Sinus infection, or sinusitis, is an inflammation of the sinuses and nasal passages. A sinus infection can cause a headache or pressure in the eyes, nose, cheek area, or on one side of the head. A person with a sinus infection may also have a cough, a fever, bad breath, and nasal congestion with thick nasal secretions. Sinusitis is categorized as acute (sudden onset) or chronic (long term, the most common type).

Anatomy of the sinuses (also called paranasal sinuses): The human skull contains 4 major pairs of hollow air-filled sacks called sinuses. These connect the space between the nostrils and the nasal passage.  These four sinuses are located above the eyes (frontal), between the eyes (ethmoid), behind the eyes (sphenoid) and behind the cheek bones (maxillary).

If you have continual infections that do not seem to improve with the medication, a CT scan of your sinuses can give more detail to the extent of infected sinuses.  If there are chronically infected sinus cavities endoscopic sinus surgery may be needed. 

Endoscopic Sinus Surgery

In endoscopic sinus surgery, an endoscope is inserted into the nose, providing the doctor with an inside view of the sinuses.

Surgical instruments are inserted alongside the endoscope. This allows the doctor to remove small amounts of bone or other material blocking the sinus openings and remove growths (polyps) of the mucous membrane.

General anesthesia will be used for this procedure, performed in a hospital or outpatient facility.

What to Expect After Surgery

Minor discomfort and symptoms similar to a bad head cold are common for several days after surgery.  Once the inflammation has subsided you will feel much better. Weekly visits to the surgeon may be necessary for about 3 weeks after the surgery to have dried blood and mucus removed.

Recovery also may involve:

  • Taking antibiotics
  • Using a nasal spray containing a steroid to reduce inflammation
  • Using saltwater washes (saline nasal lavage or irrigation) to keep the nasal passages moist and clean
  • Avoiding activities such as blowing the nose and bending forward for a few days
  • Using a humidifier to keep room air moist, especially in the bedroom

How Well it Works

Endoscopic surgery improves symptoms in about 90% of people.

However, surgery does not always completely eliminate sinusitis. Some people may need a second operation depending on the nature of the original problem.

More advanced technologies have greatly reduced the frequency of repeat procedures.  The most effective of these technologies is Propel.  Propel is a small sinus stent coated with an anti-inflammatory medicine that is placed after sinus surgery.  The spring-like design allows it to securely prop the sinuses open and deliver medicine directly to the sinus tissue, which greatly reduces inflammation and scar tissue formation during the critical days and weeks immediately after surgery.  Minimally invasive sinus surgery with Propel is clinically proven to provide relief to people with chronic sinusitis.  Additional information on the use of this stent can be found here.

Surgery is most successful when used along with medication and home treatment to prevent future sinus infections. A second surgery and future sinus infections may be avoided if antibiotics are taken to prevent reinfection.

Risks

As with any surgery, there are always some risks involved. However, endoscopic sinus surgery is very safe when performed by an experienced surgeon who has special training with endoscopic surgical techniques.

Minor complications (such as scar tissue attaching to nearby tissue, or bruising and swelling around the eyes) occur in a small number of people who have the surgery. Major complications (such as heavy bleeding, eye area injury, or brain injury) occur in fewer than 1% of cases. Most complications of endoscopic sinus surgery can be managed or prevented.

What to Think About

Sinus surgery may involve the use of scalpels, lasers, or small rotating burrs that scrape away tissue. No one method is necessarily any better or safer than another; techniques vary depending on the surgeon’s experience and preferences. The rotating burr is becoming the preferred device for sinus surgery.

Endoscopic sinus surgery does not cause as much visible scarring as traditional sinus surgery. Also, it may not cost as much as traditional surgery because there is a shorter hospital stay, if any, and a shorter recovery.

WEBMD.com