General Sinus Procedures

This video gives an overview of sinus procedures as well as what you can expect after a procedure. Patients who suffer from chronic sinusitis or recurring acute sinus infections will most likely benefit from some sinus procedure. The goals of all sinus procedures are the same — to improve ventilation, to improve the ability to deliver medications if you have chronic sinusitis, to manage, reduce, or eliminate the inflammation.

Video Transcription

Patients that suffer from chronic sinusitis, or recurring acute sinus infections, they usually are going to benefit from some sort of sinus procedure. 


The goals of sinus procedures are the same, regardless of the type of instrument that you use to perform the procedure. 


The goals are to:

Improve the ability of whatever sinus you’re treating to ventilate with the outside world. So improve ventilation.

The second goal is to improve the ability to deliver medications if you have chronic sinusitis. Because remember, if you have chronic sinusitis, that means you have inflammation that we need to medically manage with topical things, like topical steroids. So, if the medication can’t get to the area that’s inflamed, then you’re not going to be able to manage that area with topical medications. 

The third goal of a sinus procedure is to remove diseased tissue or infected debris. If you have a lot of sinus disease, which means you have a lot of inflammation at the point where maybe the sinus is so swollen, it’s completely full of inflamed tissue. We can’t just simply dilate a little area and expect all of this inflammation to go away. We actually have to go in there and get some of that out of there for you — de-bulk that disease. So in that case, it may direct the type of procedure you need. 


So, it’s how much sinus inflammation that you have, where it is, and the goals of the procedure are going to dictate which technique we use. 


The basic techniques are either going to be dilation techniques, which involve a ballon instrument like this, which only dilates pathways, or more conventional endoscopic sinus surgery techniques, that actually remove tissue. And by remove, I don’t want you to think that these things are like femurs of bone in your sinuses. These are eggshell thick partitions of bone that we remove, permanently remove, gone forever, to permanently open certain pathways. So they don’t grow back, you know, regrow.


Remember, sinus procedures are just one piece of a treatment algorithm that involves medication. So if you’re a patient that has a lot of sinus tissue inflammation, you have to remember that the procedure is only one step in the managing that inflammation. You have to do the medication portion; otherwise, you can open the sinuses all you want, but the lining that’s left behind is still going to be inflamed, and you’ll still suffer from sinus symptoms. 


After the procedure, that day, you’re going to ooze a little blood, I mean, it’s a procedure. The good news is I don’t put packing in, I don’t do splints. Actually, I don’t do packing or splints regardless of how much surgery I do, whether you have an office procedure or a hospital procedure, I just don’t find the need to put those things in patients’ sinuses because it makes you very uncomfortable. So because I don’t use packing, I don’t use gauze, you’re going to have some oozing for about a day. It will stop. And then the next day, you’re going to start rinsing your nose with the sinus irrigation water, which is just salt and water. And you’ll do that several times a day for about two weeks. At about two weeks, you’re going to be 80 to 90 percent healed. You heal very quickly from sinus procedures. 


The follow-up visits depend on the procedure. If I just do dilation alone, I see you about two weeks after the procedure. If we do something that involves a little more traditional work, then I’ll see you back at one week, and at two weeks, to make sure things are healing well. And the nice thing is, at six weeks, regardless of how you’ve had your procedure done, we do a nasal camera exam in the office. I take photos of your results, and I show you what your sinuses looked like before we did the procedure, and then I show you what they look like after the procedure.  


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