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Sniffing Out Sinus Surgery

Posted 8/23/2017 by UHBlog

Not sure if surgery on the snout is best for you? Ask us.

Sniffing Out Sinus Surgery

When your sinuses – or the nasal passages around your nose – become swollen or inflamed, they can make life miserable. Just ask anyone who’s ever had a sinus infection, or sinusitis, a condition that affects more than 3 million people each year.

Sometimes, the problem becomes chronic and lasts for three months or more. It’s then that many people look for other approaches to breathe easier.

According to otolaryngologist Brian D’Anza, MD, an ear, nose and throat specialist, when you first see your doctor about sinusitis, he or she will usually recommend conservative treatments to help rid you of the blocked-up sinuses, including:

  • Antibiotics
  • Decongestant sprays for stuffiness
  • Oral steroids
  • Antihistamines

If these don’t work, that’s when your doctor may recommend sinus surgery.

“Endoscopic sinus surgery (ESS) is done for a number of reasons,” Dr. D’Anza says. “The most common is for chronic sinusitis that doesn’t respond to more conservative treatments.”

While this type of surgery has become much more common and is considered effective in treating chronic sinusitis, people frequently have questions about what to expect. Dr. D’Anza answers some frequently asked questions about the procedure:

Q. What are the first steps in sinus surgery?

A. “When the decision has been made to recommend surgery, you will usually get a CAT scan to see where the inflammation is, evaluate sinus narrowing and plan the surgery,” Dr. D’Anza says. “If more complex surgery is needed, we use the CT images with a special machine that acts like a ‘sinus GPS.’ This helps confirm we have locations for all the important landmarks to guide the surgery.”

Q. What happens during the surgery?

A. For most people, ESS is a relatively simple outpatient procedure that’s done while you sleep using a general anesthetic. The surgery lasts anywhere between 30 minutes and three hours, depending on what has to be done.

“After you are sleeping, a thin endoscope (with camera) is inserted in your nostrils,” he says. “Bone and other material in the sinuses are removed using very small instruments. In the majority of cases, the surgical procedure is performed entirely through the nostrils, leaving no external scars. There is little swelling and only mild discomfort.”

When you go home later that day, you may have pain and experience pressure in your sinuses for a few days. Additionally, you’ll have some at-home self-care to clean and irrigate each sinus.

Other than keeping your head above your heart as much as possible, most people can usually resume their normal schedule after one week, Dr. D’Anza says.

Q. Are additional surgeries a possibility?

A. While most people won’t need multiple surgeries, it depends on what caused the chronic sinusitis to develop in the first place. If you have polyps – or growths in the lining of your nose – they may come back years down the road. If you don’t, the chance of needing additional surgery is even smaller.

“Studies looking at patient outcomes have seen better outcomes for those undergoing surgery even 10 years after the procedure compared to those who stayed with medical treatment,” says Dr. D’Anza. “In those who continue to have symptoms, the surgery can make the medicines work better and possibly slow or halt the reemergence of the inflammation.”

Q. Is surgery necessary to relieve chronic sinusitis?

A. Some people opt not to have ESS and decide to continue antibiotics, decongestants and other medical treatments, which can have side effects.

“Basically it boils down to quality-of-life issues,” he says. “Are your symptoms and/or the treatment required interfering with your life and activities of daily living?”

Brian D’Anza, MD, is an otolaryngologist-rhinologist specialist at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. D’Anza or any other doctor online.

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