Sinus Surgery

When medications such as antibiotics, decongestants, nasal steroid sprays, and antihistamines are not enough to manage recurrent or chronic sinus infections, surgery may be recommended to improve sinus drainage and overall function.

Modern sinus surgery is far less invasive than procedures performed in the early 20th century. Today’s techniques minimize discomfort, allow for quicker recovery, and leave no visible scars.

Preparing for Surgery

Before any procedure, a thorough clinical history and diagnostic workup are completed. This may include:

  • CT scan of the sinuses (without contrast)

  • Nasal physiology testing (rhinomanometry and nasal cytology)

  • Smell testing

  • Selected blood tests

Note: Traditional sinus X-rays are of limited use for diagnosing acute sinusitis and are not recommended for chronic sinus evaluation.

Surgical Options

1. Functional Endoscopic Sinus Surgery (FESS)

  • A thin fiber-optic endoscope is inserted through the nose for direct visualization of sinus openings.

  • Obstructive or diseased tissue is removed while preserving healthy tissue.

  • Most procedures are outpatient, with minimal swelling and discomfort.

  • Postoperative care may include nasal packing and saline irrigation to prevent crusting.

2. Image-Guided Surgery

  • Recommended for severe sinusitis, unusual anatomy, or revision surgeries.

  • Uses CT scans combined with real-time navigation to guide instruments safely through complex sinus passages.

  • Enhances precision and reduces risk near critical areas like the eyes, brain, and major arteries.

3. Caldwell-Luc Operation

  • Designed for chronic maxillary sinus issues or when a sinus malignancy is present.

  • Accesses the maxillary sinus through the upper jaw to create a drainage pathway to the nose.

  • Named after George Caldwell and Henry Luc, this operation improves sinus drainage in select cases.