Endoscopic Sinus Surgery

Do you have sinus problems that have not responded to medical therapy?

Sinus surgery is generally indicated for patients with sinus problems that do not respond to medical therapy. Most sinus problems do not require surgery, however, in some patients surgical intervention is necessary. Overall, the risks from modern sinus surgery are low; fortunately, the risk of a major complication is far less than 1%. 

About Endoscopic Sinus Surgery

Endoscopic sinus surgery is the modern surgical approach to the sinuses whereby an endoscope is placed through the nostrils to view the nasal cavity and sinuses directly. The endoscope illuminates and magnifies the sinus cavities permitting precise removal of diseased tissue. The surgery is considered minimally invasive and has greatly reduced the need for incisions in the facial region to access the sinuses. Endoscopic surgery can frequently be performed on an outpatient basis.

Sinus surgery is generally indicated for patients with sinus problems that do not respond to medical therapy. Most sinus problems do not require surgery, however, in some patients surgical intervention is necessary. Overall, the risks from modern sinus surgery are low; fortunately, the risk of a major complication is far less than 1%. Postoperative discomfort is usually mild and well tolerated with sino-nasal surgery. Typically, patients use approximately 4 to 5 doses of pain relievers in the first day or two after surgery.

Follow-up visits are arranged until the area is healed (four or more weeks). During follow-up visits, any scar tissue that is forming over sinus openings will be removed under local anesthesia. This is usually well tolerated by patients in the office setting.

 

Endoscopic Sinus Surgery

Figure 1a – CT scan of a patient with left frontal sinusitis and obstruction.  The gray area (arrow) represents the abnormal frontal sinus.

 

Endoscopic Sinus Surgery

Figure 1b – A deeper CT scan image of the same patient shows obstruction and sinusitis in the ethmoid (e) and maxillary sinus (m). The gray area represents an abnormal sinus consistent with sinusitis.


Endoscopic Sinus Surgery

Figure 2a - CT scan of patient in Figure 1a following surgery. The frontal sinus obstruction has been cleared and sinus drainage has normalized.  The black area represents improvement in sinus health (arrow).

 

Endoscopic Sinus Surgery

Figure 2b – A deeper CT image of the same patient in Figure 1b showing the healthy ethmoid and maxillary sinus following surgery. The gray area, which is consistent with disease, has changed to black, which signifies sinus health. The sinuses are no longer obstructed and they drain freely into the nasal cavity.

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