When antibiotics, drugs and other medication do not reduce symptoms of chronic sinusitis and complications develop, patients may be benefited by sinus surgery. The surgery removes mucosal tissue that creates obstruction and cleans up the sinus-nasal channels, ensuring drainage of the sinus cavities. Surgeons may also remove nasal polyps and straighten defected nasal septum for better airflow. However, patients may be administered antibiotics periodically and nasal steroids even after the surgery. There are two types of sinus surgeries: endoscopic and traditional.
Endoscopic Surgery
Mostly endoscopic method is used for the sinus surgeries, because it enables accurate visualization of the sinuses and the pathways without any external incision. Thus, bleeding, discomfort and swelling will be less. Recovery period will be shorter. This less expensive surgery has smaller chances of complications. The surgery may remove materials, including bone plugging the openings of sinuses. An endoscope, a slim lighted instrument, is inserted through the nose during the surgery for spotting the problem and removing the material. A set of surgical tools are also inserted to remove polyps and blocking material. Sometimes blocking material is burnt with the laser. A rotating burr may be used to scrape away the tissue. The surgery lasts between ½ hour and 1 ½ hours. It improves sinus symptoms in 90% patients. However, some times a second surgery is required. Some complications may occur during the surgery. Swelling or bruising around the eyes may occur in some patients. Incidences of brain and eye injuries or heavy bleeding are rare.
Image Guided Endoscopic Surgery
Since the sinuses are located near major arteries, eye and brain, insertion of a fiber optic tube into the sinus area is a cause of concern. To alleviate this concern, image guided endoscope technique is developed. The technique is used to treat extreme case of chronic sinusitis. The image guidance utility uses infrared signals to inform about precise real time location of the surgical tools used with the help of 3D images and CT scans.
Traditional Surgery
Traditional surgery is recommended if brain abscess occurs, pus develops in the sinus or infection spreads into the facial bones. The surgeon will make an incision through the face skin or inside the mouth to access the sinus and remove the blocking material. The surgery approach may vary from doctor to doctor and location of the sinus infection. In extensive procedures, the opening (incision) may be left open for infection drainage. The surgery may require hospitalization of the patient. Traditional surgery, an effective technique to treat chronic sinusitis, is recommended if endoscopic surgery was not successful and medications were of no use. However, risk associated with the surgery includes blindness, death, inflammation of membrane covering the brain, fluid leakage and heavy bleeding.
