Sinus surgery is an alternative treatment for patients who don’t respond well to medical management of their sinusitis symptoms.  Medical management of sinusitis usually includes prescription medications as well as over-the-counter medications to relieve sinusitis symptoms.  When these medications have been insufficient in providing long-term relief, sinusitis symptoms persist.
For these patients, your ENT (ear, nose, and throat) doctor may suggest that you have a further workup to see if there is some structural blockage impeding sinus function. Â If there is such a blockage, your ENT doctor will recommend sinus surgery as a way to remove the blockage, open the sinuses, and restore natural drainage.
Ultimately, the goal is to find an effective sinus treatment that focuses on reducing nose and sinus inflammation and keeping the drainage pathways open and functioning properly.
Sinusitis, also known as a sinus infection or rhinosinusitis, is an inflammation of the mucous-lined, air-filled spaces in your skull that connect to the nose and throat. Â When the sinuses become inflamed, blocked or swollen, normal mucus drainage may not occur trapping air and other fluids, creating vacuums and/or pressure. This pressure can cause pain, which can sometimes be intense. Â Clogged sinuses may also lead to infections.
A nasal obstruction can have many causes.  For some patients, allergies lead to swelling of the nasal and sinus lining, which causes congestion and blockage.  For other patients, the blockage may be due to a simple anatomical obstruction, such as enlarged adenoids, a polyp in the nasal passage, a deviated septum, enlarged turbinates or narrow nasal passages.
As mentioned above, sinus surgery is recommended for patients who suffer from persistent or recurrent signs and symptoms of sinusitis, and who have not responded to medical interventions and therapies.
Balloon Sinus Dilation – Balloon sinus dilation is a less invasive endoscopic sinus procedure for chronic sinusitis patients seeking relief from uncomfortable sinus pain symptoms.  During this non-invasive procedure, a tiny balloon is placed into the nose to reach the blocked sinuses and then inflated to restructure the sinus opening. Congested sinus cavities are safely drained, reducing the recurrence of symptoms and providing you with long-lasting, much-needed relief. To learn more about this procedure, check out our page on Balloon Sinus Dilation.
If your ENT doctor doesn’t need to remove anything from your sinuses, you may be a good candidate for this newer type of surgery.
Our sinus specialists at CT Sinus Center perform this procedure in-office, offering a more comfortable environment and convenient patient experience.
Functional Endoscopic Sinus Surgery (FESS) or Endoscopic Sinus Surgery – is a minimally invasive, outpatient procedure that is recommended for patients who have a structural component contributing to their sinus blockage.  For this procedure, the surgeon uses a 4mm lighted endoscope to view and access the sinuses. The sinus ostia are then identified and enlarged as a means to restore natural sinus drainage and to allow the sinus lining to return to its normal, healthy state.  Obstructive tissue and bone are carefully removed taking care to preserve the sinus lining.
Typically, endoscopic sinus surgery is clinically indicated for patients with chronic sinusitis, based on a thorough history and a complete physical examination, including nasal endoscopy and CT scans, if appropriate, and in whom appropriate medical treatment has failed. Â Patients with chronic sinusitis often report the following symptoms:
Since other conditions can mimic symptoms of chronic sinusitis, it is important to rule out other conditions that may be causing the symptoms.
Endoscopic sinus surgery is also appropriately indicated for patients who have other conditions, such as nasal tumors and nasal polyps. Â
Endoscopic sinus surgery can be done as an in-office procedure under intravenous sedation and local anesthesia, but it can also be done at an ambulatory surgery center or a hospital operating room under general anesthesia. Â It often depends on the preference of your surgeon.
Many surgeons perform endoscopic sinus surgery without nasal packing. Â If nasal packing is used, it is inserted to prevent excessive postoperative bleeding. Â Talk to your surgeon about his/her standard practice.
If you need sutures, dissolvable sutures are used for endoscopic sinus surgery.
Talk to your surgeon about the details of your case during your pre-op visit. Generally, endoscopic sinus surgery can take anywhere from 1-2 hours. The length of time varies for each patient, as additional procedures might be added on and done at the same time (e.g., septoplasty).
Time off for recovery usually depends on the type of procedure performed as well as the type of anesthesia used. Â For patients who have nasal and sinus procedures performed under general anesthesia, you may need to take 3-4 days off of work. Â During this time, patients are advised to refrain from heavy lifting or vigorous activity for 1-2 weeks.
If you have an in-office procedure done under local anesthesia, you should take 1-2 days off from work, and follow any post-surgery advice your surgeon gives you.
Patients can expect to have some fatigue, nasal stuffiness, and mild nasal drainage after endoscopic sinus surgery. Â The stuffiness typically results from swelling after the procedure and typically starts to improve after the first week. Â Most patients find that any post-operative discomfort can easily be managed with regular or extra-strength Tylenol.
Endoscopic sinus surgery helps to decrease sinus-related facial pressure, congestion, nasal obstruction, rhinorrhea (watery discharge from the nose), and headache. Â Patients report significant improvement after endoscopic sinus surgery and improved quality of life.
Since endoscopic sinus surgery for chronic sinusitis is performed in a minimally-invasive fashion with the sinuses accessed with small endoscopes placed in the nostrils, there should be no change to the facial or nasal appearance after surgery.
After endoscopic sinus surgery, most patients have found that they do well with minimal to no medication because their sinus passages have been restored to their natural state. For other patients, they reported that they still have issues with inflammation and infection, but with the sinuses now open, medication can reach the sinus lining and reduce inflammation quite effectively. Â As for treating sinus infections, these same patients reported that they need less medication to clear the infection than they did before having endoscopic sinus surgery.
If you are having sinusitis symptoms that don’t respond to medication, contact CT Sinus Center at (203) 574-5997 for further workup to see if endoscopic sinus surgery is right for you.
