Endoscopic Sinus Surgery in NYC

Sinus infections are among the most common health conditions in the United States, affecting millions of Americans each year. The paranasal sinuses are four pairs of air-filled cavities in the skull, all connected to the nasal passage and lined by a thin respiratory membrane called the mucosa. When infections, allergies, or autoimmune conditions cause this lining to become inflamed, the result is sinusitis — and when sinusitis becomes chronic or recurrent and does not respond to medication, sinus and breathing enhancement surgery can provide lasting relief by addressing the underlying obstruction directly.

When chronic sinusitis resists medication — particularly when nasal polyps have formed — endoscopic sinus surgery addresses the disease directly, removing the obstruction and restoring normal sinus drainage and ventilation. Dr. Maurice Khosh’s three decades of sinus surgery include extensive experience with both primary and revision endoscopic sinus procedures, including the most complex cases requiring intraoperative CT guidance. A founding member of the New York Head and Neck Institute and board-certified by the American Board of Otolaryngology–Head and Neck Surgery in addition to the American Board of Facial Plastic and Reconstructive Surgery, Dr. Khosh is a Fellow of the American College of Surgeons (FACS). He has been recognized as a perennial Castle Connolly Top Doctor and a Best Doctors in America honoree.

Understanding the Sinuses and Sinusitis

The sinuses play an important role in normal nasal function:

• Four Pairs of Sinuses: The frontal (forehead), maxillary (cheeks), ethmoid (between the eyes), and sphenoid (deep behind the nose) sinus pairs
• Mucosal Lining: A thin respiratory membrane lines the sinus walls and produces mucus that drains through small openings into the nasal passage
• How Sinusitis Develops: When the mucosal lining becomes inflamed — from infection, allergies, or autoimmune conditions — the sinus openings can become blocked, trapping mucus and creating an environment for infection
• Polyp Formation: Chronic inflammation can lead to the formation of nasal polyps, soft growths that further block sinus drainage and worsen symptoms

Types of Sinus Infections

Sinus infections are categorized by how long they last:

• Acute Sinusitis: Lasting less than 4 weeks, typically following a cold or upper respiratory infection
• Sub-Acute Sinusitis: Lasting 4 to 8 weeks
• Chronic Sinusitis: Lasting more than 8 weeks, often involving membrane thickening and sometimes polyp formation
• Recurrent Acute Sinusitis: Three or more episodes per year, each lasting less than 2 weeks

Understanding which category applies helps determine the right treatment approach — from medication to surgery.

When Sinus Surgery Becomes Necessary

Not all sinusitis requires surgery. The treatment approach depends on the severity and the response to conservative measures:

• Medication First: In chronic sinusitis with minimal membrane thickening and minimal polyp formation, patients often respond to a prolonged course of antibiotics combined with a short course of oral steroids
• When Surgery Is Indicated: When large polyps have formed, or when a patient does not respond to appropriate medical therapy, endoscopic sinus surgery can provide definitive relief
• Recurrent Acute Sinusitis: Sinus surgery can also help patients with chronic recurrent acute sinusitis who experience repeated infections despite medical management
• Individualized Decision: The decision to proceed with surgery is made after a thorough evaluation, often including imaging, and a discussion of the expected benefits

How Endoscopic Sinus Surgery Works

Endoscopic sinus surgery is performed entirely through the nostrils, with no external incisions:

• Endoscopic Visualization: A thin endoscope with a camera provides a magnified, illuminated view of the sinus passages on a video monitor
• Precision Instruments: Small specialized instruments are passed through the nose to remove obstructing tissue, polyps, and diseased mucosa
• Restoring Drainage: The goal is to open the natural sinus drainage pathways and restore normal ventilation and drainage
• Septal Correction When Needed: Correction of a deviated septum may be performed during the same procedure to gain access to the posterior sinuses and relieve nasal blockage
• Outpatient Procedure: Endoscopic sinus surgery is performed as an outpatient operation, with patients returning home the same day

“Endoscopic sinus surgery has transformed the treatment of chronic sinusitis. We can now address the disease directly through the nose — removing polyps, opening blocked drainage pathways, and restoring normal sinus function — without any external incisions. For patients who have struggled with chronic infections, facial pressure, and the cycle of antibiotics that never quite solves the problem, the relief from a well-performed sinus surgery can genuinely change their quality of life.” — Dr. Maurice Khosh

Revision Sinus Surgery and CT Guidance

For patients who have had previous sinus surgery that did not fully resolve their symptoms, revision sinus surgery requires particular care:

• Altered Anatomy: Previous surgery and scar tissue change the normal anatomical landmarks, making revision surgery more technically demanding
• Intraoperative CT Guidance: For revision operations, Dr. Khosh uses intraoperative CT guidance — image-guided navigation that increases both the safety and effectiveness of the surgery
• Enhanced Precision: CT guidance allows precise localization of structures near critical areas, including the eye and the base of the skull
• Complex Case Capability: This technology makes it possible to safely address the most complex revision sinus cases

Endoscopic Sinus Surgery vs. Balloon Sinuplasty

For some patients, balloon sinuplasty offers a less invasive alternative to traditional endoscopic sinus surgery:

• Balloon Sinuplasty: A less invasive technique that widens sinus openings without removing tissue; for appropriate cases, it can be performed in the office under local anesthesia with a shorter recovery
• Endoscopic Sinus Surgery: More comprehensive; removes polyps and diseased tissue, and is necessary for patients with significant polyps, extensive disease, or anatomical complexity
• Choosing the Right Procedure: The decision depends on the extent of disease, the presence of polyps, and the specific anatomy — an honest assessment of which procedure will resolve the problem is part of the consultation
• Combination Approaches: In some cases, the two techniques are combined for comprehensive treatment

Recovery After Endoscopic Sinus Surgery

Recovery from endoscopic sinus surgery is generally well-tolerated:

• Outpatient Procedure: Patients return home the same day
• Mild to Moderate Discomfort: Most patients experience mild to moderate discomfort for approximately three days
• Minor Bleeding: Scant oozing of blood is normal for about two days following surgery
• Nasal Congestion: Some congestion and drainage during the initial healing period
• Follow-Up Care: Postoperative cleaning and follow-up visits help ensure optimal healing and the best long-term result

Why Choose Dr. Khosh for Endoscopic Sinus Surgery

• Founding Member of the New York Head and Neck Institute: Leadership credential reflecting deep expertise in head and neck surgery, including the sinuses
• Otolaryngology Board Certification: Board certification specifically in the specialty most directly concerned with sinus disorders
• Three Decades of Sinus Surgery: Refined experience across primary and revision endoscopic procedures
• Intraoperative CT Guidance Capability: Image-guided navigation for the safest and most effective revision sinus surgery
• Honest Procedure Selection: Realistic assessment of whether endoscopic surgery, balloon sinuplasty, or a combination is the right approach
• Dual Board Certification: Combined facial plastic and head and neck surgery expertise
• Park Avenue Convenience: Private Upper East Side practice serving patients from across Manhattan and the tri-state area

Schedule an Endoscopic Sinus Surgery Consultation in NYC

If you suffer from chronic or recurrent sinusitis that has not responded to medication, endoscopic sinus surgery may offer the lasting relief you have been seeking. Contact our office today to schedule a consultation or for more information about this procedure, or call (212) 339-9988.