Endoscopic Sinus Surgery: Treatment, Cost and Side Effects

Endoscopic Sinus Surgery is a surgical procedure performed to treat a condition called sinusitis or inflammation of the sinuses. In this method, an endoscope inserted through the nose is used to see and perform the surgical procedure with small scale surgical instruments. The endoscopic sinus surgery is thus a minimally invasive surgical procedure.

Sinusitis or inflammation of the sinuses may occur due to blockage of the sinuses, which then fills up with fluids and may become infected. Sinusitis gives rise to symptoms like stuffy and runny nose, cough, fatigue, fever, pain in the face, dental pain, etc. Sinusitis may be acute where the symptoms appear suddenly and are short lived, or chronic where the symptoms stay for an extended period of time.

Sinusitis occurs due to blockage of the sinuses, which may be caused by a number of factors including common cold, allergic rhinitis or hay fever, small tissue growths of the nasal and sinus lining, or a shift in the nasal septum due to disease or trauma. Treatment involves draining out the accumulated fluid. Acute sinusitis is usually resolved on its own. However, chronic sinusitis requires treatment. Surgical procedures are followed if medications and other procedures are unable to resolve sinus blockage and drain out accumulated fluid.

Medications are administered first to treat sinusitis. In case medications are unable to cure the condition, sinus surgery is advised, and most sinus surgeries are performed using endoscope. The endoscope is inserted into the nasal cavity through the nose to allow the sinuses o be visualized while the surgery is performed. Small scale surgical instruments as required according to the particular case being treated are inserted along with the endoscope to perform the surgery. Small tissue buildups, polyps, bones etc. may be removed by simple tools like scalpels and tweezers. Rotating burr like tools may be used to scrape off excess growing tissue. Lasers may be used in some cases to burn and remove excess tissue. Sometimes a balloon may be used to widen the sinus passage to facilitate draining.

All these procedures are minimally invasive and relatively simple and may be performed under general or local anesthesia.

Sinusitis may be acute, where the symptoms are short term, or chronic, where the symptoms persist for a long time. Treatment is required for chronic sinusitis, where symptoms like abnormal nasal discharge, stuffy and runny nose, facial and dental pain, etc. persist for a long time. Surgical procedures are required for treatment only when medications or other treatment methods are ineffective.

Sinusitis is common and usually goes away without treatment. Acute sinusitis does not need to be treated with surgery. The chronic cases which are resolved through medications also do not need surgical treatment.

Some side effects may appear with endoscopic surgery for sinusitis in rare cases. Complications may include nasal bleeding, perpetual nasal discharge, pain in the base of the skull and eyes, eye pain that increases when bending forward, etc. Surgery may be completely unable to cure the original sinus problem in very rare cases.

A number of post treatment guidelines are prescribed after endoscopic sinus surgery. These include taking prescribed antibiotics, gauze packing inside nose to absorb blood, using prescribed nasal spray to prevent inflammation, nasal washing and irrigation with saltwater or prescribed formulae, using humidifier to maintain moisture inside the room, avoiding heavy exercise for a few days, etc.

Complete recovery takes place in about two to four weeks after the endoscopic surgery unless further complications develop.

Endoscopic Sinus Surgery costs between Rs. 20,000 and Rs. 30,000 in India, with the costs going higher if complications develop.

Longevity of the endoscopic sinus surgery results depend on the extent of the blockage treated and the nature of the blockage. In most cases the results are long term until further blockage occurs.

A number of alternative treatment practices exist for sinusitis. Herbal and traditional medications may be beneficial in reducing the blockages of the sinuses. Aromatherapy using essential oils have been found to be moderately effective in preventing and reducing blockages and inflammation of the sinuses. Breathing exercises like Pranayam are also recommended to keep the sinus passages free from blockage.