What are the Different Types of Sinus Surgeries?
Published Oct 3, 2021
Chronic sinus infections and conditions can be annoying, even debilitating to some extent. When home remedies, medications, and treatments fail to solve the problem, your doctor may recommend you have surgery.
Since sinus conditions come in different forms, the types of sinus surgeries can also vary. And if you really need surgery, your doctor will usually tell you which surgery is best for your condition.
But if you’re concerned (or curious) about what will happen during the surgery, we’ve listed down below the types of sinus surgeries and what you should know about them.
What is a Sinus Surgery?
As the name suggests, sinus surgeries are surgical procedures done to treat various sinus conditions.
If you’re not familiar with the term, sinuses are pairs of hollow cavities in your nasal area. They produce thin mucus that drains out into your nose. This drainage cleans your nose and helps keep it free from bacteria. But when the tissues lining these cavities get inflamed, the mucus will have a hard time draining out into your nasal channels. As a result, they build up and block your nasal channels making breathing difficult.
There are lots of reasons why your sinus lining can get inflamed. It could be because of allergies or an influx of bacteria. Some people are also born with deformed sinuses while others damage their sinus cavities in accidents. All of these can lead to various sinus conditions that may need surgery.
It should be noted, however, that sinus surgeries or, any type of surgeries and procedures for that matter, don’t come cheap. And some types of surgeries are not covered by insurance. Thus, the doctor will usually recommend surgery only as a last resort. If you think you haven’t yet exhausted all non-surgical alternatives, you should talk it out with your doctor.
Why Would You Need a Sinus Surgery?
Sinus infections usually clear out on their own without needing any treatments or surgeries. But if the infection has become chronic or your condition becomes so severe that it affects your daily life, surgeries may become necessary.
Some of the common sinus issues that usually require surgery are:
Chronic sinusitis
Bacteria, viruses, and fungi can cause inflammation in your sinus linings causing sinusitis. But if the sinusitis becomes chronic and no amount of medication works, the doctor will usually recommend surgery.
Nasal polyps
Nasal polyps are small, non-cancerous growths lining your nose and sinuses. Although they’re typically soft and painless, they can become irritated and swollen. When this happens, it can block your nasal passages which affect your breathing. Nasal polyps can also be treated with medication but if you want to get rid of these growths faster, surgery will help.
Nasal Structural Problems
As mentioned, many people have nasal deformities either since birth or as a result of an accident. These deformities like the deviated septum can reduce the openings in your sinus cavities causing breathing problems. Since these are structural problems, medications don’t usually work and, often, the only option is surgery.
Types of Sinus Surgeries
Sinus surgeries are performed by ear nose and throat (ENT) doctors. Depending on your condition, they may recommend one of these types of surgeries.
1. Septoplasty
Septoplasty is the surgical correction of obstructions and deformities in the nasal septum (the soft tissue that divides the nostrils). Our septum is made up of both bone and cartilage and is found in the middle of our noses. A deformed septum can block the nasal airways obstructing the airflow and even causing sleep apnea.
One of the most common conditions treatable by septoplasty is a deviated septum which, as mentioned, can either be cognitive or a result of trauma. When the septum along with the mucus membranes are moved to the right position, your nasal passages will be cleared of obstructions and your sinus drainage will return to normal.
Septoplasty is an outpatient procedure that will require general anesthesia. Like most surgical operations, it does not come risk-free with possible complications in the form of septal hematoma, infection, perforation, and bleeding.
2. Rhinoplasty
Most of us know rhinoplasty as a cosmetic procedure but it’s used to treat medical conditions too. Rhinoplasty is actually a type of nasal surgery that reshapes the structure of the nose. While some people use this operation as a chance to change their appearance, it may also be used to improve breathing and fix any nasal structural problems.
Since each of us has different nasal structures, your surgeon will develop a customized plan for you. Risks associated with this operation include bleeding, infection, or an adverse reaction to anesthesia. Rhinoplasties are usually not covered by insurance unless it’s used to treat a medical condition.
3. Balloon Sinuplasty
Balloon sinuplasty or balloon sinus surgery is the least invasive of all the surgeries on this list. It is a fairly straightforward procedure that an ENT surgeon can perform in their office under local anesthesia.
This operation involves the surgeon inserting a flexible balloon catheter into the nasal passage. Once it’s positioned correctly, the balloon is then inflated to expand the sinus cavity. This process creates microfractures in the bone, and the balloon must be kept in place while the bone reforms into its new shape. Additionally, doctors may also use a saline solution to flush out blocked mucus and pus, should there be an unwanted buildup.
After this operation, the sinuses should feel much freer and more comfortable. Recovery from balloon sinuplasty takes no more than two days, and patients have been documented to drive themselves immediately after the operation.
4. Turbinate Reduction
Nasal turbinates are the small structures within the nose that help cleanse and humidify the air that passes through the nasal passages and enters the lungs. Due to allergies, irritation, or infection, these structures can become inflamed and swollen. As a result, it obstructs the airflow and produces excessive mucus leading to congestion.
When this inflammation and swelling occurs, it will typically require turbinate reduction surgery. This will help reduce the swelling and size of the turbinates to improve breathing and sinus drainage.
The turbinate reduction surgery is performed using a needle-like instrument which is inserted into the turbinate and causes controlled damage. By the time the turbinates heal from this damage, they are significantly reduced, immediately allowing for improved airflow.
Turbinate reduction does not affect the nose’s size or structure, so you shouldn’t expect any long-term side effects from this operation.
5. Endoscopic Sinus Surgery
Not to be confused with endoscopic skull base surgery, endoscopic sinus surgery is a surgery performed to remove sinus blockages and improve sinus drainage. It is also one of the most common sinus surgeries today. Like balloon sinuplasty, this procedure uses an endoscope to view the sinuses and remove the affected tissues or bones simultaneously. Since it only uses minor incisions to remove polyps, tissue, and bone, most patients can go home right after the surgery.
However, the procedure requires a lengthy recovery period. You will need to perform at-home nasal flushes to remove dried blood and mucus for about ten days after the surgery.
6. Caldwell-Luc Surgery
This is a more invasive type of sinus surgery that is usually recommended when there are growths inside the sinus cavity.
The procedure starts with the surgeon making an incision inside the mouth in the upper jaw area. They then enter the sinus cavities from there to remove the growths within. This clears a pathway between the nose and the cavity below the eyes called the maxillary sinus which leads to improved breathing.
Unlike most sinus surgeries, recovery time for the Caldwell-Luc procedure can take several months.
What Happens Before a Sinus Surgery?
Prior to any nasal surgeries and procedures, your doctor will conduct a pre-operative screening to assess any surgery risks. You may be required to stop taking certain blood-thinning medications like Ibuprofen and aspirin as they can increase the risk of bleeding. This applies to certain herbal medicines and supplements too like Vitamin E, ginseng, ginkgo Biloba, and garlic tablets. If you’re taking certain medications or even supplements, better inform your doctor about it to avoid any possible complications.
In certain types of surgeries, you may also be forbidden to eat or drink anything past midnight on the day of your operation. This is important as the anesthesiologist can’t put you to sleep unless you have an empty stomach. Once they found out that you have had a meal or even a cup of water, they may have to cancel the operation.
If you’re a smoker, the doctor may also ask you to stop smoking at least 3 to 4 weeks before surgery. Smoking can slow down the healing process and increases the risk of infection. As such, it can severely affect the outcome of your surgery.
These pre-operative screenings are standard protocol for surgical procedures in most hospitals and may be done even if you seem to be healthy.
Post-Surgery Treatments
Most sinus surgery patients are allowed to go home on the day of the surgery. Though the recovery period may last up to three to four weeks.
To prevent infection, you will have to take antibiotics for a few days. Mild bleeding is also common a few days after your surgery, especially after sinus irrigation. When this happens, you can tilt your head back or dab your nose with a tissue. Avoid blowing your nose or go near things that may cause you to sneeze. If the bleeding worsens or persists for several days, you should tell your doctor immediately.
Since your nose is still healing from the surgery wound, it’s normal to feel slight pain or pressure in your nasal area. Your doctor will also prescribe a pain-reliever like Tylenol. As with the bleeding, if the pain persists or worsens, you should talk to your doctor.
Most patients also reported feeling very tired the first week after the surgery. That’s why, if possible, you should look into taking a break from work after your surgery to ensure a quick recovery.
After the surgical wounds have healed, you will be required a number of postoperative visits for further follow-up care.
Risks
Like most types of surgeries, sinus surgeries also come with risks such as:
Infection
Infection is always a risk in any surgery where there is an open wound. This is especially true for sinus surgeries that involve making incisions on the skin’s surface. Though with the advancement of medicine and the availability of penicillin, post-operative infections have become rare. Still, you should maintain good general hygiene and follow your doctor’s orders to lessen the risk of infection.
Bleeding
Bleeding and blood loss are always a given during surgical procedures. In some very rare cases, however, the bleeding may become so severe that the patient may need a blood transfusion.
Visual Problems
Since the sinuses are near your eyes, there’s always the possibility that the surgeon will accidentally hit one or more optic nerves during the surgery. This can lead to visual impairments like blurry or double visions which can either be temporary or permanent. Some patients may also experience swelling in the eye area and excessive tearing. Fortunately, these are very rare and some will resolve themselves without needing further treatment.
Cerebrospinal Fluid (CSF) Leak
This is a very possible yet very rare risk in sinus surgeries. The cerebrospinal fluid is a clear fluid that surrounds the brain and spinal cord. It acts as a cushion that protects the brain from banging against the skull and protects it from injury.
In sinus surgeries, the surgeon is working beneath the bones that separate the nose from the brain. As such, there’s always the possibility of a CSF leak especially when the surgery is done through the nose instead of making a skin incision.
A CSF leak can increase the risk of infections in surgeries and may even lead to meningitis. Though incidents like this are usually detected during the surgery and are promptly repaired.
Anesthesia Risks
Sinus surgeries are typically conducted under general anesthesia. Unfortunately, anesthesia can cause adverse reactions in some people such as:
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anaphylactic reaction
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temporary memory loss
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nausea and vomiting
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shivering and feeling cold
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bruising or soreness
In extreme cases, general anesthesia may even cause death. Though they are very rare – roughly one in every 100,000 to 200,000.
Alternatives to Sinus Surgeries
As mentioned, your doctor will only recommend sinus surgery when they see no other way of relieving your sinus symptoms. So before you go to a surgeon, try looking at these alternative sinus treatments first:
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nasal saline sprays
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allergy medications
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oral steroids
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antibiotics
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nasal decongestants
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probiotics
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over-the-counter pain relievers
If none of the above works and your doctor deems you really do need surgery, discuss your options first especially if the procedure won’t be covered by your insurance.
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About The Author
Judy Ponio is a professional writer based in the Philippines. Her commitment to communicating factual content in when writing is unmatched. She works hard to cross check reputable sources to ensure her work uses accurate facts.
