Table of Contents
Surgery
Surgery can unblock the sinuses when drug therapy is not effective or if there are other complications, such as structural abnormalities or fungal sinusitis.
Insertion of a Drainage Tube
The simplest surgical approach is the insertion of a drainage tube into the sinuses followed by an infusion of sterile water to flush them out.
Functional Endoscopic Sinus Surgery
Functional endoscopic sinus surgery (FESS) is the standard procedure for most patients requiring surgical management of chronic sinusitis or polyposis. The procedure allows correction of obstructions, including any polyp and ventilation and drainage to aid healing.
Candidates for the Procedure.
- In general, patients should have tried and failed extensive medical therapy. This usually includes several prolonged courses of broad-spectrum antibiotics, nasal corticosteroids, nasal saline irrigation, allergy testing and immunotherapy where appropriate, and sinus drainage where appropriate.
- Patients with nasal polyps or sinus polyps who have failed intranasal and possibly oral corticosteroids generally require surgery.
- Patients with congenital anatomic abnormalities.
- Patients with evidence of bone involvement.
- Patients with HIV who have chronic or recurrent sinusitis.
Surgery may not be as effective for patients with fungal infections or severe chronic sinusitis.
Procedure. The surgery generally proceeds as follows:
Previous Section
Review Date: 05/10/2010
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical
School; Physician, Massachusetts General Hospital. Also reviewed by
David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
