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.

Unfortunately, our western lifestyle 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 to stay healthy and 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 mucus' flow, 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, sinonasal surgery may be indicated as a last resort. The most common sinusitis symptoms include nasal discharge or stuffy nose, halitosis (bad breath) and facial pressure.

The history of a patient with sinusitis presents a key component of the preoperative evaluation. Before sinonasal surgery is considered, Dr. Vanlierde will conduct a thorough diagnostic examination. The development of diagnostic tools such as the fiberoptic endoscope and CT scanning has greatly improved the treatment of sinus problems. The ENT surgeon will observe and evaluate specific features, including 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 and diagnose sinus and nasal issues.

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.

Procedure

Sinonasal surgery is a minimally invasive surgical procedure which involves an ENT surgeon opening up the 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 mucus flow out of the sinuses. The greatest symptom reduction is seen with primary sinonasal 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 yore procedure. 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.

Recovery

The post-operative 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 advise that the patient takes a week off work. Follow up appointments will be scheduled with Dr. Vanlierde for endoscopic examinations and cleaning.