
• Sleep apnea

Remember that sinus surgery doesn’t always cure sinusitis – you may still get sinus infections occasionally. Instead, looking at it as part of your overall treatment plan would be best.

Types of sinus surgery

Functional endoscopic sinus surgery

FESS is a minimally invasive surgery to help clear the airway by removing sinus obstructions that cause pain or interfere with breathing. It is the most effective treatment for recurrent acute or chronic infective sinusitis, especially if the patient is not experiencing relief from conservative treatments. Since the endoscope is inserted through the nose, the face has no cuts or scars. A person who has this surgery will usually only feel mild discomfort for a short period. Patients usually feel the effects of surgery soon after the procedure and report fewer headaches, improved breathing, and less pain.

Balloon sinuplasty or sinus dilation

A minimally invasive procedure to treat chronic sinusitis. It aims to help keep the sinus passages open and unobstructed. If your doctor doesn’t need to remove anything from your sinuses, you may be a good candidate for this newer type of surgery.

The surgeon inserts a thin tube into your nose and guides it into the sinuses. Attached at one end of it is a small balloon. They then guide the balloon to the blocked area inside your nose, inflate, and deflate it. This helps clear the passageway so your sinuses can drain better, and you won’t be so congested. This stretches out and opens the sinus’s affected part, improving drainage and airflow. The balloon and catheter are removed after the procedure.

Septoplasty

A surgical procedure to straighten the deviated (crooked) septum to improve breathing and reduce sinus infections and/or nosebleeds. It may be done using an endoscope or through an incision.

Turbinate surgery

Turbinates are thin bones in the nose. Allergies, sinus infections, and upper respiratory infections can cause inflammation and enlargement of the turbinate mucous membrane. Enlarged turbinates can obstruct airflow and make it harder to breathe. To treat enlarged turbinates, a surgeon may remove the affected turbinates or parts of them, reposition them, or use laser or radiofrequency ablation to reduce the size of the enlarged mucous membrane.

Adenoidectomy

The surgical removal of the adenoids: The adenoids are small masses of tissue in the upper pharynx (the tube that connects the mouth and nose to the esophagus). The adenoids help fight infections. In some cases, the adenoids enlarge in children, making breathing harder through the nose. In these cases, a surgeon may perform an adenoidectomy,

Recovery

You won’t need to stay overnight in the hospital after sinus surgery as the procedure is usually carried out in a day hospital. After sinus surgery, follow-up care is essential to ensure your sinuses heal correctly. It could take up to five days to feel up for your regular physical activity. It would be best to avoid activities that elevate your blood pressure, such as weightlifting and running, until you get clearance from your doctor.

To find out if sinus surgery may be helpful, you should be seen by an ENT specialist at an Intercare Day Hospital who performs sinus surgery. This will allow for a thorough history and physical exam. Your doctor will also be able to examine your nasal cavity looking for possible anatomic causes of your sinus symptoms. This includes determining whether you have nasal polyps, a deviated nasal septum, enlarged turbinates, or enlarged adenoids. It is also essential to look for signs of active infection, such as pus draining from the sinuses.