RHINOPLASTY AND ENT SURGEON | CAPE TOWN

SINONASAL SURGERY

Sinusitis is the second most frequent infection in the body after the common cold. There are a number of reasons for this, but certainly the complexity of the anatomy and function of the sinuses play a big part. All sinuses require adequate ventilation to prevent infection and inflammation.

Our western lifestyle unfortunately adds to the problem as we have become sedentary in both our working environment and in how we spend our leisure time.

We all know that our bodies require us to exercise. This is important for our musculoskeletal system so it can stay healthy and we can decongest our nose and sinuses so that fresh air can enter through the very small orifices into the cavities.

A sinus infection occurs when there is an inflammation or swelling in the sinuses – hollow spaces in your skull that are connected to each other. The swelling can prevent the flow of mucus which can lead to pain around your face and eyes. The philosophy on the management of chronic sinusitis is to treat the condition medically, and if this is unsuccessful, as a last resort, to consider sinonasal surgery.

The history of a patient with sinusitis presents a key component of the preoperative evaluation. Before one considers sinonasal surgery, a thorough diagnostic examination will be undertaken. The development of diagnostic tools such as the fiberoptic endoscope and CT scanning has greatly improved the treatment of sinus disease. The specific features that will be observed and evaluated will include the middle turbinate and the middle meatus, any anatomical obstruction, and the presence of pus and nasal polyps. CT scanning is also used to identify the disease.

Patients can also expect to be informed about how to live a healthier lifestyle and how to sensibly use medication based on the clinical findings at the time of the assessment.

Sinonasal surgery is a minimally invasive surgical procedure that opens up sinus air cells and sinus ostia (openings) with an endoscope. The purpose of sinus surgery is to restore normal drainage of the sinuses. Normal functioning of the sinuses requires ventilation through the ostia (mouth-like opening) and is facilitated by a mucociliary transport process that maintains a constant flow of mucus out of the sinuses. The greatest symptom reduction is seen with primary surgery for patients with extensive nasal polyposis.

Surgical management of sinusitis has come a long way in the last 20 years, and is no longer the legendary painful, bloody procedure of yore.Sinonasal surgery is generally safe and effective.

Typically you will be admitted on the day of your surgery, and can expect to stay overnight. A sinus operation takes place through the nostrils, without any cuts and rarely some bruising around the eyes. No packing is used in the nose postoperatively.

The postoperative pain is minimal and usually controlled with codeine and an anti-inflammatory. You will be asked to flush your nose continuously for at least one week after the operation. We also advice that the patient takes a week off work.