Sinus surgery using a nasal endoscope is the most commonly recommended procedure for people with chronic sinusitis. The surgeon uses the same type of thin endoscope used during the diagnostic exam. This procedure requires no visible incisions, is performed under general anesthesia. The endoscope, which is inserted by a surgeon through the nostrils, is attached to a miniature camera and light source. During surgery, high-resolution images of the nasal passages and sinuses are transmitted from the endoscope to a high-definition monitor in the operating room.
The surgeon uses images from a CT scan as a roadmap to help guide the surgery based on your sinus anatomy. When the endoscope is in place, the surgeon uses tiny surgical instruments to remove unwanted tissue or polyps or to correct a deviated septum. If the turbinates—bony structures that line the nasal passages, cleaning and humidifying air as it passes—are enlarged and blocking your nasal passages, your surgeon may reduce them to improve breathing.
Endoscopic sinus surgery typically takes about two hours and does not require an overnight hospital stay. There is no swelling or bruising of the face as a result of surgery.
Endoscopic sinus surgery requires extreme precision due to the location of the sinuses near the eyes and brain. Because of this, surgeons at NYU Langone may suggest image-guided or computer-assisted endoscopic sinus surgery to allow for a more safe and thorough procedure.
Before this procedure, data from a sinus CT scan is uploaded to a computer and displayed on a high-definition monitor. There are surgical procedures that can treat these repeat infections — but when are they necessary?
If you have a serious sinus infection , the first step is to see what you can do to avoid surgery, which should be viewed as a last resort.
Consider your home and workplace environment — avoid smoke and allergy triggers, and use humidifiers to moisten the air, as dry air can be irritating. Seek treatment for allergies, which may include regular shots. Practice cold prevention by washing your hands often, avoiding sick people and treating illness if it occurs. If you continue to get sinus infections after taking these preventive measures, the next step is to receive medical therapy from an ear, nose and throat ENT specialist.
This will likely require several weeks of antibiotics, steroid medications and nasal sprays and irrigations. You might need surgery if you have badly damaged sinus tissue, benign growths called polyps , a fungal infection or structural problems that are preventing your sinuses from draining. Wrobel , MD, who is an otolaryngologist at Keck Medicine of USC , associate professor of neurosurgery and clinical otolaryngology — head and neck surgery, and director of the division of rhinology, allergy and endoscopic skull base surgery at the Keck School of Medicine of USC.
Luckily, new techniques in nasal surgery allow it to be a relatively pain-free procedure that often can be done on an outpatient basis with a short recovery time.
These surgeons specialize in problems of the ears, nose, and throat and are also called ENT doctors. If your sinus problems are so bad that you need sinus surgery, an ENT doctor will perform the surgery. Patients who respond to medical therapy do not need surgery, adds Mark A. Zacharek, MD, residency program director for the department of otolaryngology and head and neck surgery at Henry Ford Hospital in Detroit.
That may include a long course of antibiotics , sinus irrigations, and steroid medications. The next step, if there is no relief, is to get a CT scan. Says Dr.
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