Sinus Surgery
 
 
1. Why Did My Doctor Recommend My Son Have Sinus Surgery?
When aggressive medical treatment for chronic sinus infections fails, surgery may be indicated. Sinus surgery is directed at the underlying cause of sinus problems, namely blockage of sinus passageways as demonstrated by the CAT scan. In order for the sinus cavities to perform optimally, they must be able to receive air input from the nose and release mucus produced into the nose. Swelling or edema along these connecting passageways results in obstruction, pain, pressure, and usually infection. Therefore, sinus surgery is aimed at enlarging and removing any blockage to the sinus cavities.
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2. What Happens During Sinus Surgery And How Is It Done?
The technological advances in instrumentation and optics have revolutionized sinus surgery. All sinus surgery in children is now performed under endoscopic control with magnification, termed functional endoscopic sinus surgery (FESS). The specific problem area can now be precisely located and remedied without disturbing adjacent areas.

FESS takes place in an operating room under general anesthesia. The procedure is usually performed in two separate stages, two to three weeks apart. In most cases, both procedures can be done as an outpatient. In the first stage, the obstructed areas of the involved sinuses are reopened or unblocked. General nasal anatomy is inspected and involved sinus contents can be cultured. This procedure can be combined with other related nasal procedures such as adenoidectomy, septoplasty, or even tonsillectomy.

The second procedure allows cleaning of the surgical site to prevent possible scarring of the newly created sinus openings. Sinus cultures may be taken. Due to the small surgical area and minimal risk for bleeding, nasal packing is not necessary with endoscopic sinus surgery. The patient has minimal pain afterwards requiring Tylenol only.

Meticulous postoperative care ensures the success of FESS. The patient may receive antibiotics, nasal steroid sprays, and decongestants after each surgical procedure. Nasal salt water irrigation is used after surgery to cleanse and decongest the nose. Normal activities can be resumed within 3 to 7 days after surgery.
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3. Does Sinus Surgery Work?
The overall success of endoscopic sinus surgery in children is 80%. The majority of children, particularly those with asthma and antibiotic allergies, benefit dramatically from this procedure. As with all children, routine colds and viral illnesses will continue. The likelihood of complete sinus obstruction leading to chronic infection will be less.

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4. Isn't Sinus Surgery Dangerous?
Complications of FESS can be significant. Structures adjacent to the sinus cavities can be injured during surgery. These include injury to the optic nerve, eye muscles, or covering around the brain resulting in a leak of spinal fluid. To avoid such complications, make sure your chosen surgeon specializes in the treatment of children's sinus problems.
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