It is a surgical procedure for treatment of obstructed and infected sinuses. Sinuses are hollow cavities in the skull and include maxillary sinus (in cheekbone), frontal sinus (in forehead), ethmoid sinus (on the nasal bridge, between the eyes) and sphenoid sinus (behind the nasal cavity).
Sinus surgeries are indicated for:
Chronic sinusitis that is not being cured even after comprehensive medical treatment
Removal of sinus obstruction which may be caused by a foreign object or diseased tissue
Drainage of infectious material from sinuses
Removal of polyps inside the sinuses
A CT scan is done to examine the sinuses. Blood thinning medications if being taken must be stopped two weeks prior to the surgery. Smoking must be stopped for better healing.
Patient must be on fasting 8-10 hours prior to the surgery.
Sinus surgeries are performed by an ENT surgeon under general anaesthesia. Endoscopic technique is mostly followed. Image guided endoscopy is also used. The endoscope is inserted through the nose without any need for external incisions. The diseased tissue is removed and the sinus pathways are rerouted.
Pieces of bone may have to be removed to create wider space for sinuses to drain.
In some cases maxillary sinus may be approached through the upper jaw and is connected with the nose to improve drainage. This is called as caladwell luc approach.
Post operative and follow up care is extremely important to ensure success of the surgery.
The patient must lie down with head elevated above the heart so as to minimize swelling. Any strain to the surgical site should be avoided otherwise there may be bleeding. Patient is asked to start saline irrigation after the surgery.
There may be some swelling on the face but it will gradually subside. Ice pack may be applied to reduce swelling.
All the prescribed medications should be taken as per the dose, frequency and time period specified by the treating doctor.
Risk and Complications
There may be recurrence of sinus infection; the polyps may also re appear. There may be excessive dryness and crusting of nose due to nasal discharge. Another surgery may be required if sinusitis is not completely treated.
Rarely there may be damage to the eyes, skull base and palate.
Follow up care is critical to recovery. Patients must understand that if postoperative plan is not followed as prescribed then there risk of recurrence of infection and another surgery may be required.
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