Endoscopic sinus surgery: Overview
In endoscopic sinus surgery, an endoscope is inserted into the nose. It lets the doctor see inside the sinuses.
Surgical tools are inserted alongside the endoscope. This allows the doctor to remove small amounts of bone or other material blocking the sinus openings. The doctor can also remove growths (polyps) of the mucous membrane. In some cases a laser is used to burn away tissue blocking the sinus opening. A small rotating burr that scrapes away tissue may also be used.
The surgery may be done in a hospital or an outpatient surgery center. Either local or general anesthesia may be used. The procedure takes 30 to 90 minutes.
Why is endoscopic surgery for sinusitis done?
Endoscopic surgery may be needed when medicine has failed to improve or cure chronic sinusitis. It is the preferred method of surgery for most cases of chronic sinusitis that require surgery.
After endoscopic sinus surgery: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You have severe trouble breathing.
Call your doctor now or seek immediate medical care if:
- You have changes in your vision or lots of sudden swelling around your eyes.
- You have constant clear, watery discharge from your nose.
- You bleed through the bandage more quickly than what you've been told is normal.
- You have a new or worse fever.
Watch closely for changes in your health, and be sure to contact your doctor if:
- You have pain that does not get better after you take pain medicine.
- You do not get better as expected.
How well does endoscopic surgery for sinusitis work?
Endoscopic surgery improves symptoms in most people.
But surgery doesn't always get rid of sinusitis. Some people may need a second operation.
Surgery works best when it's used along with medicine and home treatment to prevent future sinus infections. A second surgery and future sinus infections may be avoided if aftercare instructions are followed carefully.
How do you prepare for endoscopic sinus surgery?
Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.
Preparing for surgery
- Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
- Understand exactly what surgery is planned, along with the risks, benefits, and other options.
- Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
- If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
- Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.
How can you care for yourself after endoscopic sinus surgery?
Minor discomfort and bleeding are common during the first 2 weeks after surgery. You may need weekly visits to the surgeon for about 3 weeks after the surgery to have dried blood and mucus removed.
Self-care may include:
- Packing the nose with gauze to absorb bloody drainage.
- Taking antibiotics.
- Using a nasal spray containing a steroid to reduce inflammation.
- Using saltwater washes (saline nasal lavage or irrigation) to keep the nasal passages moist.
- Avoiding activities such as blowing the nose, exercising strenuously, and bending forward for a few days.
- Using a humidifier to keep room air moist, especially in the bedroom. Follow the directions for cleaning the machine.
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