Procedure of Sinus Surgery

Introduction

Sinus surgery, also known as sinusitis surgery or functional endoscopic sinus surgery (FESS), is a medical procedure designed to improve drainage from the sinuses and relieve chronic or recurrent sinus infections. It becomes necessary when medical therapies such as antibiotics, nasal sprays, and decongestants fail to provide relief. The surgery aims to restore normal sinus function, reduce symptoms like facial pain and congestion, and prevent complications.

Over the years, advancements in medical technology have transformed sinus surgery from an invasive and painful experience to a minimally invasive and highly successful outpatient procedure. Understanding the procedure of sinus surgery can help patients prepare physically and emotionally and ensure a smooth recovery.

Procedure of Sinus Surgery

The sinus surgery procedure is carried out with precision and care, typically using an endoscope a thin, flexible tube with a camera at the end. Here’s a breakdown of what happens during the surgery:

1. Preoperative Preparation :- Before the surgery, patients undergo a thorough medical evaluation, including imaging studies like a CT scan of the sinuses. This helps the ENT specialist identify the blocked or inflamed sinus areas and plan the surgery accordingly. The patient is also asked to stop taking certain medications like blood thinners a few days before the surgery to minimize bleeding risk. Fasting is required 6–8 hours prior to the procedure if general anesthesia is used.

2. Administration of Anesthesia :- Sinus surgery is usually performed under general anesthesia, although local anesthesia with sedation may be used in some cases. General anesthesia ensures the patient remains unconscious and pain-free during the entire operation. The choice of anesthesia depends on the patient’s overall health, the extent of the surgery, and the surgeon’s preference.

3. Insertion of the Endoscope :- The procedure begins with the insertion of an endoscope into the nasal cavity. The endoscope transmits images to a monitor, allowing the surgeon to see inside the sinus passages clearly. This minimally invasive approach avoids the need for external incisions and enables precise navigation through delicate nasal structures.

4. Opening Blocked Sinus Pathways :- Once inside, the surgeon uses tiny surgical instruments inserted alongside the endoscope to remove obstructions. These obstructions may include polyps, thickened mucous membranes, or bone tissue that narrow the sinus openings. The goal is to enlarge these natural drainage pathways and allow air and mucus to flow freely. Depending on the condition, multiple sinuses (such as the ethmoid, maxillary, frontal, or sphenoid) may be addressed during the same session.

5. Polyp Removal or Tissue Trimming :- In cases where nasal polyps (benign growths) are present, they are carefully removed using microdebriders rotating instruments that gently shave and suction the tissue without damaging surrounding areas. If any deviated structures or swollen tissues are causing nasal blockage, they are trimmed or reshaped to improve breathing.

6. Sinus Irrigation :- Once the sinuses are opened and cleaned, the surgeon may irrigate them with a saline solution to remove any remaining debris or infection. This ensures that the sinuses are as clear as possible and reduces the risk of postoperative infection.

7. Placement of Temporary Packing or Stents :- After the cleaning and reshaping are complete, temporary packing materials or small dissolvable stents may be placed inside the nose to support healing tissues and minimize bleeding. These materials also help prevent the newly opened sinuses from closing during the healing phase. In some cases, drug-eluting stents are used to reduce inflammation and keep the sinus pathways open.

8. Postoperative Monitoring and Recovery :- The patient is closely monitored in a recovery room as the effects of anesthesia wear off. Most sinus surgeries are done on an outpatient basis, meaning patients can return home the same day. Detailed postoperative instructions are provided, including the use of nasal sprays, saline rinses, pain management, and follow-up appointments.

Recovery After Sinus Surgery

Recovery after sinus surgery typically takes about 1 to 2 weeks, although complete healing may take longer. During this time, patients may experience mild bleeding, congestion, or fatigue. They are advised to avoid strenuous activities, smoking, and blowing their nose. Regular follow-up visits are crucial to monitor healing and remove any crusting or debris from the nasal passages.

A successful recovery is often marked by significant relief from sinus symptoms, improved breathing, reduced headaches, and fewer sinus infections.

Conclusion

Sinus surgery has come a long way, offering relief to countless individuals who struggle with chronic sinusitis. The modern approach, using minimally invasive techniques like endoscopic sinus surgery, ensures high precision, quicker recovery, and minimal discomfort. Knowing what to expect during each step of the procedure can empower patients to make informed decisions, prepare adequately, and participate actively in their recovery.

If you’ve been suffering from persistent sinus infections despite trying multiple medications, sinus surgery might be the long-term solution you need. Always consult a qualified ENT specialist to determine whether the procedure is right for you.