Endoscopic Sinus Surgery

Sinus surgery has truly evolved over the years. Sinus surgery was once performed through external incisions on the face and in the mouth. With recent advances in technology, including the nasal endoscope, sinus surgery is now commonly performed entirely through the nose, without face or mouth incisions. The nasal endoscope is a small, lighted metal telescope placed into the nostril. The endoscope allows the surgeon to see inside the nose and sinuses, and work within these areas.

The most common reason for doing endoscopic sinus surgery is “chronic rhinosinusitis”, or more commonly “chronic sinusitis”. Chronic rhinosinusitis is a general term for inflammation (swelling) of the nose and sinuses. Chronic means that the inflammation remains in the nose and sinuses and does not go away over time (usually for at least 3 months). Infection, nasal polyps (non-cancerous swelling of the nasal/sinus lining), allergies or irritants, and other things may cause this inflammation of the nose and sinuses. Often, we do not know exactly why patients have chronic rhinosinusitis or chronic sinusitis.

Less common reasons to have sinus surgery may include: recurrent infections (meaning the infections go away with medicines but return very quickly), sinus infections that spread to the eye, face or brain, nasal polyps, impaired sense of smell, tumours of the nasal and sinus cavities (cancerous or non-cancerous growths), leaking brain fluid into the nose, tear duct blockage, and others. Additionally, recent advances in endoscopic sinus surgery allow your sinus surgeon to reach areas of the brain and pituitary gland for neurosurgeons, or to the orbits (eye sockets) for certain ophthalmology procedures. 

Endoscopic Sinus Surgery: Goals of the Procedure
Endoscopic sinus surgery is designed to improve the drainage of the sinuses and to improve airflow through the nose. This procedure opens the natural drainage pathways of the sinuses to restore their function and health. In chronic sinusitis, the sinuses are unable to drain adequately due to inflammation. As a result, nasal secretions can become trapped in the sinuses and become chronically infected. The goal of surgery is to carefully remove the thin, delicate bone and mucous membranes that block the drainage pathways of the sinuses.  Fungus may grow within the sinus forming large concretions and very thick gel like material. Removal of this material from the sinus is vital to the treatment of fungal sinusitis.
Endoscopic sinus surgery goals include:
Reduction of the number and severity of sinus infections
Improvement in symptoms associated with sinusitis
Improvement of airflow through the nose
Improvement in a patient’s sense of smell