Sinuses / Sinus Surgery

Sinus Surgery, or Functional Endoscopic Sinus Surgery (FESS), is a minimally invasive procedure used to treat chronic sinusitis, blockages in the sinuses and recurrent acute sinusitis and nasal polyps. It widens the openings between the sinuses and the nasal passages, allowing for better drainage and ventilation and can remove nasal polyp at the same time. The surgery is typically performed through the nostrils, avoiding external cuts or changes to the nose's shape. 

Sinusitis is a very common problem, with Acute Sinusitis frequently occurring after upper respiratory tract infections.

Occasionally, acute sinusitis can develop into a chronic picture - Chronic Rhinosinusitis (CRS). This condition can lead to many days taken off work, with the associated health economics issues.

Sinus conditions can also exacerbate pulmonary (lung) problems, eg asthma.

Tumours of the nose and sinuses are uncommon, but do occur, and may present with similar symptoms to sinusitis. They are also managed in conjunction with other hospital departments.

Patients with symptoms of nasal obstruction, nasal discharge, headaches/facial pain, smell disorders, or 'post-nasal drip' may have sinus problems which can be assessed.

The key aspect of good sinus surgery is the opening of the sinus drainage pathways, whilst preserving the mucosa (lining) of this pathways as much as possible. This prevents scarring of this area, and narrowing of these openings.

FESS (Functional Endoscopic Sinus Surgery):

This is the most common type of sinus surgery. It involves using a thin, endoscope (a telescope) to visualize the inside of the sinuses and nasal passages. It is Minimally Invasive: FESS is performed through the nostrils, meaning no cuts are made on the face or outside of the nose. 

Benefits:

Reduced Sinus Infections: By opening the sinuses, the risk of recurring infections is decreased. 

Improved Breathing: Clearer nasal passages can lead to easier breathing. 

Reduced Symptoms: May alleviate pain, congestion, and reduced sense of smell. 

Risks and Complications:

Bleeding: Nosebleeds after surgery are common, but usually mild and self-limiting.

Infection: Although rare, infection can occur after any surgery.

Damage to the Eye Socket: In rare cases, bleeding into the eye socket can occur, potentially requiring further surgery.

Brain Fluid Leakage: This is extremely rare, but can occur if the surgery is performed near the base of the skull. 

Recovery:

Time to Return to Work: Most people can return to work after 2 weeks, but recovery varies depending on the extent of the surgery and individual circumstances. 

Post-Surgery Care: Nasal saline rinses and steroid sprays are typically recommended for 6-8 weeks to help keep the nasal passages clear and moist after surgery. Usually no more than paracetamol and ibuprofen for the first few days is required for pain relief.