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Sinusitis
Last updated October 2004
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Is Surgery Ever Required?

Surgery can bring relief when all other courses of treatment have failed to improve breathing. It is especially effective when polyps are present or when a deviated septum prevents adequate passage of air through the nose.

A doctor will not recommend surgery unless symptoms have been chronic or frequent over a period of time, and either have not responded to medication or are especially severe.

Sinus surgery can correct:

  • Swelling and blockages caused by chronic sinusitis

  • Swelling and blockages caused by repeated attacks of acute sinusitis

  • Deviated septum

  • Polyps

  • Tumors

Endoscopic Sinus Surgery

While there are several different types of sinus surgery that may be recommended, endoscopic sinus surgery is rapidly becoming the surgery of choice for more and more doctors.

Endoscopic sinus surgery utilizes a thin, lighted instrument called an endoscope.

  • Much like a telescope with a wide-angle camera lens, the endoscope is inserted in the nostrils, and the doctor looks inside the sinuses   The spaces between the bones in the face where air passes and mucus drains through an eyepiece.

  • The endoscope beams a light into different parts of the nose and sinuses, allowing the doctor to see what is causing blockages.

  • Surgical instruments can then be used next to the endoscope to remove the blockages and improve breathing.

Unlike most traditional surgeries, endoscopic sinus surgery does not involve cutting through the skin, as it is performed entirely through the nostrils. Therefore, most people can go home the same day. Additionally, it leaves no visible scars and causes less pain and discomfort.

Depending upon the extent of the surgery, a local anesthetic   A drug that numbs only the area where surgery will be performed,  allowing the patient to stay awake during the procedure or general anesthetic   A drug that causes the patient to sleep during surgery, so that no pain is experienced during the procedure may be used.

For more information about endoscopic sinus surgery, go to Endoscopic Sinus Surgery.

Sinus Washouts

A sinus washout   A minor operation to clear the maxillary sinuses is a minor operation in which one of the maxillary sinuses   The pair of sinus cavities located in the cheekbones, the pair closest to the cheekbones, is punctured with a small needle passed through the nose. The excess mucus   The fluid made by the lining of the nose and sinuses, which carries dust and other particles out of the nose is then washed out of the sinus. When the sinuses are clear, and any infection or pus   A mixture of dead bacteria, white blood cells and other body secretions created by the body to rid itself of infection has been washed out, the swelling will go down. The mucous membrane   The lining of the nose and sinuses. There are also mucous membranes in other parts of the body and cilia   The tiny hairs along the mucous membrane that move mucus through thesinuses and out the nose are then able to return to normal functioning.

Sinus washouts are rarely painful and are usually performed under a local anesthetic, which means the person is awake but cannot feel any pain in the area of the operation. However, the procedure can be uncomfortable, as the needle can create a crunching feeling, and the washing of the mucus can feel quite strange.

A general anesthetic, which puts the person completely to sleep, is preferred with children. Some adults may also feel more comfortable under general anesthesia.

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