Sinus surgery – Treating chronic sinusitis

What we call a nose is only the visible part of a highly complex organ that serves to breathe, smell, and form a voice. Overall, the outer nose has a sophisticated system of cavities that are interconnected, including the paranasal sinuses (the four sections for the intake of air on the face). Pathological changes in this area can have multiple causes and lead to impaired nasal breathing.

What is sinus surgery?

Sinus surgery is a procedure performed when there is continual congestion in the sinuses that is causing significant breathing problems but is not solvable with medications. It involves a variety of techniques that can help to expand the sinuses and relieve chronic breathing issues or other illnesses such as chronic sinusitis. These sorts of problems can also stem from a congenital defect or nasal trauma.

Dr. Gregory will carefully analyze this in advance of the nasal surgery and discuss it with each patient in detail. However, he himself does not perform sinus surgery, as these fall into the domain of otolaryngology (throat, nose, eyes). If the cause of the breathing hinderance is in the area of the paranasal sinuses, Dr. med. von Gregory will notify the appropriate specialist whom he remains in close contact with that will perform the surgery instead.

When is a sinus surgery necessary?

Sinus surgery may be necessary in the following circumstances:

  • Chronic sinusitis: people often experience inflammations in the mucous membranes associated with a cold, but this typically heals afterwards. It becomes chronic sinusitis when this inflammation leads to increased swelling of the mucous membranes to a point in which the narrow passages within the sinuses are blocked. This can cause continual breathing problems, headaches and facial pain.
  • Growths in the region of the paranasal sinuses (polyps): chronic inflammation in the mucous membranes can also result in extra tissue growths (polyps) that create congestion in the sinuses, so removing these improves nasal functionality.
  • Pathological changes to the inside of the nose: any type of change to the sinus system (such as too large nasal turbinates) can create a disturbance within the drainage and ventilation of the sinuses, resulting in a necessary surgical intervention.

Before, during and after the surgery, Dr. med. von Gregory will always be in constant communication with the throat, nose and eye specialist who will perform the surgery separate from Dr. med. von Gregory’s practice. All patients can therefore always rely on extensive care and look forward to a relaxed treatment.

Sinus surgery procedure - How long does a sinus surgery take?

Sinus surgery begins with the administration of general and local anesthesia. Sinus surgery procedures are typically done endoscopically, meaning instruments are inserted inside the nostrils. Only rarely are external incisions required.

Then one or more of three techniques can be used. The first option is the removal of thin bone layers which may be done to widen the access to the paranasal sinuses. The second option is the removal of mucosal proliferation (polyps) with a sling or laser. The last option involves an extension to the narrow access to the paranasal sinuses through a balloon dilation, i.e. a balloon catheter is implemented that is inflated at the bottleneck to create an expansion.

In general, the length of the operation depends on which techniques are used. Using his many years of practice on all techniques, Dr. med. von Gregory will discuss with the patient in advance as to which one is suitable, as well as provide a suitable recommendation for a specialist to handle the operation. After the operation, sometimes a splint is placed in the nose to collected blood and wound secretions. Finally, the patient is taken to a cozy relaxation room until the anesthesia wears off.

Sinus surgery course of treatment and recovery

Due to Dr. med. von Gregory’s extensive experience with sinus surgery, he will provide more in-depth information regarding the suitable course of treatment and recovery guidelines during a personal consultation with the patient. Afterwards, he will recommend an experienced specialist to provide the operation.Course of Treatment and Recovery Timeline

Before the Operation During the 14 days leading up to the operation, don’t take painkillers in order to stop from reducing blood clotting. Refrain from smoking to reduce risk of infection.
Length of Operation 2-3 hours
Use of Anesthetic Local anesthesia and general anesthesia
Hospitalization Ambulatory (outpatient care, no overnight stay)
Removal of Splints After about 2 days
Work-ready After about 7 days
Exercise 50% of normal regimen after 1 week, full normal regime after 2 weeks

Sinus surgery recovery guidelines

Dr. med. von Gregory is always looking for the best and most efficient methods to help patients reach a full recovery, so he highly recommends the following: keep the head propped up 24 hours after surgery, avoid smoking, sneeze with an open mouth, avoid strenuous activities, refrain from blood thinning agents, and take care of the mucous membranes by avoiding nicotine, alcohol and other harmful chemicals like nasal sprays. The specialist who performs the operation will also provide recovery guidelines that should be abided by.

Sinus surgery complications and risks

Paranasal sinus surgery is a routine procedure with very good chances for success. After the inflammation subsides and the wound heals, most patients feel an immediate improvement and have overall from then on a better quality of life. Despite all care, however, risks can never be fully ruled out in this operation.

In rare cases, complications or injuries of adjacent structures (eye socket, meninges, vessels such as tear ducts) may occur. This may temporarily lead to increased lacrimation or visual disturbances. However, these complications are very rare.

Sinus surgery cost

The costs for sinus surgery vary based upon the individual circumstances of each patient and will be discussed during a consultation. The expert specialist recommended by Dr. med. von Gregory will provide thorough information about all required costs.