Most Common Sinus Surgeries.

Sinusesarethe hollow spaces or intricate system of small passageways that exist around the eyes and nose (nasal cavities) and in front of the face. Air passes through these cavities and this helps the skull feel lighter.

Sinuses produce mucus to moisturize the nasal cavities and safeguard from infections, dirt and other pollutants. Sinuses are layered with cilia, extremely fine hair-like cells, that help drain mucus from the empty spaces and out through the nose.

What is Sinusitis?

Due to cold, allergens and other nasal infections, the sinuses are blocked and mucus builds up in the hollow spaces leading to inflammation of nasal sinuses. This condition is medically termed as Sinusitis.

Some of the common symptoms of Sinusitis are:

• Cold and cough

• Stuffy nose with discolored nasal drainage

• Difficulty in breathing

• Facial Pain and Headache

• Loss of sensation over face

• Pressure around nose, eyes and forehead

• Blocked ears or experience changes in hearing

• Poor sense of smell and taste

• Sleep apnea

• Snoring

Why and When do you need SinusSurgery?

It is time for sinus surgery when individuals experience constant and recurrent sinus infections, have abnormal nasal bone structure or any other abnormal growth, for eg. Nasal polyps, in the sinus.

An ENT doctor or specialist will suggest sinus surgery only when other medical treatments and procedures have failed.

The main purpose of the surgery isto clear the drainage pathways of the sinusesand remove blockages such as:

• nasal polyps

• mucous membranes

• swollen cilia tissues

• tumors

• abnormal bone growth

Most Common Types of Sinus Surgeries

Listed below are common sinus surgical procedures conducted by ENT surgeons:

• Nasal Endoscopy

• Somnoplasty

• Functional Endoscopic Sinus Surgery (FESS)

• Balloon Sinuplasty

• Septoplasty

• Image Guided Endoscopic Surgery

• Laser Turbinate Surgery

• Caldwell-Luc Surgery

1. Nasal Endoscopy

Nasal Endoscopy isused in the initial diagnostic evaluation of patients complaining of nasal or sinus problems. By using a flexible endoscope, the doctor can view and examine the entire nasal structure and the nasopharynx (junction between nose and throat) where abnormalities responsible for sinus infections are noticed.

Nasal Endoscopy is a painless procedure that helps identify conditions such posterior nasal polyp and/or nasal septal deviation, enlarged adenoids or any other infections near the opening of the sinuses. It is also used view paranasal sinuses that are otherwise diagnosed using radiologic techniques.

Nasal Endoscopy is an important post-sinus surgery follow-up method used in nasal cleaning and prompt patient recovery.

2. Somnoplasty

Somnoplasty is a minimally invasive surgical procedure, where a needle electrode emitting radiofrequency energy is used to shrink excess tissue obstructing upper airway. This procedure is commonly used to remove blocks in the palate and uvula (snoring), base of tongue (obstructive sleep apnea) and in chronic nasal obstruction (nasal turbinates’).

3. Functional Endoscopic Sinus Surgery (FESS)

FESS is a surgical procedure used to improve the natural drainage system of sinuses. An endoscope, an illuminated thin fiber-optic tube, is inserted into the nostrils to reach openings of sinuses. Tiny microscopes and surgical instruments are sent through this tube which are used to remove blockages or any obstructive tissue and clear out the natural openings of sinuses.

This is an outpatient procedure and usually takes two hours to complete. The patient may experience swelling in the nostrils and this discomfort exists for a short period of time. Many patients return to normal activity within a week’s time. FESS can be done frequently.

4. Balloon Sinuplasty

Balloon Sinuplasty is a minimally invasive surgical procedure where a tiny balloon is inserted into the nose and reached into sinus passage. The balloon is inflated to clear out and open the blocked nasal sinus passage and then deflated and pulled out. This procedure will enable the sinuses to drain.

5. Septoplasty

Septum is that part of the nose that divides it into right and left nostrils. This is made out of bone and cartilage. At times, the septum can have a hole or a tear and can vibrate while breathing. This causes difficulty in breathing and leads to chronic sinus problems. Septoplasty is a surgical procedure where the torn or deviated septum is corrected and put in place. This alleviates the breathing difficulties.

6. Image Guided Endoscopic Surgery

Image Guided Endoscopic Surgery is a latest sinus surgical procedure that is usually recommended for patients suffering with severe sinus blockages or failed sinus surgeries. An endoscope and a near 3D mapping system is used to guide the surgeon to move through narrow sinus passages and clear or remove blockages accurately.

7. Laser Turbinate Surgery

Laser Turbinate Surgery is mainly used to reduce the size of turbinates or structures inside the nose that may cause congestion. CO2 and KTP lasers are used in this procedure to clear the congestion in the sinuses. This is a quick and painless procedure that lasts for about 20 minutes.

8. Caldwell-Luc Surgery

Caldwell-Luc Sinus Surgery is an invasive and less common procedure used to remove growths inside the sinus cavity and improve nasal drainage. The surgeon makes a small cut in the upper jaw just above the second molar teeth and enters the sinus cavity to clear out blocks and help nasal drainage. A local or general anaesthesia is administered.

Alternatives to Sinus Surgery

Seasonal changes often lead to sinus infections and can be managed using:

• antihistamines

• allergy medications

• antibiotics

• oral steroids

• nasal steroid sprays

• nasal saline rinses or sprays

• nasal decongestant sprays