Sinus infections can leave you feeling drained, fatigued and miserable. For people diagnosed with chronic sinusitis for whom prescription medications don’t bring relief, a surgical procedure may be helpful.
“In sinus surgery, we open the natural drainage passageways to allow for adequate ventilation and drainage. After surgery, we can get medications into the sinuses.” says R. Peter Manes, MD, a Yale Medicine surgeon specializing in otolaryngology. Sinus surgery also enables your doctor to biopsy the sinus pathways to check for signs of bacteria or tumors.
At Yale Medicine, we perform several types of sinus surgeries not available elsewhere, and our surgeons are expert at making repairs if a previous sinus surgery was unsuccessful.
What is balloon dilation of the sinuses?
The goal of balloon dilation of the sinuses is to open up the sinus pathways. This is done by surgically inserting a catheter tipped with a small balloon into the sinuses. The surgeon moves the catheter to the site of the blockage and, once there, the balloon is inflated to open up the sinus pathway. Once this is done, it is removed. This procedure is similar to a cardiac procedure called balloon angioplasty, which expands the blood vessels in the heart to relieve blockages. Balloon dilation helps improve air flow and drainage in the sinuses, provides access for medications and also helps prevent future sinus infections.
Balloon dilation of the sinuses is typically performed in your doctor’s office. The procedure is not for everyone. Often, prescription medications or standard functional endoscopic sinus surgery are the best treatments. However, for some people who are not healthy enough to have traditional surgery, balloon dilation may be an option.
Only with a thorough evaluation can your surgeon decide what is the best treatment for your sinuses.
What is functional endoscopic sinus surgery?
A surgeon performs functional endoscopic sinus surgery to open up the natural drainage pathways of the sinuses. If you have chronic sinusitis, your sinuses are not draining adequately. As a result, your normal nasal secretions get trapped in the sinuses and become infected. This causes the facial pain, headaches, fatigue and discomfort that make you feel so miserable.
The goal of functional endoscopic sinus surgery is to carefully remove thin bones and mucous membranes that may block the drainage pathways of your sinuses. The term “endoscopic” refers to the use of small nasal telescopes that allow doctors to perform the surgery through the nostrils.
The surgery is most commonly done on an outpatient basis and is typically performed using general anesthesia. (If local anesthesia with intravenous sedation is an option, your surgeon will discuss this with you). Patients may return to regular activity in one to two weeks.
Not all patients are candidates for functional endoscopic sinus surgery. For instance, you can’t ave this procedure if you have certain types of tumors. Also, your doctor may recommend functional endoscopic sinus surgery as one aspect of a course of treatments; it may not itself be a cure. After surgery, medication remains a very important part of treatment of chronic sinusitis.
What can I expect after surgery?
Your doctor will provide detailed instructions for your post-operative care. The instructions may vary, but most people require nasal irrigations, oral antibiotics, oral steroids and pain medicine. A post-operative visit is usually needed one week after surgery. During this visit, the surgical cavity is cleaned and inspected. Your doctor may remove early scar tissue.
Some bloody discharge is common for approximately two weeks after the procedure. You should not blow your nose for at least two weeks.
You can expect to have follow-up visits over the weeks and months following surgery.
What are the risks of functional endoscopic sinus surgery?
Bleeding: Although the risk of bleeding appears to be reduced with this type of surgery, in rare situations significant bleeding occurs that requires termination of the procedure. Bleeding following surgery could require placement of nasal packing and hospital admission. A blood transfusion is rarely necessary.
Postoperative Infection: Any surgical procedure carries the risk of post-operative infection. If an infection develops after surgery, antibiotics are prescribed.
Recurrent sinus infections: Although endoscopic sinus surgery provides significant benefits, surgery is not usually a total cure for sinusitis. You can expect to keep taking sinus medications after surgery, though you’ll likely need less. In some instances, additional surgery may be needed.
Other risks: Some people experience tearing of the eye from sinus surgery or sinus inflammation. If persistent, this may require additional surgery. You may experience numbness or discomfort in the upper front teeth for a period of time. Swelling, bruising, or temporary numbness of the lip may occur, as well as swelling or bruising around the eye. Subtle changes in the sound of your voice are common.
What other procedures may be done during sinus surgery?
Some patients have a deviation of their septum, the cartilage between their nostrils. Sometimes, that condition is corrected at the time of surgery through a procedure called a septoplasty.
What distinguishes Yale Medicine?
We perform several types of sinus surgeries not available elsewhere, and our surgeons are expert at making repairs if a previous sinus surgery was unsuccessful. In addition, our surgeons use the latest image-guidance technologies.