What is sinusitis?
Sinusitis is infection or
inflammation of the
mucous membranes that line the
sinus cavities . When a mucous membrane becomes inflamed, it swells. This can
block the normal drainage of fluid from the sinuses into the nose and throat.
Bacteria and fungi (plural of fungus) are more likely to grow and cause
infection in sinuses that can't drain properly.
often is the result of viral infection, typically a cold. Nasal allergies or
other conditions that block the nasal passages can also lead to
There are two types of sinusitis: acute (sudden) and
chronic (long-term). You may have chronic sinusitis if:
- You have had more than three sinus infections
in 1 year that needed antibiotics to clear up, OR
- You have had a sinus infection for more than 8
weeks that antibiotics have not cleared up.
Sinus surgery may be a good treatment for some people who
have chronic sinusitis.
What is sinus surgery?
The goal of sinus surgery
is to help the sinuses drain. To do this, a surgeon usually enlarges the
openings of the sinuses by removing:
- Infected, swollen, or damaged tissue.
- Bone, to create a wider opening for drainage of mucus from the
- Growths (polyps) inside the nose or sinuses.
There are two types of sinus surgery: endoscopic and
traditional. Endoscopic surgery is done most often.
- Endoscopic surgery may be done to remove small amounts
of bone or other material blocking the sinus openings or to remove nasal
growths (polyps). Normally, a thin, lighted tool called an endoscope is
inserted through the nose so the doctor can see and remove whatever is blocking
- Traditional surgery may be done when complications of
sinusitis-such as the development of pus in a sinus, infection of the facial
bones, or brain
abscess-have occurred. In this type of surgery, the
doctor makes an opening into the sinus from inside the mouth or through the
skin of the face.
If there is a problem with a structure inside the nose
(such as a
deviated septum ), this may be fixed during the same surgery. Surgery to repair
the septum is called septoplasty. For more information, see the topic
Repair of a Deviated Septum (Septoplasty).
After surgery, the doctor may prescribe:
- Antibiotics to help fight
- Steroid medicines to reduce
inflammation and improve healing.
- Pain medicine.
Regular doctor visits are needed for 2 to 6 weeks after
surgery to make sure the sinuses are healing well.
is always done by an ear, nose, and throat (ENT) specialist (also called an
Who needs surgery for sinusitis?
Very few people
need surgery to treat sinusitis. You may need surgery if you have been through
the following steps:
- You have been diagnosed with chronic
sinusitis by an ENT doctor.
- After being diagnosed, you have used
the maximum medical treatment for sinusitis. Maximum medical treatment includes at least 4 to 6 weeks of
steroid medicine, and other prescription medicines to
clear up the infection and reduce the swelling in your sinuses.
You have had a
CT scan of your sinuses after using the maximum
medical treatment as prescribed by your doctor. It is very important to have
the CT scan done after this treatment. By reducing
swelling and infection as much as possible, this treatment lets your doctor see
what could be causing the repeat infections.
You might need surgery if:
- The CT scan shows that something is keeping
the sinuses from draining properly.
- Your doctor suspects that you
have a sinus infection caused by a fungus. This may be the case if antibiotics
have not cleared up the infection. Antibiotics work for bacterial infections
but not for fungal infections.
- You have a serious problem from
sinusitis, such as the spread of the infection beyond the sinuses. This rarely
happens, and it would require more extensive surgery.
What are the benefits of sinus surgery?
- By helping the sinuses drain, sinus surgery
helps prevent sinus infections.
- Your sense of smell may
What are the risks of sinus surgery?
- Minor problems occur in a small number of
people who have sinus surgery. These include scar tissue attaching to nearby
tissue, bleeding or infection, a hole in the nasal septum, or bruising and
swelling around the eyes.
- Serious complications are rare but may
include heavy bleeding, injury to the eye area, inflammation of the membrane
that covers the brain (meningitis), leakage of the fluid that
surrounds the brain, or brain injury.
- Surgery may decrease your
sense of smell.
- The surgery may not work, so you might need a
If you need more information, see the topic