The paranasal sinuses are air filled spaces in your facial bones, which warm and humidify the air as it passes through your nose, serve as a cushion against facial trauma, decrease the weight of your skull and increase the resonance of your voice. There are eight sinuses (4 on each side). Each are lined by cells that secrete mucous, and through the motion of microscopic hairs (cilia), push the mucous out into your nose. This is a continuous self-cleaning process. Occasionally, the openings to these sinuses can become blocked, and the mucous backs up, becomes colonized with bacteria and becomes infected, leading to a sinus infection. Sinus infections are often caused by viruses and resolve on their own. Bacterial sinus infections often require antibiotics. Preventing further infections requires unblocking the openings to the sinuses. In most cases, this blockage is caused by inflamed tissue from either allergies or infections, and treating the cause will solve the problem. In some patients however, the blocked sinus passageways cause repeated infections, or an infection that doesn’t clear. These patients benefit from endoscopic sinus surgery.
Functional Endoscopic Sinus Surgery, refers to a procedure where the blockages of the sinuses are opened endoscopically, leaving the mucous cells and tiny hairs intact to function. The procedure is typically performed under general anesthesia. If your nasal septum or inferior turbinates are causing blockage, they will be corrected at the same time. Your surgeon will then use the endoscope and specially designed instruments to widen the openings to the affected sinuses. In severe cases, computer image guided software may be used to provide localization in 3D during the case. In this case you may be asked to have a special CT scan performed prior to the procedure. Soft sinus sponges are sometimes placed following the procedure to stent open the sinus openings, and to prevent bleeding.
Endoscopic sinus surgery is performed on an outpatient basis and there is typically little pain after the surgery. Minor bleeding and some discomfort are common. You may need to follow up with your surgeon in 2-3 days to have the sponges removed. Keeping debris out of the healing sinus cavities is extremely important, as crusting and debris can lead to infection, inflammation and even scar tissue formation. Initially you will be asked to keep things moisturized with a saline spray. As your nose heals, sinus irrigations will be added to wash out any crusting or debris. It is very important that you attend all of the follow up visits following endoscopic sinus surgery. Your surgeon will clean out any debris that has accumulated, to prevent scar tissue from forming.
Endoscopic Sinus Surgery is very effective in reducing or eliminating future sinus infections and sinus headaches.