Endoscopic Sinus Surgery

What is sinusitis and how does it occur?

Sinuses are air-filled spaces in the facial bones around the nose and connected to the nose. The most common disease of the sinuses is sinusitis, which is an inflammatory disease of the sinuses.

Sinusitis usually occurs as a result of blockage of the mouths of the sinuses following an upper respiratory tract infection. In the early (acute) period, symptoms such as nasal congestion, facial and headache, nasal and postnasal drip may be the most common. At this stage, the diagnosis is often made with camera examinations and there is no need for computed sinus tomography to support the diagnosis. This early disease is called acute sinusitis and is treated with antibiotics and nasal sprays.

What is chronic sinusitis and why can it occur?

In some patients who do not respond to drug treatments, sinusitis may become chronic. Cartilage-bone curvatures in the nose (septum deviation), diseases in the nasal concha (concha), the presence of diseased tissues called polyps and which should not be present under normal conditions, and respiratory allergy may also predispose to this condition. Apart from these, some infections of the upper teeth and dental treatments may also predispose to sinusitis.

What are the symptoms of chronic sinusitis?

In chronic sinusitis, patients mostly complain of persistent facial pain, headache, dark nasal discharge, nasal congestion and postnasal drip. In addition, there may be complaints such as bad breath and cough.

Sinüzit hastalığı ve tedavisi
Sinüzit Tedavisi

How is sinusitis diagnosed?

The diagnosis of sinusitis is made with a detailed nose and sinus examination with a camera. During this examination, septum and turbinate diseases and polyps that cause anatomical disorders are evaluated.

Computed tomography is requested in order to support the diagnosis, to evaluate the drug therapy given and to create the surgical plan in patients who are thought to be chronic. In some special cases where sinus inflammation spreads out of the sinus, magnetic resonance (MR) examination may be requested.

How is chronic sinusitis treated with surgery?

The method called ‘endoscopic sinus surgery’ is preferred in the treatment of sinusitis that does not respond to drug treatment and has been diagnosed as chronic with computerized sinus tomography. Sinusitis surgeries are performed under general anesthesia, through the nose, without making an external incision, accompanied by a camera. The basic principle here is to clean the inflammation and polyps, if any, filling the sinuses, to open the mouth of the sinuses, so that the sinuses can be re-ventilated.

In the same session, if any, nasal cartilage and bone curvature can be corrected, nasal concha can be reduced and aesthetic nose surgery can be performed.

How to open sinuses with balloon?

Balloon instruments ‘balloon sinoplasty’ are frequently used to open the mouth of some sinuses more easily in endoscopic sinus surgery. Sinusitis surgery with balloons is not an alternative to endoscopy sinus surgery. Balloons are auxiliary devices used in sinusitis surgery.

Why are navigation systems used in surgery?

During endoscopic sinus surgery, navigation technology can be used to avoid damage to tissues adjacent to the sinuses, such as the eye and brain. This technology helps people who have had previous surgery and whose anatomy has deteriorated, as well as patients with polyps.

What should be considered after sinusitis surgery?

There is no pain after sinusitis surgeries. Since dissolving tampons are usually placed in the nose after the surgery, they do not need to be removed. It is tried to be kept open by washing the nose with saline and sprays. Moisturizing drops are used to reduce crusts that may occur in the nose and sinuses. After the sinusitis surgery, the patient is seen once a week for 3-4 weeks and the nose is cleaned.

More detailed information will be given about the conditions to be considered before and after the surgery, possible complications and possible risks.