After surgery, there are often blood crusts, clots, and debris which must be removed from the operated sinuses in order to prevent scarring and promote proper wound healing. In order to ensure a good long term outcome, the operated patient should continue to irrigate with saline several times a day as recommended by the surgeon.
Typical post-operative visits are one week after surgery, then two weeks after surgery, then one month after surgery. Depending on how the body is healing, visits will either continue on this pace or become more spaced out. Medications will also be added and removed as the body is healing.
An Image guidance machine allows the surgeon to use a patient’s CT scan and various measured points along the patient’s face to create a navigable 3D map of the sinuses. It allows the surgeon to confirm anatomical landmarks and determine if cells are full opened and if we are getting close to the eye or skull base. It is not officially the standard of care, but is quickly becoming more heavily used because it allows the surgeon to be more efficient and safe.
The risks of sinus surgery include but are not limited to scarring, bleeding, infection, injury to the eye, injury to the brain with leakage of cerebrospinal fluid, and the risk of general anesthesia. The risk of scarring is greatly reduced by frequent nasal cleaning and irrigation after surgery. The risks of injury to the eye and injury to the brain are extremely low- less than 0.5% in experienced hands – and have become even less encountered with the use of image guidance.
The operative time can vary between 1 hour and 4 hours depending on what needs to be done.
Not entirely. Without previous surgery, much of the topical therapy that is used inside the nose can only reach the nasal cavity and possibly the area called the middle meatus where the sinuses drain. This can help decrease swelling of the mucosa around the drainage pathways, but little actually gets into the sinuses themselves.
Yes, there are many procedures available such as turbinate out-fracture, coblation, and cautery. Most of these procedures attempt to create a scarring reaction within the turbinate to reduce their size. While numerous effective techniques exist, there is a lack of consensus regarding the best one and the long-term results of these procedures are mixed. Under certain circumstances, our physicians may employ some of these other techniques to give our patients the best individualized care possible.
The turbinates play an important role in nasal physiology. They serve to warm and humidify the air that we breathe and to regulate the amount of air that we can breathe in at once. Removing too much of the inferior turbinates can result in the sensation of worsening congestion called “empty nose” syndrome or excessively dry nasal condition called rhinitis sicca. A proper turbinate reduction procedure must reduce the size of the turbinate enough to achieve a wider nasal airway while leaving the majority of its lining intact. This will ensure that the patient gets the most of out of the procedure without worsening symptoms.
Yes, they are present in everyone’s nose unless removed by a physician. Some people even have extra or accessory turbinates.
While it is possible, it is extremely rare for the nasal septum to return to its deviated state without additional nasal trauma.
It depends. A deviated septum can limit the space that is available for nasal breathing. This limitation can render a patient more susceptible to blockage due to inflammation from infection or allergies. A deviated septum can also block the regions where the sinuses empty. This can lead to more frequent and longer lasting sinus infections. Finally, the a deviated septum can cause turbulent airflow which can lead to excessive dryness of the nasal lining and subsequent bleeding or epistaxis (hyperlink). Thus, septoplasty may be recommended by our physicians for any one of the aforementioned reasons even if your nasal breathing is not affected.
