Patient Information on Sinus Surgery

Endoscopic Sinus Surgery

What is endoscopic sinus surgery?

Endoscopic sinus surgery describes the use of endoscopes (telescopes) to operate inside the nose to enlarge the natural opening of the sinuses into the nasal cavity to allow ventilation and drainage of the sinuses. Traditionally sinus surgery has in the past often involved external excisions on the face and below the upper lip but this is only very rarely required nowadays. Sinus surgery usually takes about 1 - 1 1/2 hours to perform, involves an overnight stay in hospital and a week to 10 days off work. In most cases patients experience minimal postoperative discomfort, usually requiring panadol only and often no pain relief on the day following surgery. They are able to resume light duties within 2-3 days and return to normal activities within a week or so.

Because of the close proximity of the sinuses to other important structures such as the eye and the brain, there are small but significant potential risks associated with surgery, which include injury to the bone of the eye socket and leak of cerebrospinal fluid (brain fluid) from the roof of the sinus if the bone of the roof of the nasal sinuses is breached. Fortunately these complications are very rare and in most cases do not result in any significant permanent problem.

Endoscopic sinus surgery is often performed for patients who have a history of frequent episodes of sinusitis which have required repeated courses of antibiotics (or in the treatment of nasal polyps in selected patients). Typical symptoms include facial pain, nasal obstruction, purulent nasal discharge, postnasal drip and loss of sense of smell.

After care following surgery is an important part of the success of endoscopic sinus surgery. Typically patients return to the rooms a fortnight after surgery for removal of crusting and old blood clot from the nose using suction and local anaesthetic sprayed into the nose. A check is also made for adhesions which can form in the early postoperative period. Patients may be prescribed antibiotics and advised to use saline sprays in the initial postoperative period. Often three or four visits are required to check the interior of the nose while the sinuses heal and revert to a healthy state. In most cases the benefits of endoscopic sinus surgery (prevention of recurrent acute attacks of sinusitis or resolution of the symptoms of chronic sinusitis) are sustained for a lifetime, although some conditions, in particular nasal polyps, may have a tendency to recur after a few years.

If there are any postoperative problems patients should contact me.