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Acute sinusitis is usually treated with medications or flushing before sinus surgery is considered. The ENT physician may find that the recurrent infections are not as responsive to treatments after some time. In these cases, surgery to enlarge the nasal passageways and drain the sinuses is considered.
Before sinus surgery options are considered, the ENT physician will first ask a series of questions about clinical history. Then, a diagnostic workup will be undertaken to determine the underlying cause of the sinusitis before considering sinus surgery. Some tests include CT imaging, nasal physiology, smell testing, and blood analysis.
We currently use FESS in sinus surgery. This includes functional endoscopic sinus surgery and image-guided surgery.
FUNCTIONAL ENDOSCOPIC SINUS SURGERY (FESS)
Sinus surgery was first developed in the 1950’s, where an endoscope (a very thin fiberoptic tube) was entered into the passageways to clear the mucus from the major sinuses. Functional endoscopic sinus surgery has improved over the last several decades. It involves getting direct visualization of the sinuses by inserting an endoscope through the nose. Using state-of-the-art tools and instruments, diseased tissues and obstructions are removed. There is very little swelling after this procedure, and only mild discomfort. No external scars are obtained because this sinus surgery is performed exclusively through the nostrils. It is less extensive than other procedures and it can be performed on an outpatient basis.
There are always areas of concern when it comes to inserting an endoscope into the sinuses because they are close to the eyes, brain, and major arteries. Image-guided sinus surgery eliminates those concerns with the use of new technology. This surgery is most often recommended when the individual has severe chronic sinusitis, has had previous surgery that changed anatomical landmarks, or if the patient has congenital anatomical abnormalities in the sinuses. In this procedure, a CT scan is combined with real-time imaging to determine the location of the instruments using infrared signals. It is easier to navigate surgical instruments in this manner.