Endoscopic sinus surgery

What is sinusitis?

Your sinuses are air-filled spaces at the front of your skull, between your eyes and above your upper jaw, that are connected to the inside of your nose. Sinusitis is an infection of the mucous membrane that lines your sinuses. It causes symptoms of pain, a blocked nose, discharge, reduced sense of smell and the feeling of mucus at the back of your nose or throat.

The mucous membrane that lines your sinuses produces mucus, which helps to keep the air you breathe clean, warm and moist. If the opening between a sinus and the inside of your nose gets blocked, the mucus gets trapped and can become infected.

This can cause the mucous membrane to become inflamed, causing it to swell and form extra folds in your nose and sinuses. These are called polyps (small growths) and usually make the symptoms worse.

What are the benefits of surgery?

The aim is to widen the passage between the sinus and your nose so that mucus no longer becomes trapped. This should prevent the sinusitis from coming back but your sense of smell may not improve.

Are there any alternatives to surgery?

Antibiotics may help to clear the infection.

If your sinusitis is caused by an allergy, you may be able to prevent sinusitis by avoiding the ‘triggers’ of your allergy or by taking medication such as antihistamines or a nasal steroid spray.

If you use a nasal steroid spray for a long time, you can reduce the size of polyps, which may mean that you do not need surgery.

What does the operation involve?

The operation is usually performed under a general anaesthetic but a local anaesthetic can be used. The operation usually takes 1 to 2 hours.

Endoscopic sinus surgery is performed through your nostrils and does not result in any facial scars or change to the outside shape of your nose.

Your surgeon will use a small telescope (endoscope) to examine your nasal passages. They will use instruments to remove any polyps and to widen the passages from your sinuses into your nose.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Smoking stops your nose clearing mucus properly and this can increase the feeling of a blocked nose. People who continue to smoke after sinus surgery are more likely to need another operation.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some of these can be serious and can even cause death.

General complications of any operation

• bleeding
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• venous thromboembolism (VTE)
• chest infection

Specific complications of this operation

• adhesions, where scar tissue forms deep inside your nose
• leak of fluid from your brain
• damage to the orbit (the bone around your eye)
• double vision
• blindness
• toxic shock syndrome, which is an infection of your bloodstream
• damage to your tear duct
• reduced sense of smell

Consequences of this procedure

• pain

How soon will I recover?

You should be able to go home the same day.

If you had non-dissolvable packing in your nose, you will need to stay overnight and the packing will be removed the next morning.

Do not blow your nose for at least a week. Your nose will continue to feel blocked for a few weeks.

Your surgeon will give you a nasal spray or drops for you to use. You may be given a course of antibiotics to reduce the risk of infection.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery.