Information Leaflet: Paranasal sinus surgery
As a result of your health problems and the condition of your paranasal sinuses we recommended an operation.?In addition to the well-known maxillary and frontal sinuses there also exist the small - but often afflicted - ethmoidal cells as well as the sphenoidal sinuses.
They are air-entrained cavities lined with mucosa which are connected to the main nasal cavity via small ventilation canals. As a result of prior paranasal sinus inflammations these canals may be narrowed by old scars or, for example, obstructed by polyps.
Given that secretion staunches in badly-aerated paranasal sinuses, this condition may lead an increased propensity to infections and, yet again, generate more scares, etc. etc. Thus, the most frequent reasons for a surgery of the paranasal sinuses are:
- Propensity to infection with respect to the paranasal sinuses
- unilaterally or bilaterally aggravated nasal breathing
- excessive nose secretion, and
- disturbed olfactory function.
paranasal sinus surgery may help to considerably improve an already existing bronchial asthma condition.
How is this surgery performed?
The operation is performed under general anaethetia through the nostrils. Under microscopic and endoscopic guidance the narrowed ventilation canals are expanded in a way and manner that no excessive swelling will have to be expected in connection with colds or allergies in future. At the same time, existing polyps, cysts or secretion retentions are removed from the paranasal sinuses. Enlarged nasal concha or any curvation of the nasal septum can be corrected in the same surgery. At the end of the surgery a tamponade is inserted into the nose. It helps to arrest bleeding and must stay there for 2 days.
What are the risks involved as a result of this surgery?
As a result of the nasal tamponade, after the surgery patients are required to breath through the mouth – at least for the moment. When the nasal tamponade is removed bleeding may occur for a few minutes and – in rare cases – require a new nasal tamponade or (extremely seldom) bleeding control in the operating room. In the further healing process, your nose can still hampered by swellings, secretions and scab for several days. Thus, a follow-up treatment and cleaning will be required. Generally, within a month, your nose feels normal again.
In principle, every surgery poses risks to the adjacent anatomic structures. In the case of paranasal sinus surgery this includes the eyes (double vision, impaired vision, including loss of sight), the brain (flow of cerebrospinal fluid, cerebral inflammation, cerebral bleeding), lacrimal ducts (tears keep running), large vessels (threatening loss of blood) and olfactory mucosa (loss of olfactory function). All these events are extremely rare and never happened while we operated up to now. Another very extremely rare event is the sealing-off of sinuses as a result of the re-cicatrisation of the ventilation canals and the formation of mucuous cysts (mucocele) which would require further surgery. In very rare cases bruises in the eye region occur, they disappear without further intervention.
All in all, the chances of success are very good. In some patients with nasal polyps, however, it can be observed that such polyps redevelop again within a few years.
What do I have to do before, during and after the surgery?
Already 10 days before surgery patients are not allowed to take ANY KIND OF PAINKILLERS as these drugs disturb coagulation! In the post-operative period, blood pressure should not be unnecessarily increased so as to avoid bleeding. Even though patients are permitted to get up very soon, any kind of physical effort has to be strictly avoided. This means that bathing, showering and washing your hair is not permitted for a period of 5 days after surgery until you have your first follow-up exam in our practice. Blowing your nose during the first 10-14 days is absolutely not permitted (you are allowed, however to "snuffle" without any kind of restrictions). Approximately 3 weeks after the surgery you can slowly start with your sportive activities again.