Sinus surgery is a specialized surgical treatment targeting sinus obstruction or inflammation, primarily aimed at improving sinus ventilation and drainage functions. This procedure uses precise instruments or endoscopic techniques to remove tissue obstructing the sinus openings, addressing issues such as recurrent infections, headaches, or diminished sense of smell. The goal of the surgery is to restore the natural drainage of the sinuses, reduce reliance on antibiotics, and enhance the patient's quality of life.
The main categories include "Functional Endoscopic Sinus Surgery (FESS)" and "Nasal Turbinate Reduction." FESS utilizes an endoscope to magnify the visual field, removing hypertrophic sinus mucosa or bone to enlarge the sinus openings for better secretion drainage. Turbinate reduction targets hypertrophy of the inferior turbinates, removing part of the tissue to improve nasal airflow.
Suitable for patients with chronic sinusitis who have not improved after six months of medication. Other indications include nasal polyps blocking the sinus openings, structural abnormalities of the sinuses (such as deviated nasal septum), or recurrent sinus infections leading to abscess formation.
The surgery is usually performed under general anesthesia, lasting about 1-3 hours, with a hospital stay of 1-3 days. The surgeon will choose an approach through the nasal cavity or oral cavity based on the lesion location, using electrocautery or ultrasonic instruments for tissue trimming. Postoperative care includes regular cleaning and the use of steroid sprays to prevent tissue proliferation.
The surgery can significantly improve symptoms, with studies showing that over 70% of patients experience symptom relief one year after the procedure. Compared to medication, surgery provides a long-term solution to anatomical issues, reducing recurrent infections and antibiotic use.
Short-term risks include nosebleeds, infections, or mucosal damage. Long-term risks include nasal stenosis or permanent loss of smell; severe cases may lead to cerebrospinal fluid leaks or injury to periocular nerves. Close monitoring of nasal secretions' color and quantity is necessary postoperatively.
Patients with uncontrolled diabetes, coagulation disorders, or heart disease should first treat their underlying conditions. Discontinuation of anticoagulants (such as aspirin) for one week before surgery and completion of sinus anti-inflammatory treatment are required. Within three months post-surgery, strenuous activities should be avoided, and regular follow-up examinations are necessary to assess nasal recovery.
Surgery is often combined with medication therapy, such as postoperative steroid sprays to reduce tissue proliferation. Invasive treatments like nasal cauterization should be avoided simultaneously to prevent excessive tissue damage. Diabetic patients need to adjust insulin doses to cope with postoperative stress responses.
Large clinical studies show that FESS has a 75% symptom improvement rate at one year post-operation, with a 60% reduction in abnormal sinus CT findings. Long-term follow-up indicates that patients on combined medication therapy have a recurrence rate of less than 20% within five years. However, complex cases may require secondary surgeries for adjustments.
Non-surgical options include high-dose steroid sprays, sinus irrigation, or biologic therapies. Conservative treatment is suitable for mild symptoms, but those with recurrent infections or structural obstructions still require surgery. These alternatives often involve antibiotic rotation and may need to be continued for over two years.
Patients should undergo nasal endoscopy or imaging examinations (such as CT scans) to evaluate sinus structures and inform the doctor of current medications, especially anticoagulants or antiplatelet drugs. Additionally, fasting for 12 hours before surgery and adjusting chronic disease medications as per medical advice are necessary. On the day of surgery, family members should accompany the patient to ensure safe discharge afterward.
How long do nasal congestion or bleeding last after surgery?Nasal congestion typically lasts 1 to 2 weeks due to nasal packing or tissue swelling. Mild bleeding may persist for several days; if bleeding is heavy or continues beyond 24 hours, immediate medical attention is required. The doctor may prescribe nasal cleaning solutions or ointments to promote recovery and reduce infection risk.
When can normal activities or work resume after surgery?Generally, light work can be resumed after 1 to 2 weeks, but strenuous activities or heavy lifting should be avoided for at least 4 weeks to prevent wound disruption. Recovery time is shorter for endoscopic sinus surgery (FESS); more complex procedures involving temporomandibular joint surgery may require longer rest. Specific arrangements should follow the physician's assessment.
What long-term care should be observed after surgery?Continued nasal hygiene using saline sprays or prescribed medications is essential, along with avoiding exposure to tobacco smoke and excessive dust mites. Regular follow-up visits are crucial, typically at 1 month, 3 months, and 6 months post-surgery, to monitor sinus patency and healing progress.
Is recurrence of sinusitis possible after successful surgery?While successful surgery significantly improves sinus ventilation and reduces infections, recurrence remains possible if the patient has allergies or environmental factors that are not managed. Postoperative control of allergens, maintaining nasal cleanliness, and avoiding long-term use of decongestant nasal sprays are recommended to sustain long-term benefits.
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