Sinus Surgery

In order to appreciate how a sinus operation can cure chronic sinusitis, it is important to understand what sinuses are and how they can cause problems.

The purpose of sinus surgery is to help improve the sinuses’ draining capabilities and, ideally, reduce the chances of the sinus passages becoming blocked again.

Before you are offered a sinus operation, your doctor will want to find out where exactly the problem is occurring. To do this, he or she might need to carry out an X-ray or a CT scan or use an endoscope (a small tube with a camera on) to take a closer look at the problem.

Though there are several different types of sinus surgery, they all fall into two camps, either ‘traditional’ or ‘endoscopic’. Traditional sinus surgery involves making a small external incision and cutting out the affected area, while endoscopic surgery accesses the sinus via tubes inserted up the nostrils.

In the UK today, most sinus surgery is endoscopic, and the two most common procedures are known as Functional Endoscopic Sinus Surgery (FESS) and Balloon Sinuplasty Surgery. The main difference between these two types of surgery is that Balloon Sinusplasty Surgery doesn’t involve any kind of incision – the sinus membrane and/or nasal passage is left wholly intact.

Functional Endoscopic Sinus Surgery (FESS)

This is the traditional method of surgery and involves the following steps:

You will usually have a general anaesthetic, although a local anaesthetic is sometimes used.
The surgeon will either insert an endoscope up your nose or use a combination of a powerful headlight and angled lenses to see what he or she is doing.
Having found the obstruction or constriction, your surgeon will then use a variety of fine instruments to cut or scrape away tiny slices of bone or infected tissue.
After surgery, you will probably be given a sponge dressing to soak up any blood. This will be removed after a few hours.
Unless the option is discussed before the surgery, there will be no need for this kind of operation to involve external incisions. You might need a few stitches inside your nostril, but these won’t be externally visible and will dissolve over time.

Typically, FESS won’t last more than an hour, although this depends on the extent of the problem and which sinus is being operated on.

Balloon Sinuplasty Surgery

Ballon Sinuplasty Surgery is a newer form of sinus surgery and is less invasive than FESS. It involves the following steps:

Both general and local anaesthetic are suitable for this procedure, and you should talk to your health professional about your options.
Your surgeon will insert a sinus guide catheter (a flexible hollow tube) up one nostril under endoscopic visualisation. This ensures they can see exactly where the sinus problem is.
Once the blockage has been located, a sinus guide-wire or illumination system is inserted via the original catheter.
This guide-wire or illumination system is then used to place the second catheter in exactly the right position. This second catheter contains a tiny inflatable balloon.
Once in position, the balloon will be gently inflated to reshape the blocked passage. It will then be deflated and removed.
Finally, a third catheter, known as the ‘irrigation catheter’ is inserted and used to flush out any infected mucus.