Endoscopic Sinus Surgery

The para-nasal sinuses are four pairs of cavities in the skull that are connected to the nasal passage. A thin respiratory lining known as mucosa covers the sinus walls. Infections, allergies and autoimmune problems can lead to inflammation of the sinuses. Sinus infections are one of the most common maladies in the US, affecting 40 million Americans each year. Sinus infections can be categorized into: acute (lasting less than 4 weeks), sub-acute (lasting 4 to 8 weeks), chronic (lasting more than 8 weeks) and recurrent acute (greater than three or more episodes a year, each lasting less than 2 weeks).

In chronic sinus infections, when membrane thickening and polyp formation is minimal, patients may respond to a prolonged course of antibiotics combines with a short course of steroid tablets. However, when large polyps have formed, or when a patient fails to respond to medical therapy, sinus and breathing enhancement surgery can be curative. Sinus surgery can also alleviate chronic recurrent acute sinusitis.

Sinusitis Treatment or Sinusitis Surgery

Dr. Khosh is an expert in performing sinus surgery. Sinus surgery is performed with endoscopic cameras and small instruments that fit through the nose. During endoscopic sinus surgery, correction of a deviated septum may be necessary to gain access to the posterior part of the nose and relieve nasal blockage. In revision sinus operations, Dr. Khosh uses intra-operative CT guidance to increase the safety and effectiveness of the surgery. Sinus surgery is an outpatient operation. Patients should expect mild to moderate pain for about three days, and scant oozing of blood for two days.

More recently, a new technique, balloon dilatation sinuplasty has become an accepted sinusitis treatment choice. Balloon dilatation sinus surgery is a less invasive method of treating sinus obstruction. In appropriate cases, balloon dilatation sinus surgery can be performed under local anesthesia, as an office procedure. The recovery from balloon dilatation sinus surgery is less prolonged than endoscopic sinus surgery.

Contact our office today to schedule a consultation or for more inforamtion about this type of procedure. You'll be glad you did!

Frequently Asked Questions About Sinus Surgery

Do you pack the nose after sinus surgery?
Dr. Khosh does not use nasal packing after sinus surgery. Nasal packing is uncomfortable and its removal can be painful.

What do you use to stop bleeding after sinus surgery?
In most instances, a well-executed sinus operation does not cause significant nose bleeding. When bleeding is notable, I use specialized gels or pastes that promote blood coagulation.

How is balloon dilation sinus surgery performed?
In balloon sinus surgery small catheters are threaded into the narrowed sinus passage. A balloon, situated at the tip of the catheter, is then inflated. The balloon expansion causes widening of the obstructed sinus passage. This is similar to how angioplasty helps to open a narrowed artery in the heart.

Do allergies cause sinus and nasal polyps?
Allergies are a common contributor to sinus polyp formation. In patients who suffer from chronic sinus infections, allergy evaluation is important.

I suffer from asthma and chronic sinusitis. Can sinus surgery help my asthma?
Studies have shown that in patients who suffer from asthma and chronic sinusitis, sinus surgery can lead to improved control of the asthma.

In sinus surgery, are all sinuses always opened?
No. Sinus surgery is designed to open only the sinus cavities with obstructed drainage pathways. In most individuals with chronic sinusitis, the ethmoid and maxillary sinuses are involved. Less commonly, the sphenoid and frontal sinuses reveal obstruction. Typically, sinus obstruction is bilateral in nature.

Are sinus polyps always benign?
In greater than 95% of cases, sinus polyps are benign. When sinus obstruction is unilateral in nature, or when CT scan shows bone destruction, malignancy should be considered.