Endoscopic Sinus Surgery

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Endoscopic sinus surgery is a procedure that involves removing blockages in the sinuses to relieve symptoms associated with conditions like sinusitis, nasal polyps, septal deviations or turbinate hypertrophy.

The Goals of the Procedure

The goals of endoscopic sinus surgery include:

- - Reduce the number and severity of sinus infections
  - Improve symptoms associated with sinusitis
  - Improve airflow through the nose
  - Improve a patient’s sense of smell

How to Prepare for Surgery

Patients will need to take prescribed medications to help reduce inflammation. In addition, patients will need to obtain medical clearance from their physician before surgery. Additional lab testing and studies may be ordered to make sure the patient is cleared for a safe surgery.

Patients who smoke will need to stop smoking three to four weeks before surgery and avoid smoking for an additional month after surgery. Smoking increases the risk of poor surgery outcomes and causes increased scar tissue and poor healing.

Medications like aspirin and NSAIDs such as Motrin, Aleve and Advil increase the risk of bleeding during and after sinus surgery and should be stopped at least two weeks prior to surgery. Patients should also stop taking the following:

- - Vitamin E
  - Gingko biloba
  - Ginseng
  - Garlic tablets
  - St. John’s Wort
  - Coumadin
  - Plavix

Patients should avoid eating or drinking anything after midnight before the day of surgery. If patients have had anything to eat or drink before surgery, the anesthesiologist will not be able to administer anesthesia and the surgery will be cancelled.

What to Expect During the Procedure

The procedure will be performed under general anesthesia. The surgeon will use an endoscope, which is an instrument with a thin camera and light at the end of the rod, to help visualize and magnify the sinus tissues. The surgeon will then use specialized instruments to remove natural blockages, nasal polyps and scar tissue. If the patient has a deviated septum or turbinate hypertrophy, the surgeon will use special instruments to straighten the septum and reduce the size of the turbinates. Because endoscopic sinus surgery does not involve cutting through the skin, patients are able to go home the same day.

After the Procedure

It is normal for patients to have some bloody discharge for three to five days after the surgery. To stop bleeding, patients should tilt their head back slightly and gently breathe through their nose. Patients are encouraged to use a nasal saline mist (such as Afrin) every three to four hours after surgery to stop bleeding and keep the nose moist. Patients will feel some nasal and sinus pressure and pain for a few days after surgery. Extra-strength Tylenol may be taken to address mild post-operative discomfort. Patients will feel very tired for one week after surgery and should plan on taking one week off from work.

Potential Side Effects and Risks

The procedure is relatively safe with few risks. However, patients may experience the following rare side effects:

- - Bleeding
  - Infection
  - Cerebrospinal fluid (CSF) leak
  - Changes in vision
  - Changes in nasal breathing or sense of smell
  - Persistent or recurrent sinus disease

Endoscopic Sinus Surgery

The Goals of the Procedure

How to Prepare for Surgery

What to Expect During the Procedure

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