Endoscopic Sinus Surgery

The sinuses are air-filled spaces in the bones around the nose. Each one drains into the nose through a narrow channel. When that channel blocks, fluid collects inside the sinus and infection follows. Endoscopic sinus surgery opens the blocked channels.

The surgeon works through the nostrils with an endoscope, which is a thin telescope with a camera. Nothing is cut on the face and no scar shows.

When the doctor recommends it

Surgery is not the first treatment. Medicines come first: nasal sprays, rinses and, when infection is present, antibiotics. The doctor recommends surgery when

• sinus infections keep coming back after full medical treatment
• the sinuses are blocked all the time and your nose stays congested
• nasal polyps, which are soft swellings of the lining, fill the nose
• a fungal infection or a cyst sits inside a sinus
• the infection threatens to spread towards the eye or the brain

What a CT scan shows

Before the operation the doctor orders a computed tomography scan of the sinuses. The scan shows which sinuses are blocked, how the channels run, and where the walls between the sinus and the eye or the brain lie. The surgeon plans the operation on these images.

The operation

The operation is done under general anaesthesia and takes about one to two hours. The surgeon opens the blocked channel of each affected sinus and removes the diseased lining, the polyps and any cyst. Healthy lining stays where it is, because it carries the mucus out of the sinus.

If the septum is crooked and blocks access, the surgeon straightens it in the same operation.

Most patients go home the same day or the next morning.

After the operation

Your nose feels blocked for the first week. Crusts form inside while the lining heals, and they make breathing harder for a while. This settles.

• Rinse your nose with salt water, as often as the doctor says.
• Do not blow your nose for the first week.
• Do not do heavy sport for two weeks.
• Take the medicines the doctor prescribes.

Come to every follow-up appointment. At these visits the doctor cleans the crusts out of the nose under the endoscope. This cleaning decides how well the sinuses heal, and it matters as much as the operation itself.