"ENDOSCOPIC SINUS SURGERY"

Endoscopic Sinus Surgery is the name given to operations used for severe or difficult to treat sinus problems. In the past sinus operations were done through cuts in the face and mouth but endoscopic sinus surgery allows the operation to be performed without the need for these cuts. These endoscopes give us a bright enlarged view of the inside of your nose and sinuses and allow us to use special instruments to remove disease and/or enlarge the drainage passage of your sinuses. Endoscopic sinus surgery is safer than other methods of operating on the sinuses. The other methods of operating on the sinuses involve cuts in the face or mouth.

Usually the operation is done with you asleep (General Anaesthetic) but it can also

Be done in some cases with just your nose anaesthetised (Local Anaesthetic). I will discuss this option if suitable in your case. The operation is all done inside your nose. I will use special telescopes and instruments to unblock your sinuses by removing small amounts of bone and swollen lining blocking your sinuses. Once the sinuses are unblocked, the inflammation usually settles and your problems should start to get better. There should be no need for cuts outside your nose unless the operation is a complicated one in which case I will discuss with you before the operation.

Immediately after the operation you may feel your nose is almost completely blocked. This may be because of some dressing inside your nose or some special plastic sheets called splints. These are not used in every case but I will explain if they have been necessary in your case. Dressings, if used, will usually be removed from your nose within 24hrs but plastic splints may have to stay longer.

It is common to have a stuffy blocked up nose even after removing the dressing or splints due to swelling and some blood. In addition you will notice some blood from your nose for a week or two.

It is common to get mild headache and to have some mild pain over the nose for a few weeks after the operation. This usually responds to simple painkillers like paracetamole.

It is important that you do not blow you nose at all for the first 48hrs following your operation and do so as little as possible for a week thereafter. You can wipe any discharge from the nose. I normally recommend the use of drops, ointments and salt water sprays after the operation. Some mucus and blood stained fluid may drain from your nose for the first week or two following the operation and this is normal.

Do NOT smoke while recovering from the operation.

It is important to stay away from dusty and smoky environments while you are recovering.

You are likely to go home on the day of your surgery or the day after your operation depending on the size of your operation. You will need to rest at home for at least a week. If you do heavy lifting and carrying at work you should be off work for at least two weeks. You will need to come back for review, usually around two weeks after surgery. I will give you the exact date before you are discharged from the hospital.

All operations carry some element of risk in the form of possible side effects. There are some risks that you must know about before agreeing to this operation. These potential complications are very uncommon and are NOT likely in most of the patients.

  • Bleeding - Bleeding is a risk of any operation. It is very common for small amounts of bleeding to come from the nose in the days following the operation. Major bleeding is extremely uncommon and it is very rare to need another operation to stop this bleeding. If you get significant bleeding, you may require temporary packing inside the nose to control it.
  • Eye injury - The sinuses are very close to the wall around your eye. Sometimes minor bleeding can occur into the eye socket and this is usually noticed as some bruising around the eye. This is usually minor and gets better without any special treatment, although it is important that you do not blow your nose. Serious bleeding into the eye socket has been reported, however this is incredibly rare. This can cause severe swelling of the eye and can even cause double vision or in very rare cases loss of sight. If such a serious eye complication did occur you would be seen by an eye specialist and may require further operations.
  • Leak Spinal Fluid - The sinuses are very close to the bone at the base of the brain. All sinus operations carry a small risk of damage to this thin bone with leakage of fluid from around the brain into the nose, or other related injuries. Again this an incredibly rare complication. If this happens you will have to stay in hospital longer and may require another operation to stop the leak. On very rare occasions infection has spread from the sinuses into the spinal fluid causing meningitis but this is extremely uncommon.

In general, serious complications are very rare. In a survey of all ENT surgeons who do this type of operation in England, eye complications happened in one in every five hundred operations and spinal fluid leaks happened in one case in every thousand operations, so the risks are small.

CLINIC INFORMATION

Northampton General Hospital
NHS Hospital
Northampton NN1 5BD
Tel - 01604 634700
BMI Three Shires Hospital
Private Hospital
Northampton NN1 5DR
Tel - 01604 620311

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