Is Sinus Surgery Painful?

Continuing our video series, Dr. Jerome Hester answers “Is sinus surgery painful?”.

The following is transcript of the video for your convenience:

If an individual has recurrent sinus infections or a sinus infection that just doesn’t go away, surgery is one option for treatment. If you look at the goal of sinus surgery it is basically to reestablish the normal ventilation and drainage of the sinuses. Originally this was done with very aggressive surgery, where incisions were made sometimes on the face itself, and actually the goal was to destroy some of the sinuses, so they would not bother the patient. This was at times very successful, however, as one may imagine by the scope of such a surgery, were painful and had a prolonged recovery.

A little over 30 years ago there was in introduction of endoscopes, which are small telescopic cameras that allow the surgeon to actually enter the nose and find the natural openings of the sinuses, where very small instruments can be used to provide access to the openings and create larger openings and removal of infection. This improved the recovery time dramatically from the original surgeries, but still left the patient with a five to seven day recovery.

In addition, recently, there have been advances made with packing materials. Packing is a substance that’s generally placed in the nasal cavity after surgery, to hold pressure on that area to reduce bleeding and maintain the openings. Not only was it painful to have the packing in place for sometimes three to seven days, but it’s removal was also sometimes described by the patient as the worst part of the whole surgery. Newer devices have been manufactured, which allowed us to avoid the use of packing, many times because these devices just self absorb and do not need to be removed and put much less pressure on the system.

Within the last decade, advances have been made further to eliminate the need for cutting or removal of tissue and instead, simply, dilating the sinus openings. This can be accomplished either by a higher pressure balloon system or by a lower pressure osmotic system, where fluid is drawn from the sinus cavity into a device, which then expands. Placement of these devices carefully into the sinus openings can then allow for these openings to be dilated, the device is removed, and the patient many times can return to normal activity either the same day or at the worse the very next day. This allows a marked improvement over the last several decades in the recovery time and the uncomfortable period following sinus surgery.