regarding endoscopic operations for
inflammatory sinus conditions

Introduction

The sinuses or paranasal sinuses are located in the facial skull and are connected to the nasal passages. A distinction is made between the anterior (frontal), mandibular (maxillary), ethmoid (ethmoidal) and sphenoidal (sphenoidal) sinuses. In the case of inflammatory conditions of the sinuses (sinusitis) it may be necessary to surgically treat one, several or all sinuses, the ethmoidal sinus usually plays a central role in this.  

The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, certain aspects of this document are not applicable in your individual case or should be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting).  

The purpose of the operation

The main goal of the surgery is to create a good connection between the sinuses and the nasal passages. For this purpose, certain bone or mucous membrane structures in the nasal or sinus cavities are removed, sometimes it is also necessary to remove polyps that have arisen as a result of the chronic inflammation. In most cases, your doctor will not decide on surgery until drug treatment proves insufficient to cure your sinusitis. Even after surgery, however, at least temporary treatment with medication is usually also required, and it is also not absolutely certain – even after surgery – that the sinusitis will be completely controlled. The technical aspects of the operation The operation is performed along the nostrils, whereby the surgeon uses optical instruments – possibly video equipment. So there is no need for an external incision in the face. To minimize blood loss and optimize visibility, the surgeon uses medication that is placed in the nose (Adrenaline, Nafazoline, Cocaine). The boundaries of the sinuses are formed by the cranial cavities and meninges, as well as by the eye sockets. At the end of the procedure it is usually not necessary to place a bandage in the nasal passages. An intravenous line will remain in the arm until you can and may drink normally again after surgery.

Immediate Effects

Nasal congestion, crusting in the nose, and loss of mucus and blood from the nose are normal. Eye tears or mild headaches are also possible. Additional or ongoing infection of the nose is possible. Each of these effects can be controlled or prevented with medication.

Late Effects

Healing after endoscopic sinus surgery is usually slow. Scabs and deformities are avoided by regular nasal rinses and topical care in the nose.  

Serious and/or exceptional complications

Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. A bruise in the eye socket may necessitate urgent reoperation. Loss of cerebrospinal fluid from the nose is a complication that usually results from variations in sinus anatomy and may also require reoperation. Finally, there is a very small risk of damage to the optic nerve resulting in blindness, damage to the muscles of the eye or the lacrimal ducts. Massive, life-threatening nosebleeds are very rare, if they occur they usually happen during or within the first 24 hours after surgery. The degree of difficulty of an endoscopic sinus surgery depends, among other things, on the severity of the sinusitis, on any previous sinus surgery and on the extent of surgery required, so that the risk is not the same in all cases. In addition, these risks must be weighed against the complications that can occur if the sinusitis is not treated or only treated with medication.

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