Sinus Surgery

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Kemas kini Tarikh 11/05/2020 . 5 minit bacaan
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Definition

What is Sinus Surgery?

Sinus surgery is a procedure that aims to open the pathways of the sinuses and clear blockages. This is an option for people with ongoing and recurrent sinus infections, for people with abnormal sinus structure, or abnormal growths in the sinus.

The purpose of Sinus Surgery is to relieve your symptoms and cut down on how many infections you get.

When is Sinus Surgery needed?

A person may require sinus surgery to treat a variety of issues. Common reasons include sinusitis and nasal polyps.

Sinus surgery may also be required due to other infections, ongoing blockages, abnormal growths, and other issues that cause inflammation in the nasal passages and sinuses.

Precautions

What should you know before undergoing Sinus Surgery?

Not everyone can safely undergo this procedure. Eligibility depends on many factors, including individual condition, medical history and general health.

What are the complications and side effects?

After the operation, it’s common to experience:

  • Mild discomfort
  • Fatigue
  • Nasal congestion
  • Small amounts of bleeding

The complications that can occur during sinus surgery are mostly rare and include the following:

  • Bleeding after surgery tends to happen within the first 24 hours. However, it can sometimes occur later, after days or even weeks. If a clot develops within the bony partition between the nasal passages, commonly called the septum, then it must be removed.
  • Intracranial complications. The septum attaches to the roof of the nose. This thin layer of bone may be damaged during sinus surgery. However, this is a very rare complication. Brain fluid can leak into the nose and, in severe cases, can lead to an infection in the lining of the brain such as meningitis. While this issue is extremely rare, it is often identified and repaired while the initial surgery is taking place.
  • Damage to the eye or surrounding tissue. As the sinuses are so close to the eye, bleeding can sometimes occur into the eye. This happens when the thin layer of bone that separates the sinus from the eye is damaged. This is rare and, again, is usually spotted and treated while the surgery is taking place. In extremely rare instances, visual loss and blindness have been reported. There have also been rare reports of damage to the muscles that move the eye, which can lead to temporary or permanent double vision. Other instances may lead to a change in how the tear ducts work, causing excessive tearing.
  • Changes to a person’s voice. Sinuses affect the resonance of a person’s voice. A complication of sinus surgery can sometimes lead to a change in someone’s voice.
  • Loss of smell or taste. After sinus surgery, a person’s sense of smell usually improves due to the airflow being restored. However, it can worsen in rare cases depending on the extent of swelling or infection. This is often temporary but can be prolonged.
  • Dealing with sinus infections is the main reason why sinus surgery is done. A person with sinusitis can develop other infections in this area as a result of surgery. However, this complication is also possible if a person doesn’t undergo surgery for a long-term sinus infection.
  • Nasal issues. Sinus surgery usually improves airflow. However, in rare cases, surgery can worsen this. Small amounts of scar tissue may also build up in the nasal passage that will require another procedure to remove.

It is important you understand the precautions and know the possible complication and side effects before having this Sinus Surgery. If you have any questions, please consult with your doctor or surgeon for more information.

Process

How do I prepare for Sinus Surgery?

  • Take any medicines the ENT doctor has prescribed for you.
  • For at least seven to 10 days before surgery, your doctor may tell you to try to avoid medications such as aspirin, ibuprofen (Motrin or Advil), naproxen (Aleve), and other nonsteroidal anti-inflammatories (NSAIDS).
  • Tell your doctor about any medicines or supplements you are taking, and tell any other doctors you’re receiving care from that you’re planning sinus surgery.
  • It is recommended to stop smoking at least three weeks before surgery, and continue not smoking for at least a month afterward.
  • On the day of your surgery, you should consider not eating or drinking anything after midnight.

What happens during Sinus Surgery?

This can depend on several factors, including the chosen surgery technique, the specific condition being treated, the severity of the patient’s sinus condition, and others. In general, surgery takes a few hours—enough time for the surgical team to place the patient under anesthesia, introduce the nasal endoscope and other necessary tools into the sinuses, remove the tissue that needs to be removed, and prepare the patient for recovery.

The most common type of sinus surgery is endoscopic sinus surgery. However, there are other procedures that may be carried out.

Functional endoscopic sinus surgery (FESS)

FESS is carried out with a tool called an endoscope. This is an illuminated, thin fiber-optic tube. The endoscope is inserted into the nose to reach the openings of the sinuses.

Micro-telescopes and surgical instruments can then be passed down the endoscope and used to carry out the procedure. The surgeon will use these tools to remove obstructive tissues and other blockages to clear the sinuses.

The entire procedure is carried out through the nostrils and leaves little to no scarring. Some swelling may occur, but it will disappear quite quickly.

A person who has this surgery will usually only feel mild discomfort for a short period of time.

FESS can be performed frequently. It can also be carried out on an outpatient basis.

Image-guided surgery

Image-guided endoscopic surgery is a newer procedure that may be recommended for severe forms of sinus blockages or after previous sinus surgeries.

In addition to using an endoscope, this type of surgery uses a near-three-dimensional mapping system to show the surgeon the position of the surgical instruments. This is done using CT scans and infrared signals.

Using this guidance, a surgeon can navigate difficult sinus passages and remove tissues and other blockages accurately.

Caldwell-Luc operation

This procedure is less common and more invasive. It tends to be carried out when there is a growth present inside the sinus cavity.

The Caldwell-Luc operation aims to remove growths and improve sinus drainage. It creates a pathway between the nose and the cavity beneath the eye called the maxillary sinus. This window then aids drainage.

The surgeon makes a cut in the upper jaw, above one of the second molar teeth inside the mouth. They then enter the sinus cavity through this cut. This surgery may be performed under local or general anesthetic.

What happens after Sinus Surgery?

After sinus surgery has taken place, nasal packing may be used. Nasal packing is the insertion of sterile gauze-like material into the nasal passage to control bleeding.

Use of packing depends on the type of surgery performed. The packing can be absorbable and will dissolve over time. If the packing is non-absorbable, a doctor will have to remove it.

Recovery periods vary depending on the surgery performed and other factors such as age and general health. However, many people experience very little discomfort after sinus surgery. Most individuals can go home the same day as surgery.

If you have any questions or concerns, please consult with your doctor or surgeon for more information.

Recovery

What should you do after Sinus Surgery?

  • Sleep your head raised, perhaps using an extra pillow, for a while.
  • Avoid blowing your nose for a week or so.
  • Try to keep your mouth open when you sneeze. This will take some of the pressure off your nasal cavities.

You should start to feel better and have fewer symptoms a few days after the procedure.

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