Acute sinusitis is an infection that can be treated with conservative methods that depend on the cause. When sinusitis becomes chronic, or recurring, these measures aren’t always enough to bring relief. In these cases, ENTs consider several surgical options. Here, our ENT specialists explain chronic sinusitis and the surgeries that can help bring relief.

What Is Chronic Sinusitis?

Sinuses are hollow areas of the skull around the nose and eyes. Sinusitis is inflammation in the sinuses. Acute sinusitis is often caused by a viral infection. When inflammation and symptoms last for several weeks, it is considered chronic sinusitis.

Chronic sinusitis can be caused by several factors, including infection, inflammation, and structural issues. Symptoms of chronic sinusitis include congestion, pain or pressure in the face or head or around the eyes, nasal drainage, and loss of smell.

When to See an ENT for Chronic Sinusitis Surgery

Acute sinusitis typically lasts seven to ten days. If symptoms persist for weeks, you might have chronic sinusitis. You can always see an ENT for evaluation and treatment options. Many patients benefit from conservative treatments, like saline irrigation and nasal steroid spray.

When is sinus surgery necessary? When these more conservative alternatives to sinus surgery are not enough and don’t provide adequate relief, it’s time to think about surgical procedures.

Types of Sinus Surgery

Our ENTs offer patients a few different types of procedures to reduce inflammation and resolve uncomfortable symptoms like congestion. Before offering surgery, the specialist will evaluate you to determine if you are a good candidate for a procedure and, if so, which one.

ENTs evaluate patients by inserting an endoscope into the nose. This is a thin tube with a camera that allows them to see the nasal passage and sinuses. Some patients may need a CT scan or MRI for a better look at polyps or a deviated septum.

FESS Sinus Procedure

FESS, or functional endoscopic sinus surgery, is the most commonly used procedure for chronic sinusitis and is a minimally invasive sinus surgery. Most patients who have not responded well to conservative management and have ongoing symptoms are candidates for this simple, outpatient procedure.

To do it, surgeons will apply a nasal decongestant and a numbing solution. They then insert an endoscope and surgical tools into the nose. They remove bone, polyps, and any tissue that is blocking the sinuses. They may also use a rotating tool called a burr to scrape tissue away.

Balloon Sinuplasty

In balloon sinuplasty, surgeons use an endoscope to insert a balloon. They then gently inflate the balloon to widen the sinus openings. Balloon sinuplasty is generally safe and often has a faster recovery time and causes less pain than FESS.

Because balloon sinuplasty doesn’t involve removing any tissue, it’s not right for all patients. For example, if you have nasal polyps that need to be removed, you’ll need a different procedure.

Septoplasty

Septoplasty corrects a deviation in the septum, the narrow tissue between the two sides of the nasal cavity. This procedure can be useful for anyone whose deviated septum contributes to chronic sinusitis and related symptoms.

For septoplasty, patients typically receive general anesthesia. The surgeon makes a small incision on the side of the nose to reshape the septum.

Turbinectomy

Turbinates are small, bony structures inside the nose that, when grown too large, can contribute to the symptoms of chronic sinusitis. Surgeons performing endoscopic sinus surgery or septoplasty might also perform a turbinectomy by radiofrequency ablation. They use a small tool to deliver energy to the turbinates, causing them to shrink in size. This is a simple outpatient procedure when done on its own.

Functional Rhinoplasty

Rhinoplasty is surgery that changes the structure, shape, and appearance of the nose. While it is often done for cosmetic reasons, rhinoplasty can also be functional. If the structure of the nose is contributing to chronic sinusitis, your ENT might recommend this procedure.

Patients typically receive general anesthesia for a rhinoplasty, although it is still usually an outpatient procedure. The surgeon makes a small incision on the side of the nose or inside the nostrils to manipulate and shape bones and cartilage to improve function.

Sinus Surgery Recovery

Recovery from sinus surgery depends on the procedure type and any complicating factors. Recovery from FESS can take a few months, but you should be able to return to most normal activities within a week or two. You’ll be directed to avoid certain things, like blowing your nose or strenuous activity for a period of time. Your surgeon will give you nasal rinses and appropriate medications.

Recovery from balloon sinuplasty is usually faster. The same restrictions often apply but for less time. Follow your surgeon’s instructions for recovery and follow-ups.

Full recovery and healing from rhinoplasty or septoplasty can take several months. Rhinoplasty usually has the longest recovery time. You can expect to experience swelling for a few months. The details of the recovery period vary a lot by patient, so follow up with your surgeon and follow all instructions.

Consult an ENT for Chronic Sinusitis

Ready to discuss your options? Sinus surgery success rates are high, but it’s not the right choice for every patient. Schedule a consultation with one of our ENT surgeons for an evaluation.