Anything that blocks any of the sinus cavities can contribute to respiratory problems, facial pain, distracting sinus headaches, and other issues that can affect quality of life. If drainage pathways are being blocked by structural abnormalities, swollen or damaged tissue, problems with mucous membranes, nasal polyps, or tumors, surgery may be recommended. Severe symptoms related to sinusitis may also contribute to a need for surgery involving one or more of the sinus passageways.

Functional Endoscopic Sinus Surgery (FESS)

A thin, flexible instrument called an endoscope can be inserted into the nose for diagnostic purposes to get a better view of sinus cavities. An endoscopy done for treatment purposes involving sinus cavities is referred to as functional endoscopic sinus surgery. It’s performed with special instruments an ear, nose, and throat doctor may use to remove scar tissue, nasal polyps, or other sources of obstruction. Since the entire procedure is performed through the nostrils, there’s no scaring.

Balloon Sinuplasty

This is a newer procedure that may be done when there isn’t a structural issue with the sinuses or obstruction that needs to be removed. Performed through the nose, a balloon sinuplasty involves the use of a thin tube with a small balloon attached to the other end. It’s inflated to clear the affected sinus cavity to improve drainage and minimize issues with congestion.

Image-Guided Surgery

With this type of endoscopic surgery, a 3D mapping system is used to help with the placement of instruments and provide a more detailed view of the affected area. It’s a process that involves CT scans and infrared signals. As with other endoscopic procedures, special instruments are used to correct sinus blockages or remove tissues with better precision. In some situations, image-guided surgery may be done as a follow-up to traditional sinus surgery if other issues need to be addressed.

Caldwell-Luc Operation

If there is a growth blocking a sinus passageway or a need to improve drainage, a Caldwell-Luc operation may be performed. It’s a more invasive type of sinus surgery that involves creating a pathway between the maxillary sinus below the eye and nose. An incision is made into the upper jaw inside of the mouth to access the affected sinus cavity.

Post-Surgery Recovery

Most sinus procedures involve the use of sinus or nasal packing to control bleeding. If packing is internally placed, it may be absorbable. Otherwise, it will be removed following the initial healing period. Medication may be prescribed to manage post-surgery discomfort. It’s normal to experience fatigue or temporary nasal congestion after some procedures. Patients typically have follow-up visits to an ENT doctor to determine if recovery is progressing as expected. Recovery periods are usually shorter with minimally invasive sinus surgery.

If sinus surgery isn’t absolutely necessary, an ear, nose, and throat specialist may suggest antibiotics to resolve blockages linked to recurring infections. Oral steroids may be a first attempt at treatment for tissue swelling in nasal cavities.