Sinus Surgery: Types, Causes, Procedure, Cost, and Is It Safe?

Sinusitis is the inflammation or the swelling of the sinus tissue, which can cause it to get filled with fluids. The cavities behind your cheekbones, eyes, and in your forehead are called sinuses. These make the mucus used to keep our noses moist, helping them protect against dust and pollution.

Sinusitis is usually treated by medications, but sinusitis surgery is needed in the case of -

• An inflamed nose
• Inflamed sinuses
• Other common sinus problems.

Your surgeon will enlarge the openings of the sinus and the inside of the nose to allow the air to pass (sinus surgery). It also helps the drainage to flow out to help restore the natural balance of the body and cure any sinus problems. However, sometimes the polyps, bone, or tissue need to be removed.

Sinusitis Surgery aims to clear the sinus by removing the blockage of the draining paths. It might mean removing:-

• Tissue that is damaged or swollen
• Thin bones
• Polyps in the nose
• Mucous membranes
• Tumours in the nasal passage

Your doctor might recommend sinusitis surgery to cure nasal polyps or sinusitis. What do these conditions mean, and what are the symptoms you should look out for? The swelling of the nasal passages or the sinuses is known as sinusitis. Some common symptoms of sinusitis include:-

• Nose congestion or discoloured nasal discharge
• Headaches or pressure around the eyes, forehead, or nose
• Loss of hearing or blocked ears

We have a nasal lining inside our sinuses and nasal passages, which might swell in varying sizes and are known as nasal polyps. Larger polyps often block one’s sinuses, causing an infection. These may also cause loss of smell and lead to breathing issues.

Most people with nasal polyps might not experience any symptoms, but some common ones to look out for include:-

• A runny or congested nose, causing breathing issues or snoring
• Loss of taste or smell
• Headaches and facial pain
• Continuous sinus infections

Other than these two frequent conditions, sinus surgery is advised in cases of abnormal tissue growth, nasal blockages, and other infections causing inflammation of the nasal passages and sinuses.

Endoscopic sinus surgery is the most commonly-used sinus surgery, but there are other procedures that your doctor might recommend. These include:-

FESS - Functional Endoscopic Sinus Surgery

It is a popular alternative to endoscopic sinus surgery, where the surgeon uses a tool known as an endoscope. The thin tube is fibre-optic and is inserted into the nose to get a visual image of the sinuses.

Your surgeon will pass surgical instruments and other micro-telescopes to clear the blockage and remove any obstructive tissues. The process is minimally invasive, carried out through the nostrils, and leaves almost no scars. FEES might cause minimal discomfort, but nothing permanent and ensures quick recovery.

Cadwell-Luc Surgery

Cadwell-Luc surgery is used to treat foreign growth in the sinus cavity but is more invasive and less opted for. Your doctor will remove conditions like nasal polyps by this method to improve the draining of the sinus.

The surgeon removes the unwanted tissue growth and creates a small pathway called the maxillary sinus. This is done between the cavity under the eye and the nose to facilitate sinus drainage.

Image-Guided Surgery

If you have recurrent sinus infections and have already had surgery, your doctor will recommend you have an image-guided surgery. The newer process is also used to treat severe cases of blocked sinuses.

Just like functional endoscopic sinus surgery, your surgeon will use an endoscope to visualise the sinus infection. Additionally, a three-dimensional mapping form like CT scans is used to help the surgeon see the position of the different surgical instruments to safely guide these across the difficult passages.

Balloon surgery

This is a new type of surgery that is only prescribed when there is nothing to be removed from the sinuses. In it, the doctor inserts a thin tube into the nose attached to one end of which is a small balloon.

The balloon is guided to the congested area within the nose and is inflated. Doing this clears the passageway and the sinuses can now be drained more effectively.

What does Sinus Surgery Involve?

Sinus surgery is a minimally invasive procedure, but the recommended approach depends on your condition. If your doctor chooses functional endoscopic sinus surgery, an endoscope is inserted using your nostrils. Additionally, they can also use some other surgical equipment to clear the blockage.

Cadwell-Luc and Image-Guided surgeries also follow similar procedures but are comparatively more invasive. However, you do not need to worry about any complications, since the expert medical team at Pristyn Care will take care to follow all safety guidelines and ensure a safe recovery.

Before the Procedure

Sinusitis Surgery is a regular, minimal procedure, but just like other procedures, there are some common precautions you need to adopt. These will help you feel more comfortable throughout the process:-

• Clear Your Doubts with Your Doctor - It is natural to have doubts about the process and the side effects they might have. Asking your doctor to clear your questions and detail the procedure can help you relax.
• Fasting - After midnight of the day before your surgery, you will not be allowed to drink or eat anything. If you have regular medications, your doctor will instruct you about which you can have or need to pause. They may also prescribe some additional medicines for the morning of the surgery.
• Do Not Smoke - Smoking might have unforeseen effects on the surgery, which is why your doctor will ask you to stop smoking at least three weeks before the date.
• Avoid Taking Certain Medications - Medicines like ibuprofen, aspirin, naproxen, and other non-steroidal anti-inflammatories should be stopped at least two weeks before the procedure. These might lead to blood thinning and inhibit the effect of anaesthesia.
• Clearance From Your Primary Physician - Your primary healthcare provider needs to clear you medically for a sinusitis surgery. Ensure that you provide them with your old records and inform them about the scheduled sinus surgery to receive a medically fit certificate.

During the Procedure

Endoscopic sinus surgery is performed entirely through the nostrils. Thus, you can expect that your surgeon will not make an incision on your skin. The minimally invasive procedure does not demand a long time and much attention for recovery. Your surgeon will use an endoscope to help visualise the affected sinus tissues and work on them. Surgical instruments are used to open the sinuses wider, look for signs of blockage, and treat them.

In the other two sinus surgery procedures, Cadwell-Luc, and Image-Guided Surgeries, incisions are made, which makes the recovery process a bit longer than the FESS surgery.

After the Procedure

Some common symptoms and side effects that you can expect after a sinus surgery include:-

• Bleeding - You might bleed for the first 3-5 days after sinus surgery, but if it continues after this period, you should consult a doctor. When bleeding occurs, slightly tilt your head and take small, gentle breaths through the nose. Your doctor might also prescribe a nasal spray that you can use if this does not stop bleeding.
• Pain - Just like any other surgical procedure, you should expect some pain in the sinus and nasal passage for a few days. Avoid medications like Aspirin, Advil, and other NSAIDs, and ask your doctor for a mild dose of the medicine they seem fit.
• Fatigue - You might experience weakness for a week after the surgery, which is why following proper recovery guidelines are necessary.

Post-surgical recovery guidelines to help you relive these side effects and relax after a sinus surgery include:-

• Use a Saline Wash to spray your Sinuses
• Follow the Prescribed Medications and Instructions
• Avoid weight lifting, straining, and nose blowing to prevent bleeding
• Steer clear of NSAIDs (Non-Steroidal Anti-Inflammatory Medications) as they can cause blood thinning
• Use a Saline Mist Spray every 2-3 hours

You should also keep a look out for these complications and contact your healthcare provider:-

• Fever of more than 101℉ after the day of the procedure
• Loss of vision or swelling of the eye
• Neck stiffness or severe headache
• Digestive problems like diarrhea
• Nose bleeding that does not stop even with nasal sprays

Traditionally, several incisions were made on the face to destroy the sinuses, which is why a sinus surgery was invasive and painful. However, with the progress of medical science, surgeons now use a tool known as an endoscope to operate and treat the blockages.

The minimally invasive procedure ensures quick recovery, which is quite a dramatic improvement from the previous methods. Additionally, new medications and devices have helped minimise the pressure and chances of any side effects.

Sinus surgery is a minimal procedure where side effects are not too common. Some complications that you might face, depending on the surgical procedure and the case, include:-

• Nasal bleeding or congestion
• Loss of vision or smell
• Brain infection or injury

The medical team at Pristyn Care follows all guidelines and tries their best to ensure you do not face these complications and make a fast recovery.

In case you have the following severe symptoms or if they last longer than 10 days, you should contact your doctor:

• Fever or body pain
• Nasal discharge/congestion or trouble breathing
• Facial pain

In case of recurring sinus infections or more serious cases, some common symptoms include:-

• Fever of over 39.4 ℃ (or 103℉)
• Stiff neck or severe body pain
• Changes in vision or hallucinations

Endoscopic sinus surgery is safe and the chances of any complications are quite low. However, just like any surgery, you might face certain side effects like:-

• Blood loss and uncontrollable nasal bleeding
• Recurrence of sinus infections or symptoms
• Loss of vision as the sinuses are close to the eye sockets
• Loss of taste or smell
• Other nasal infections

You can talk to your doctor about the possible complications before choosing to undergo sinus surgery.

Generally, one can return home after sinus surgery, but recovery takes longer. Following the doctor’s prescribed medications and recovery guidelines help prevent any complications and offer relief.

Additionally, the complication of the case and the chosen surgical procedure determine the recovery period. On average, it is advised to rest for at least three to five days before resuming one’s regular lifestyle. Other than that, avoiding strenuous activities like heavy lifting is crucial. Limit your physical activity and consult your doctor for a detailed guideline and recovery plan.

Sinus problems can be treated with medications, but you might need sinus surgery in case of recurrent infections and the occurrence of symptoms and sinus issues. Additionally, if someone has infected sinus tissues, fungal infections, irregular structures, or polyps (tissue growth), sinus surgery is the cure. Chronic sinus issues can lead to loss of vision and taste, making the surgery necessary.

New techniques and research in the field of medicine have helped doctors come up with less invasive procedures to treat sinus problems. Endoscopic Sinus Surgery does not require incisions and is relatively a pain-free procedure.

One might be at the risk of some serious complications like loss of vision, but these are very unlikely. Different studies found that the average success rate of sinus surgery can be anywhere between eighty to ninety percent.

The average sinus surgery cost in India ranges anywhere from INR 45,000 to INR 75,000. The infrastructure of the hospital and the experience of the surgeons also affect the cost of the procedure. As for functional endoscopic sinus surgery, the price ranges between INR 55,000 and INR 65,000.

After sinus surgery, a proper diet and recovery plan can help you get back to your lifestyle as soon as possible. Some foods that you can include in your diet after sinusitis surgery are:-

• Easy-to-chew foods like mashed potatoes and scrambled eggs
• Herbal tea like chamomile and peppermint
• Cooked vegetables like peas, carrots, and beans
• Juice that does not contain citrus/vitamin C
• Soft custards or puddings
• boiled pasta with non-acidic sauces

Some common foods that you should refrain from after a sinus surgery include:-

• Spicy foods that might cause indigestion
• Acidic foods like citric fruits, orange juice, and tomato ketchup
• Alcohol beverages that might cause blood thinning
• Bread that might upset your stomach

Sinus issues can be managed with medications but severe conditions and polyps can only be treated using sinusitis surgery. However, your nasal polyps can grow back even after proper management using surgery. Hence, it is important to follow up regularly with your doctor and keep your condition in check.

What are the post-treatment guidelines for sinus surgery?

Other than following an intensive recovery plan and taking prescribed medications on time, some other things that you should follow include:-

• Avoid blowing your nose or rubbing on it
• Avoid anti-inflammatory medications that can thin your blood
• Do not use nasal sprays that are not saline-based
• Look for out-of-the-place symptoms like high fever, digestive issues, and severe headache

Some side effects or complications of sinus surgery that you might face, include:-

• Persistent infections or symptoms
• Nasal bleeding or infection
• Loss of vision or skull pain
• Need for further surgical procedures and measures
• Unusual symptoms and persisting problems like nasal swelling, high fever, or discoloured nasal fluid

If you notice any symptoms out of the ordinary or are in pain, consult your healthcare provider for a quick resolution.

If you have non-persistent or non-infectious sinus problems, medications might be enough for you. However, you must get it checked by your doctor and ask for future management guidelines.

In case you face recurring sinus problems, sinus surgery is an effective procedure that can be administered under the supervision of an expert medical team. Following a balanced diet, light exercises, and post-procedure treatment guidelines can further help minimise the chances of reoccurrence of sinus problems.