What are the sinuses and what is sinusitis?

The sinuses are air pockets or cavities in the face. They are connected to the inside of the nose through small openings called ostia. There are four groups of sinuses:

  1. Frontal sinuses (in the forehead)
  2. Ethmoid sinuses (between the eyes)
  3. Maxillary sinuses (in the cheek bone area)
  4. Sphenoid sinuses (in the middle of the head, behind the eyes)

They assist the control of the temperature and humidity of the air reaching the lungs, regardless of how cold, hot or dry the  weather is. They naturally produce mucus and if this is unable to drain from the sinuses it can becomes infected causing sinusitis.

What is endoscopic sinus surgery or FESS?

Endoscopic sinus surgery and functional endoscopic sinus surgery (FESS) are names given to operations for people with chronic or severe sinus infections. Endoscopic sinus surgery is done from inside the nose and avoids external cuts. Before surgery, the specialist will examine your nose with a small telescope and arrange for a CT scan of your sinuses.

Why have sinus surgery?

Sinus surgery is required to unblock the ostia of the sinuses to drain your sinuses, relieving your discomfort and preventing infection. This will give the inside lining of your nose a chance to heal.

How is the operation done?

The operation is all done inside your nose – there will be no scars or bruises on your face. An endoscope telescope’ is inserted into the nose. The diseased sinuses are identified and are opened up using special instruments. If there are any polyps in the nose they are removed. The natural pathways of mucus drainage are enlarged to prevent blockage and the diseased lining (mucosa) is removed. The operation takes about two hours depending on the extent of the disease that must be treated.

Sometimes the doctor may need to straighten the partition wall inside the nose to get access to your sinuses .

After your operation Packs and splints

We may need to put a dressing in each side of your nose to prevent bleeding. The dressings are called ‘packs’ and they will block your nose up so that you have to breathe through your mouth. They will be removed before you are discharged. This may be a little uncomfortable and you may get a little bit of bleeding which will usually settle quickly

Does it hurt?

It is common for your nose to be quite blocked and to have some discomfort for a few weeks after the operation. You may also get some blood-coloured watery fluid from your nose for the fi rst two weeks – this is normal.

Will I have to stay in hospital?

You should expect to stay in hospital for aday or over night and will need to rest at home for two weeks afterwards. Ask your nurse on admission if you need a sick note.

Will I have to come back?

Your doctors’ will usually see you in the outpatient department 2-4 weeks after your surgery to assess the affect of your surgery.

After you leave hospital?

  1. Blow your nose gently for the fi rst week orit might start bleeding.
  2. You may be given nasal drops, spray ordouches to help clear your nose.
  3. If you are going to sneeze, sneeze withyour mouth open to protect your nose.
  4. You may get some blood coloured wateryfluid from your nose for the fi rst two weeksor so, this is normal.
  5.  Your nose will be blocked both sides likea heavy cold for 10-14 days after theoperation and you may get a dry mouth,take sips of water regularly to help with this.
  6. Try to stay away from dusty or smoky places.
  7. You should not play sports for about onemonth after the operation.
  8.  Avoid all moderate and heavy lifting forabout 10 days after the operation.