{"id":1603,"date":"2026-09-10T13:17:22","date_gmt":"2026-09-10T10:17:22","guid":{"rendered":"https:\/\/www.gedizserin.com\/en\/?p=1603"},"modified":"2026-09-10T13:20:02","modified_gmt":"2026-09-10T10:20:02","slug":"when-is-surgery-needed-for-chronic-sinusitis","status":"publish","type":"post","link":"https:\/\/www.gedizserin.com\/en\/when-is-surgery-needed-for-chronic-sinusitis\/","title":{"rendered":"When Is Surgery Needed for Chronic Sinusitis?"},"content":{"rendered":"<p>If nasal congestion, thick postnasal drip, facial pressure, and decreased sense of smell continue for months rather than weeks, the question is not only \u201cDo I have sinusitis?\u201d The answer to the question <strong>when is chronic sinusitis operated on<\/strong> is given by evaluating the duration of the complaints, the results of the treatments applied, the appearance of the sinuses on tomography, and the anatomical structures inside the nose together. The aim is not to operate on every sinusitis patient, but to safely restore the natural ventilation and drainage pathways of the sinuses in suitable patients.<\/p>\n<p>Chronic sinusitis usually presents with complaints such as nasal congestion lasting longer than 12 weeks, nasal or <a href=\"https:\/\/www.gedizserin.com\/en\/does-postnasal-drip-mean-chronic-sinusitis\/\">postnasal drip<\/a>, facial pain-pressure sensation, and loss of smell. These symptoms are not always seen with the same severity. While some patients apply because of frequent antibiotic use, for others the main problem is constant mouth breathing, decreased sleep quality, or a feeling of fullness in the head that does not go away during the day.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">\u0130ndex<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.gedizserin.com\/en\/when-is-surgery-needed-for-chronic-sinusitis\/#How_is_the_decision_for_surgery_made_in_chronic_sinusitis\" >How is the decision for surgery made in chronic sinusitis?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.gedizserin.com\/en\/when-is-surgery-needed-for-chronic-sinusitis\/#Symptoms_that_do_not_improve_despite_adequate_medical_treatment\" >Symptoms that do not improve despite adequate medical treatment<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.gedizserin.com\/en\/when-is-surgery-needed-for-chronic-sinusitis\/#Disease_that_significantly_affects_daily_life\" >Disease that significantly affects daily life<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.gedizserin.com\/en\/when-is-surgery-needed-for-chronic-sinusitis\/#When_is_chronic_sinusitis_operated_on_Common_situations\" >When is chronic sinusitis operated on: Common situations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.gedizserin.com\/en\/when-is-surgery-needed-for-chronic-sinusitis\/#What_is_the_aim_of_endoscopic_sinus_surgery\" >What is the aim of endoscopic sinus surgery?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.gedizserin.com\/en\/when-is-surgery-needed-for-chronic-sinusitis\/#Risks_of_surgery_and_realistic_expectations\" >Risks of surgery and realistic expectations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.gedizserin.com\/en\/when-is-surgery-needed-for-chronic-sinusitis\/#Which_questions_should_be_answered_during_the_preoperative_consultation\" >Which questions should be answered during the preoperative consultation?<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"How_is_the_decision_for_surgery_made_in_chronic_sinusitis\"><\/span>How is the decision for surgery made in chronic sinusitis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The decision for surgery is not based on a single tomography image or a single complaint. First, the patient&#8217;s history is listened to in detail; allergies, asthma, smoking, reflux, immune system problems, previous nasal surgeries, and medications used are evaluated. Then, with nasal endoscopy, the inside of the nose, the drainage area of the sinuses called the middle meatus, the presence of polyps, and the nature of the discharge are examined.<\/p>\n<p>Paranasal sinus computed tomography is the main imaging method for surgical planning. Tomography shows which sinuses are affected, whether there is obstruction in the natural drainage channels, and the anatomy of neighboring structures such as the eye socket or skull base that must be preserved during surgery. However, seeing mild mucosal thickening on tomography alone does not mean that surgery is required. Imaging findings should be compatible with the patient&#8217;s complaints and endoscopic examination.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Symptoms_that_do_not_improve_despite_adequate_medical_treatment\"><\/span>Symptoms that do not improve despite adequate medical treatment<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The first approach in chronic sinusitis treatment is usually medication and care methods. Nasal irrigation with saline, intranasal corticosteroid sprays used upon the physician&#8217;s recommendation, control of allergies, and medication treatment for infection in necessary patients are parts of this approach. Antibiotics are not necessary in every chronic sinusitis case; their duration and selection should be determined according to clinical findings.<\/p>\n<p>If significant relief cannot be achieved despite these treatments being applied for the correct duration and with the correct method, surgery comes into consideration. The definition of \u201cadequate treatment\u201d is individual. For example, the treatment plan of an asthmatic patient with chronic rhinosinusitis with polyps is different from the plan of a patient experiencing recurrent sinusitis due to structural narrowing.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Disease_that_significantly_affects_daily_life\"><\/span>Disease that significantly affects daily life<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The decision for surgery is not made only according to the number of infections. Living with a constantly blocked nose, not being able to sleep comfortably at night, not being able to smell, feeling postnasal drip while speaking, or experiencing head-facial pressure that affects work performance are clinically important. Especially loss of smell, sleep disturbance, and recurrent attacks may seriously reduce quality of life.<\/p>\n<p>In some patients, the source of complaints thought to be related to the sinuses may be different. Migraine, dental problems, temporomandibular joint diseases, or neurological causes may lead to facial pain. Therefore, facial pain alone is not a sufficient reason for sinus surgery. Correct diagnosis is the most important stage in avoiding unnecessary intervention.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"When_is_chronic_sinusitis_operated_on_Common_situations\"><\/span>When is chronic sinusitis operated on: Common situations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><a href=\"https:\/\/www.gedizserin.com\/en\/what-do-we-do-in-sinus-surgery\/\">Functional endoscopic sinus surgery<\/a> is often considered in chronic sinusitis patients who do not benefit from medical treatment and whose examination and tomography findings are compatible with the disease. Surgery may also be necessary in special conditions such as nasal polyps, significant narrowing of the sinus openings, recurrent acute sinusitis attacks, or a fungal ball.<\/p>\n<p>Advanced septal deviation, turbinate enlargement, or structural problems related to previous trauma and surgeries inside the nose may negatively affect sinus drainage. Correction of these structures may be planned in the same session as sinus surgery in some patients. However, having septum surgery does not always mean that sinus surgery is required, just as sinus surgery does not solve every nasal obstruction problem on its own.<\/p>\n<p>Dental-origin sinusitis also requires a separate evaluation. Especially in patients with one-sided, foul-smelling discharge and maxillary sinus involvement, dental root infection, implant procedures, or an oral-sinus connection should be investigated. For a permanent solution, the dental-origin problem should also be addressed by the relevant specialty together with treatment of the sinus.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"What_is_the_aim_of_endoscopic_sinus_surgery\"><\/span>What is the aim of endoscopic sinus surgery?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>In the current approach, sinus surgery is a procedure performed through the nostrils with endoscopes and does not require an external incision. In the method called functional endoscopic sinus surgery, diseased tissues are cleaned to the necessary extent and the natural drainage channels of the sinuses are opened. The goal is to increase ventilation of the sinuses and make it easier for the medications used to reach the relevant areas.<\/p>\n<p>The extent of surgery is not the same for every patient. While intervention in only a limited sinus region may be sufficient, a more extensive procedure may be required in widespread polyp disease. Planning is more delicate in cases that have previously undergone surgery, have altered anatomy, or have recurrent disease. In these cases, detailed tomography examination, endoscopic evaluation, and an experienced surgical approach are especially important.<\/p>\n<p>The surgery is performed under general anesthesia. The duration of the procedure varies according to the number of sinuses to be treated and accompanying nasal surgeries. Advanced imaging, high-resolution endoscopic systems, and navigation technology when necessary contribute to surgical planning in complex anatomies; however, the main determining factors are the correct indication and meticulous surgical technique.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Risks_of_surgery_and_realistic_expectations\"><\/span>Risks of surgery and realistic expectations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>As with every surgical procedure, endoscopic sinus surgery has risks such as bleeding, infection, adhesion formation, recurrence of the disease, and the need for additional intervention. Because of the anatomy of the sinuses close to the eyes and skull base, rare but important risks such as eye-related complications or cerebrospinal fluid leakage should also be discussed in detail before surgery.<\/p>\n<p>In the first days after surgery, nasal congestion, mild bloody discharge, and crusting may be expected. During the healing period, saline irrigations, prescribed sprays, and regular endoscopic follow-ups are a continuation of the treatment. Especially in <a href=\"https:\/\/www.gedizserin.com\/en\/can-sinusitis-recur-after-sinus-surgery\/\">chronic sinusitis with polyps<\/a>, surgery should not be considered a one-time solution that completely eliminates the disease. Long-term control of accompanying conditions such as allergies, asthma, or widespread mucosal inflammation is one of the fundamental parts of success.<\/p>\n<p>The measure of a successful surgery is not only that the tomography looks clear. The patient&#8217;s ability to breathe more comfortably, improvement in sleep and smell function, reduction in attacks, and being able to continue daily life more comfortably are more meaningful outcomes. On the other hand, complete recovery of long-standing loss of smell cannot be guaranteed in every patient. Expectations should be determined realistically according to examination findings.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Which_questions_should_be_answered_during_the_preoperative_consultation\"><\/span>Which questions should be answered during the preoperative consultation?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>At the decision stage, the cause of the patient&#8217;s disease, which sinuses are affected, and which complaints the surgery is expected to correct should be clearly explained. Medications used, blood thinners, allergies, asthma treatment, and previous surgeries must be shared. Especially in patients who have previously undergone sinus or nasal surgery, information about previous operations and current tomography images may facilitate planning.<\/p>\n<p>In Prof. Dr. Gediz Murat Serin\u2019s approach as well, the decision for sinus surgery is based not only on imaging results, but also on detailed examination, endoscopy, the patient&#8217;s respiratory function, and expectations regarding quality of life. In cases accompanied by structural problems inside the nose, functional needs are kept at the center of the plan.<\/p>\n<p>It is not necessary to accept living with long-lasting nasal congestion or recurrent sinusitis attacks as normal. Proper evaluation may show that control can sometimes be achieved with regular medical treatment, while in other cases surgery is a suitable option for lasting relief. The healthiest step is to consult an ENT specialist who will evaluate your symptoms and imaging results together and make the decision according to your individual condition.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>If nasal congestion, thick postnasal drip, facial pressure, and decreased sense of smell continue for months rather than weeks, the question is not only \u201cDo I have sinusitis?\u201d The answer to the question when is chronic sinusitis operated on is given by evaluating the duration of the complaints, the results of the treatments applied, the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1608,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-1603","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"_links":{"self":[{"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/posts\/1603","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/comments?post=1603"}],"version-history":[{"count":4,"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/posts\/1603\/revisions"}],"predecessor-version":[{"id":1607,"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/posts\/1603\/revisions\/1607"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/media\/1608"}],"wp:attachment":[{"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/media?parent=1603"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/categories?post=1603"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.gedizserin.com\/en\/wp-json\/wp\/v2\/tags?post=1603"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}