When do you need Sinus Surgery, and How to prepare for them?

Many people experience symptoms known as sinus infections, which can cause significant pain and discomfort in the face. Meanwhile, there are numerous ways to treat sinus infections, one of which is sinus surgery. This article will inform you about sinus surgery and what you should do if you are considering having one.

What is the sinus, and what are their abnormalities?

The paranasal sinuses, also known as “sinuses,” are a group of paired air-filled spaces located around the nasal cavity. Humans have four pairs of sinuses: maxillary sinuses, which are located under the eyes in the maxillary bones, frontal sinuses, which are located superior to the eyes in the frontal bone, ethmoidal sinuses, which are located between the nose and the eyes in the ethmoid bone, and sphenoidal sinuses, which are located in the sphenoid bone.

The sinus’ roles are currently being debated, and no function has been confirmed. However, because the sinus is connected to the nasal cavity via the Ostium maxillare of maxillary sinuses, allergies or infections can cause it to become blocked and filled with fluid, resulting in pressure and pain in the face, teeth, or ear. These abnormalities are called sinusitis, which most commonly occurs in patients with nasal allergies, asthma, airway abnormalities such as nasal polyps or a deviated septum, and patients with weakened immune systems who suffer from an increased risk of fungal infections.

Sinusitis is classified into three major types: acute sinusitis, which lasts less than four weeks and is usually caused by viruses, subacute sinusitis, which lasts four to twelve weeks, and chronic sinusitis, which lasts more than twelve weeks and is usually caused by bacterial infections. While recurrent acute sinusitis is sinusitis that returns four or more times in a year and lasts less than two weeks each time.

How to treat sinusitis?

Using nasal swabs, nasal endoscopy, and biopsy in combination with an examine of medical history, doctors diagnosed sinusitis by looking for a sign of swelling, draining, or blockage in your ears, nose, and throat. Some cases of chronic sinusitis may necessitate a CT scan for detailed imaging of your sinuses to be analyzed by an otolaryngologist or ear, nose, and throat specialist.

Sinusitis can be treated at home with over-the-counter cold and allergy medications, decongestants, and frequent nasal rinses with sterilized saline. Alternative therapies such as acupressure and facial massage may help relieve sinusitis-related symptoms. Meanwhile, if your condition does not improve, your doctor may prescribe intranasal steroid sprays to relieve discomfort, antibiotics like augmentin and levofloxacin, or antihistamines to treat allergies or infections that cause sinusitis. Chronic sinusitis is treated with a combination of intranasal steroids, antihistamines, and leukotriene modifiers, which help to prevent breathing problems. However, in cases involving structural issues, polyps, or fungal infections, surgery may be required.

What is sinus surgery?

Sinus surgery is a surgical procedure that is used to remove infected sinus tissue, bone, or polyps that cause chronic sinusitis. Sinus surgery is used to treat blocked sinus passages, as opposed to turbinate reduction surgery, which is used to reduce the size of the bony structure inside the nose known as turbinates.

There are currently three major types of sinus surgery.

• Functional endoscopic sinus surgery (FESS): FESS is the most common type of sinus surgery. This type of surgery are being done through the endoscope, using them to locate the location of the blockade in the sinus, and then the tools will be inserted to widen the passage or to remove the tissue, bone, or polyps that cause the blockade.
• Balloon sinuplasty: Balloon sinuplasty also uses the endoscope to locate the blockade in the sinus. Thus, the catheter is later inserted to guide a balloon into the desired position, and then the balloon is inflated to increase the passageway to your sinuses in the same way as a stent being used in angioplasty.
• Caldwell-Luc surgery: Caldwell-duc surgery is the surgery to cut open the anterior wall of the maxilla bone and made two separate openings to the maxillary sinus, one to gain access to the antrum and the other to the naso-antral wall for drainage. Caldwell-Luc operation is currently reserved for selected patients with extensive maxillary disease, particularly those with massive polyposis or fungal disease.

Sinus surgery will be recommended only in patients who have failed to respond to medication or who have structural abnormalities in their sinus passages. Despite the possibility of complications such as tearing eyes, numbness, or empty nose syndrome, sinus surgery is highly effective in the treatment of sinus problems, with many patients experiencing relief within weeks of surgery.

What to expect when receiving sinus surgery?

If you are an eligible candidate for the surgery, your doctor may prescribe antibiotics or anti-inflammatories. Doctors would also require you to stop smoking at least three weeks before your surgery, refrain from taking aspirin for at least seven days before your surgery, and refrain from eating or drinking after midnight on the day of your surgery.

On the day of the procedure, the doctor is going to put a decongestant and a local anesthetic or numbing solution into your nose. Then, through your nose, an endoscope will be inserted, followed by surgical tools for FESS or a catheter for balloon sinuplasty to help clear the blockage in your sinus passageway. When the procedure is completed, the instruments and endoscope are removed, and your nose is packed with gauze to absorb any blood or discharge. 

Meanwhile, the procedure for the Caldwell-Luc surgery begins with general anesthesia. Then, to access the wall of your maxillary sinus, surgeons will make an incision in your gum between your upper lip and gum tissue. The surgeon will then make a small hole in your sinus wall to remove any damaged or diseased bone or tissue and expand the maxillary sinus opening. When the procedure is complete, the stitches are used to close the gum incision.

Patients must rest in a recovery room until the anesthesia wears off, which can take up to a day. Doctors may prescribe pain relievers and antibiotics to help patients recover from surgery. For a week, patients must wear gauze under their noses and sleep with their heads elevated. Patients may also experience mild to moderate pain and a crusty or stuffy nose for up to a week. 

Sinus surgery at Phyathai 1 International

Our highly experienced otolaryngologists at the Ear, Nose, and Throat Center of Phyathai 1 International are frequently dealt with various types of sinusitis and ready to provide you with a wide variety of treatments including advanced medications and sinus surgery using minimally-invasive procedures which are highly effective while requires only a single day of recovery.

If you currently experience with sinusitis, we recommend consulting with our specialist at the Ear, Nose, and Throat Center of Phyathai 1 International, which opens from Monday to Saturday from 8.30 am to 7 pm. To ensure the fastest procedure time, We recommend taking a reservation by phone at number (+66)2-201-4600 ext.2365-67 or by E-mail at [email protected].