Surgery for Sinusitis and Polyps

Nasal obstruction due to polyps, deviated septum, obstructed sinuses on CT scan, frequent sinusitis, headaches, loss of smell, facial ache and pain, post nasal drip, chronic cough are some of the reasons that patient may be referred to be considered for surgery. Medical treatment of infections, allergy and eliminations of factors such as smoking, enviourmental allergens, and dietary modifications will help. Antibiotics, oral steroid therapy, and nasal steroids can also improve sinus conditions.

The main aim in sinus surgery is to open up the sinus passages to allow better drainage as they can be narrow and can often block with simple infections and allergy related swelling of the sinus mucosa. Sinus surgery is technical and requires prior planning and patient preparation. Patient should always have a CT scan on the sinuses to look at the anatomy and the disease. Preoperative antibiotics and steroids will reduce swelling and reduce bleeding during surgery. If there are polyps there will be more bleeding and will make the visualisation of structures difficult in this narrow area.

Surgery is performed with an endoscope and powered instruments with surgeon using the CT scan as a road map to find directions from one sinus to the other. The disease such as polyps and pus can be very close to the brain and the eye making this surgery one of the most challenging operations. The risk of any injury to eye or brain is less than 1 in 10000. Surgery takes approximately 90 minutes. Some patients will stay overnight and you can expect to have some minor bleeding in the first 48 hours. The nose is not packed with gauze unless there is excessive bleeding. Most patient return to work in 5-6 days.

Nasal Polyps

CT scan of sinuses