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About the Surgery
If medication isn’t working for you, surgery may help your nose and sinuses function normally.
Sinus surgery may be an option if medical treatment has not relieved the symptoms your chronic sinus infections (sinusitis). The goal of sinus surgery is to flush out infected material, open up blocked passages, and keep enough healthy tissue so that your nose and sinuses can function normally.
Today, functional endoscopic sinus surgery (FESS) is the most common surgical method to treat chronic sinus infections. It’s performed through your nostrils with a magnifying endoscope (thin tube with a lighted end). This may be less risky and have a faster recovery time than traditional sinus surgery, which cuts through the face or mouth. FESS is a precise, minimally invasive way to open your sinuses and treat chronic sinus infections .
Surgical treatment of chronic sinus infections usually involves one of three common FESS procedures; ethmoidectomy, maxillary antrostomy, or powered septoplasty with turbinoplasty. There are many other types of sinus surgery that doctors perform. Your ENT specialist (otolaryngologist) will recommend the sinus surgery that is best for your condition.
More: Maxillary antrostomy
More: Powered septoplasty with turbinoplasty
All treatment and outcome results are specific to the individual patient, and will form part of your consultation with your healthcare professional.
Please consult your healthcare professional for a full list of benefits, indications, precautions, clinical results, and other important medical information that pertains to sinus surgery.
You probably have some questions about sinus surgery and which procedure might be right for you. Be sure to ask your doctor any questions that you may have in regards to your condition and treatment options.
The ethmoid sinuses are located between your eyes and the bridge of your nose. They’re key to treating most sinus infections as all other sinuses drain through or next to them. So if your ethmoid sinuses are blocked, the infection can spread to the other sinuses.
An ethmoidectomy removes infected tissue and bone in the ethmoid sinuses that blocks natural drainage. The surgeon views your ethmoid sinuses with an endoscope, a thin flexible tube with a very small camera and light at the end of it.
Another special instrument, called a microdebrider (MY-cro-duh-BRY-der), has a tiny, curved rotating tip that helps the surgeon put the instrument where it’s needed.
The microdebrider and the camera help the surgeon to identify and remove affected tissue and bone more precisely, without damaging healthy tissue.
The maxillary sinuses are located right behind your cheekbones. In adults, these are the sinuses where an infection usually occurs. Your maxillary sinuses drain into your nose about one-half inch below the corners of your eyes. This area of your nose is called the osteomeatal complex.
When this part of your nose is blocked, the maxillary sinuses no longer drain properly and infection can develop. Often, the sinus opening itself becomes blocked, too. The procedure to clear the sinus opening is called a maxillary antrostomy. The procedure to clear the osteomeatal complex is called an uncinectomy. Usually, both are performed together.
In rare cases, a maxillary antrostomy doesn’t help drain the maxillary sinus completely or there may be diseased tissue that can’t be removed in this way. If so, your surgeon may need to create a new drainage pathway between the maxillary sinus and the nose (a Caldwell-Luc procedure).
A powered septoplasty with turbinoplasty is mainly performed to improve your breathing and sinus drainage.
The septum is the bony cartilage wall between the two sides of your nose. It helps support your nose and guides airflow. The septum is supposed to be straight, but sometimes it’s not, due to injury or other factors. A crooked or deviated septum can make it hard to breathe through your nose and prevent proper drainage. This may make you more likely to get a sinus infection (sinusitis).
The turbinates are delicate, bony, scroll-like structures in your nose. The mucous lining of the turbinates is very important because it filters and humidifies the air you breathe before it enters your lungs, and keeps your nose moist.
If your septum is crooked, then one half of the inside of your nose is larger. The turbinates may adjust by getting bigger, too, and make the blockage worse. This is why a powered septoplasty with turbinoplasty is often performed.
During a septoplasty, your ENT surgeon straightens your septum so that air can flow through both sides of your nose normally. In a turbinoplasty, the goal is to reduce the turbinates enough to improve your breathing and sinus drainage, while preserving enough tissue for normal turbinate function.
A special instrument called a microdebrider (MY-cro-duh-BRY-der) has a tiny curved tip that helps the surgeon put the instrument where it’s needed to straighten your septum and reduce your turbinates. Because this equipment may allow the surgeon to be more precise, there may be less risk of removing too much tissue and causing complications.
Be sure to ask your doctor any questions that you may have in regards to your condition and treatment options.
Most patients with chronic sinus infections don’t need surgery. Medical treatment and lifestyle changes are usually effective. However, if these treatment options fail to work, surgery may be an option.
Having surgery is a big decision. Many factors have to be considered first. For example: How severe are your symptoms? What does a CT scan show? How is your general health?
You and your doctor will decide if sinus surgery is the best choice for you. If you’re an older adult, or if you have a child that may need sinus surgery, special considerations need to be taken. It’s important to work with your doctor to get the treatment that’s best for you or your family member.
Today, Functional Endoscopic Sinus Surgery (FESS) is the most common surgical method to treat chronic sinus infections. In a FESS procedure, the surgeon uses a magnifying endoscope to see and remove affected tissue and bone.
Before FESS, surgeons cut directly into the outside of the face to find the problem and remove it, increasing infection risks and recovery time. FESS is a precise, minimally invasive way to open the sinuses and treat chronic sinus infections.
The three sinus procedures discussed here may be performed using FESS. Which one your ENT doctor uses depends on multiple factors, including the cause of your chronic sinus infection. In general, the goal of sinus surgery is to flush out infected material, open up blocked passages, and keep enough healthy tissue so that your nose and sinuses can function normally.
Your recovery time depends on your overall health and which sinus surgery you have (ethmoidectomy, maxillary antrostomy, or powered septoplasty with turbinoplasty). Usually, you should plan to be away from work or school for at least several days after your surgery. Your doctor will give you specific advice on your estimated recovery time and instructions on how best to care for yourself to help speed recovery.
Every individual tolerates pain differently. Many patients manage sinus surgery pain with oral pain medication. Your doctor can tell you what to expect, based on the type of surgery you have. Facial swelling or bruising is rare, but the inside of your nose will be swollen and sore for a while. This may make breathing through your nose difficult for several weeks.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.