Surgery for sinusitis is indicated in cases of recurrent acute sinusitis or chronic sinusitis, in which symptoms last more than 12 weeks, and symptoms do not improve with the use of medication.
This type of treatment is normally done when sinusitis is caused by changes in the nasal septum, nasal polyps, narrowing of the orofacial cavities, fungal infections or when sinusitis does not improve with other treatments, for example.
There are different sinusitis surgery techniques that can be performed by a doctor, the most common being endoscopic sinusectomy, which allows the correction of nasal changes, facilitating the drainage of mucus, improving the symptoms of sinusitis.
When is indicated
Surgery for sinusitis is indicated in the following cases:
- Chronic sinusitis, in which symptoms last more than 3 months;
- Recurrent acute sinusitis;
- Deviated septum;
- Nasal polyps;
- Narrowing of orofacial cavities.
Surgery for sinusitis allows the correction of nasal changes, in addition to opening the drainage holes in the sinuses, facilitating the drainage of mucus retained in the sinuses, improving the symptoms of sinusitis.
Surgery for sinusitis is generally recommended by an otorhinolaryngologist when treatment with medication is unable to alleviate symptoms. See how sinusitis is treated.
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How to prepare for surgery
Some precautions are recommended to prepare for sinus surgery, such as:
- Clarify all your doubts about the surgery with your doctorand recovery;
- Report all medications, vitamins and nutritional supplements that you take frequently, as some can affect recovery;
- Tell your doctor if you are allergic to anesthetics or any other medicine;
- Inform your doctor about the use of anticoagulant medicationssuch as warfarin, heparin, rivaroxaban, acetylsalicylic acid or clopidogrel, as the doctor may advise stopping these medications a few days before surgery;
- Inform if you have any health problems;
- Do not smokeat least 3 weeks before surgery;
- Avoid drinking alcoholic beverages at least the day before surgery;
- Absolute fasting at least 8 hours before surgery, as per medical advice;
- Take your usual medicines normallywith little water, as per medical advice.
In addition, before undergoing surgery, you must also take all the tests requested by your doctor, such as blood tests and surgical risk, to assess your general health status and the risk of complications. Find out how surgical risk is performed.
How is the surgery done
Surgery for sinusitis is normally performed by an otorhinolaryngologist in the hospital, using general anesthesia.
Therefore, before starting the surgery, saline solution is administered into the vein by the nurse, so that the anesthetist can perform general anesthesia and also to hydrate and administer medications.
Surgery for sinusitis can be performed with different techniques, which depends on the anatomical change or condition that is causing the sinusitis, and generally lasts around 30 to 60 minutes.
After surgery, it is recommended that the person remains in the hospital for approximately 24 hours so that they can be monitored and the effect of the anesthesia wears off.
Types of surgery
The main surgical techniques that can be performed by a doctor for sinusitis are:
1. Functional endoscopic sinusectomy
Functional endoscopic sinusectomy is the most used technique, in which it is not necessary to make cuts and, therefore, there is no scar related to the procedure and recovery time is shorter when compared to traditional surgery.
Videoendoscopy sinusitis surgery consists of introducing an instrument through the nostril with a small camera attached to its end.
In this way, the doctor is able to visualize the interior of the nasal sinuses, being able to drain the accumulated secretion, promote adequate aeration of the sinuses and remove tissue or bone that may be causing obstruction.
2. Balloon sinuplasty
Balloon sinuplasty is another type of sinus surgery performed using an inflatable balloon.
In this type of surgery, the doctor inserts a thin instrument that has an inflatable balloon at the tip, into the person’s nostril.
When the instrument arrives at the correct location, the balloon is inflated, breaking some small bone parts that are squeezing the channels, facilitating the removal of secretions.
3. Caldwell-Luc Surgery
Caldwell-Luc surgery is another technique that can be performed by the doctor when other techniques have not been effective in relieving sinusitis.
In this type of surgery, the doctor makes a small cut in the gum, to reach the maxillary sinus, and thus remove damaged tissue or bone, in addition to making a new opening in the maxillary sinus, to drain secretions from the nasal sinuses.
What is recovery like?
Recovery from surgery for sinusitis is relatively quick, however it can be a little painful and, therefore, it is important to follow the doctor’s instructions.
Therefore, during this phase it is recommended:
- Avoid touching your nose;
- Wash your face only with cold water;
- Take all medications prescribed by your doctor;
- Eat a soft, cold diet for the first week;
- Avoid eating hot foods or drinking hot drinks for 7 days;
- Wash your nose daily or as directed by your doctor.
It is normal for a person to have nasal obstruction, facial swelling and bleeding after surgery for sinusitis, however, these symptoms pass over time as the inflammation subsides.
To promote recovery and alleviate discomfort, your doctor may recommend applying ice to the nose or face or using anti-inflammatory medications.
Headache, pressure in the ears and a feeling of heaviness in the face are also common in the first 3 to 4 days and can be treated with painkillers prescribed by the doctor.
From the 8th day onwards it is possible to return to your normal activities and physical activity can occur after the 1st month, however it is important to first consult your doctor to find out if there is any risk.
Possible risks
Complications from surgery for sinusitis are rare, especially when the surgery is done in a certified clinic.
However, as the sinuses are very close to the eyes and the base of the brain, in some cases, bleeding, damage to the eyes and vision, or infection of the eyes and brain may occur.
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