Sinus Surgery Procedures

When medications for sinusitis (infection in the sinuses) fail to provide relief, you may need to have sinus surgery in order to heal your sinuses. There are a number of different surgical procedures your surgeon may consider.

• Surgical tools

Functional endoscopic sinus surgery

• In functional endoscopic sinus surgery, an endoscope (a fiber-optic tube with a microscope) is inserted into the nose to examine the sinus openings. During the exam, abnormal tissue is removed to improve the drainage and health of the sinuses. This is a non-invasive form of surgery typically done in an outpatient setting. No incisions are made so there is no visible scarring. There is small degree of swelling and mild discomfort after having this procedure.

Image-guided surgery

• Because the sinus cavities are so close to the eyes and brain, a new endoscopic surgery technique includes the use of an image-guided tool. A three-dimensional mapping system and computed tomography scan (CT scan) are used to help guide the endoscope throughout the passages of the sinuses, locating the precise position of the irregularities requiring surgery. A CT scan and infrared signals are also used during this procedure that provides the surgeon a real-time positioning of the sinuses and obstructions. This is especially helpful for patients who have abnormal sinus anatomy.

Caldwell Luc operation

• The Caldwell-Luc operation is used to improve the drainage of the maxillary sinus that is located within the sinuses beneath the eye. Surgery is performed through the upper jaw and an opening (window) is carved out to connect the maxillary sinus with the nose. This improves drainage of the sinuses and helps to prevent sinusitis. This technique is also performed when a malignancy (cancerous growth) is found in the sinus cavity.

Before surgery

• Before any sinus surgery, a surgeon will do a careful examination of your sinuses. He will also take a thorough history of your symptoms and ask about any medicines you are taking. A CT scan will be done before the surgery to determine the anatomy of your sinuses and locate any obstructions that may be impeding proper drainage of the sinuses.

After surgery

• After the surgery, packing will be placed inside your nose to promote healing. Approximately 10 days after surgery, the doctor will typically irrigate (wash out) your sinuses to prevent scabbing and crusting from occurring inside your nose. He may then instruct you to do saline (saltwater) irrigation at home. You should plan to rest and avoid any strenuous activities for a few days. You should also be sure not to blow your nose or bend over to avoid causing pressure inside the sinuses that can harm delicate tissues.