Sinus surgery has truly evolved over the past 30 years. Once performed through external incisions (surgical cuts on the face and in the mouth) that required extensive nasal packing (i.e. gauze or other material placed in the nose to control bleeding after surgery), traditional sinus surgery caused significant pain and discomfort, and was often followed by a long recovery period and even hospital stays.
With advances in technology introduced in the 1980s, including the nasal endoscope (small, lighted, metal telescope placed into the nostril), sinus surgery is now commonly performed minimally invasively. This means the procedure is done entirely through the nose, without face or mouth incisions. The endoscope allows the surgeon to see inside the nose and sinuses, usually with a special video camera attached and high definition monitor. Today, endoscopic sinus surgery is typically done with no nasal packing, mild pain, and shorter recovery times, on an outpatient basis under general (and sometimes local) anesthesia.
What to Expect
The goal of the surgery is to identify the narrow channels that connect the sinuses to the nose, enlarge these narrow openings/channels, and improve drainage from the sinuses into the nose. During endoscopic sinus surgery, your ENT surgeon inserts a small telescope (nasal endoscope) through the nostril to view your nose and sinuses.
In chronic sinusitis with polyps, your surgeon also removes all the obstructive polyps, and provides wide-open sinus cavities. You may then require daily long-term nasal irrigations (saline with or without medications) to wash away and control the production of inflammatory chemicals your body produces which cause chronic inflammation. Therefore, surgery is designed to facilitate long-term medical care of your sinuses. It is very individualized depending on the extent of disease and underlying causes of the chronic inflammation.
Sinusitis may affect some or all your sinuses. Your symptoms, examination in the physician’s office, and CT scan will determine which sinuses need to be opened and to what extent.
Endoscopic sinus surgery may be done under local or general anesthesia. Sometimes your surgeon will also straighten the nasal septum (divides the two sides of the nose) during surgery, if it contributes to your nasal congestion or obstructs adequate visualization of your sinuses during sinus surgery. The turbinates, which filter and moisten air inside of the nose, may also require surgery, for the same reasons.
Who is a Candidate?
Your ENT specialist may recommend endoscopic sinus surgery to treat or help manage the symptoms of the following conditions:
- Cerebrospinal fluid (CSF) leaking into the nose
- Chronic sinusitis
- Impaired sense of smell
- Nasal congestion or obstruction
- Nasal polyps
- Recurrent sinus infections
- Sinus infections that spread to the eye, face, or brain
- Tear duct blockage
- Tumors of the nasal and sinus cavities
Additionally, recent advances in endoscopic sinus surgery allow your sinus surgeon to reach areas of the brain and pituitary gland to assist neurosurgeons in performing minimally invasive procedures for tumors which would have required a craniotomy in the past. It also allows transnasal (through the nose) approaches to the orbit (eye socket) to assist ophthalmologists in removing certain tumors only accessible through external orbital approaches and facial incisions.
Each individual case is different. Your sinus surgeon will determine if endoscopic sinus surgery is the best choice for your nasal/sinus problem and will consult other members of the rhinology and endoscopic skull base team (such as neurosurgery, ophthalmology, or radiation oncology) as needed.
Why Choose UHealth?
Ranked in the nation’s top tier by U.S. News & World Report. The ranking reflects the team’s dedication to excellence in research patient care and outcomes. Surgeons, audiologists, biomedical engineers, speech pathologists, researchers, and psychologists collaborate with many research programs at the University of Miami Miller School of Medicine to deliver the best possible multidisciplinary care to pediatric and adult ear, nose, and throat patients.
Highly specialized rhinology doctors. The experts at University of Miami Health are here to help you breathe easier, smell better, and rest better with an accurate diagnosis and leading edge treatments,in a compassionate setting. Our fellowship-trained providers specialize in the nasal airway, and our rhinology specialists have completed specialized training in nasal and sinus disorders. They have dedicated their clinical and research careers to caring for nasal and sinus disorders.
Our academic health center provides you with more treatment options. Our ENT specialists are experts in the field of rhinology. As part of an academic health center, we are proud to offer breakthrough treatments not available to other facilities in South Florida. We also offer our patients early access to clinical trials and new medical and procedural treatments. We provide comprehensive care for a wide array of rhinologic conditions, backed by expertise, research, and education.
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