During endoscopic sinus surgery, the surgeon looks directly into your nose and sinuses through a narrow tube called an endoscope. During an endoscopy procedure, the scope may be attached to a camera, and the surgeon can open nasal and sinus passages, as well as remove any diseased tissue through the scope. Mary Szczygiel, of Southbridge Mass., had chronic sinusitis for most of her life. At age 65, she decided to undergo sinus surgery to improve sinus drainage, remove diseased sinus tissue, and open up her nasal passages. " I finally feel like my suffering with sinusitis is over,” says Szczygiel, “Sinus surgery has given me my life back." What Happens After Sinus Surgery? “After sinus surgery, you should expect sinus congestion, mild sinus headaches, and perhaps a small amount of nasal oozing of blood, but this is usually not a significant problem. You should expect to take one to two weeks off from work depending on the physical nature of your job,” says Mark A. Zacharek, MD, residency program director for the department of otolaryngology and head and neck surgery at Henry Ford Hospital in Detroit. Sinus surgery is one that can be done under general or local anesthesia, and usually patients are fine to go home the same day. “In most cases, [nasal] packing is not needed, or absorbable packing can be used so you do not need to come back for packing removal after surgery. Sinus pain is not usually severe," says Martin Citardi, MD, chairman of the department of otolaryngology and head and neck surgery at the University of Texas Medical School in Houston. It can take several months for your sinuses to fully recover after sinus surgery. “I did not have much sinus pain at all,” Szczygiel recalls, “but it did take a long time to experience the complete results of the surgery. In my case, it took about one year before I really started to appreciate how much better I felt.” Possible Complications and Risks of Sinus Surgery “Most complications after surgery are related to issues of bleeding, infection, and anesthesia risk,” says Dr. Zacharek. “Bleeding that requires urgent return to the operating room is rare but can happen.” If bleeding is active during surgery, it can be controlled with nasal packing. “Infection of the sinuses after the surgery may happen and can be treated effectively with appropriately chosen antibiotics,” says Zacharek. “Anesthesia risks are associated with cardiac arrest, stroke, and death. Though these are rare, proper medical clearance and evaluation by a cardiologist prior to sinus surgery is necessary if you have a history of cardiac disease, diabetes, hypertension, or hyperlipidemia,” says Zacharek. There have also been reports of injuries to the eye and brain during sinus surgery, but they are very rare. Zacharek points out that the national quoted risk of these injuries is 1 percent. “More serious complications such as brain injury resulting in major hemorrhage or blindness are fortunately very rare when these surgeries are performed by someone experienced in these techniques," notes Zacharek. These rare risks are due to the physical proximity of the inner sinus cavities to the brain and the eyes. Some other possible complications include loss of smell and a change in voice quality. Change in voice may be noticed if the physical structure of the sinuses is significantly changed by the surgery, but this is not usually a problem unless you are a voice professional. Sense of smell is usually improved, but may be damaged in rare cases. How You’ll Improve During Sinus Surgery Recovery Dr. Citardi stresses that, after sinus surgery, post-operative care is as important as the surgery itself. During the first few weeks, you will frequently return to your doctor’s office to be examined with an endoscope, and you will have your nose and sinuses cleaned out. “The most important post-operative care issues for patients include close follow-up with the surgeon,” stresses Zacharek. “Additionally, sinus irrigation with sterile saline solution is important. You should also sleep with your head elevated for two to three days after surgery to allow for better nasal airflow. Avoid blowing your nose for a 7 to 10 day period and avoid heavy exercise or contact sports for three to four weeks to prevent bleeding.” “I would certainly urge anyone with chronic sinusitis to consider sinus surgery,” says Szczygiel. “Find a good, experienced surgeon that you can work with and remember to be patient. Learning how to do sinus irrigations and keeping my allergies under control was a big part of my recovery. Sinus surgery works, but keeping your sinuses healthy is an ongoing process.” Sinus surgery can be a very effective treatment for chronic sinusitis when medical treatments, including prolonged courses of antibiotics, have failed. Remember that complete recovery can take several months, and that good post-operative care after sinus surgery, including working closely with your surgeon, is as important as the procedure itself. Find more information in the Everyday Health Ear, Nose, and Throat Center.
