Sinus surgery is recommended for patients who have not responded well to medical interventions and therapies, and who suffer from persistent or recurrent symptoms of sinusitis.

Unfortunately, medical management of sinusitis symptoms with prescription medications as well as over-the-counter medications just doesn’t work for all patients. These medications simply fail to provide long-term relief and as a result sinusitis symptoms persist.

Alternatively, for these patients, an ENT (ear, nose, and throat) doctor may recommend sinus surgery as corrective treatment and may suggest further workup to see if there is some structural blockage impeding sinus function. If there is such a blockage, sinus surgery is effective in removing the obstruction, opening the sinuses, and restoring natural drainage. It is also effective in reducing nose and sinus inflammation and keeping the drainage pathways open and functioning properly.

Sinusitis, also known as a sinus infection or rhinosinusitis, is an inflammation of the mucosa-lined, air-filled spaces in your skull that connect to the nose and throat. When the sinuses become inflamed, blocked or swollen, normal mucus drainage may not occur trapping air and other fluids, creating vacuums and/or pressure. This pressure can cause pain, which can sometimes be intense. Clogged sinuses may also lead to infections.

Nasal obstruction can have many causes. For some patients, allergies lead to swelling of the nasal and sinus lining, which causes congestion and blockage. For other patients, the blockage may be due to a simple anatomical obstruction, such as enlarged adenoids, a polyp in the nasal passage, a deviated septum, enlarged turbinates, or narrow nasal passages.

There are a few surgical options available for patients who don’t respond to medical management of their sinusitis symptoms.

Balloon sinuplasty (BSP) is a less invasive endoscopic sinus procedure for chronic sinusitis patients seeking relief from uncomfortable sinus pain symptoms. During this non-invasive procedure, a tiny balloon is placed into the nose to reach the blocked sinuses and is then inflated to restructure the sinus opening. Congested sinus cavities are safely drained, reducing the recurrence of symptoms and providing patients with long-lasting, much-needed relief. To learn more about this procedure, check out our page on Balloon Sinuplasty.

If your doctor doesn’t need to remove anything from your sinuses, you may be a good candidate for this procedure.

FESS is a minimally invasive, outpatient procedure that is recommended for patients who have a structural component contributing to their sinus blockage. For this procedure, the surgeon uses a small, lighted endoscope to view and access the sinuses. The sinus ostia are then identified and enlarged as a means to restore natural sinus drainage and to allow the sinus lining to return to its normal, healthy state. FESS is all about restoring function. Obstructive tissue and bone are carefully removed taking care to preserve the sinus lining.

The main differences between the two procedures are:

• Balloon Sinuplasty is performed in the doctor’s office. FESS is usually performed as an outpatient procedure.
• FESS involves making incisions that are very precise in order to remove or minimize problematic bone or tissue
• within the nasal passages. Balloon Sinuplasty doesn’t involve any cutting of bone or tissue.
• Balloon Sinuplasty is used when enlarging a blocked sinus passage is sufficient. FESS is used to help correct more significant physical problems such as removing nasal polyps or correcting a deviated septum.

• Both procedures are less invasive treatment options.
• The procedures take less time to perform than traditional sinus surgeries and the methods allow for quicker and more often painless recovery times.
• Normal activity can resume within a few days to a week.

The FESS procedure is clinically indicated for patients with chronic sinusitis, and for whom appropriate medical treatment has failed.

Patients with chronic sinusitis often report the following symptoms:

• Nasal congestion
• Purulent drainage (consisting of pus)
• Postnasal drip
• Facial pressure and headache
• Diminished sense of smell (hyposmia)
• Loss of smell (anosmia)
• Nasal obstruction

Since other conditions can mimic symptoms of chronic sinusitis, it is essential to rule out other conditions that may be causing the symptoms. To ensure sinus surgery is clinically indicated for the patient, an ENT doctor will review the patient’s medical history and conduct a complete physical examination, including nasal endoscopy and CT scans, if appropriate.

FESS is also appropriately indicated for patients who have other conditions, such as nasal tumors and nasal polyps.