Endoscopic Sinus Surgery (ESS)

Sinus Surgery

The goal of Sinus Surgery is to restore normal sinus ventilation and their “drainage" function after becoming physically obstructed either by scar tissue following recurrent infection or by nasal polyps. Medical treatment alone (antibiotics and nasal sprays) cannot solve the problem. This is a minimal invasive procedure, therefore after the procedure the same day you can go home.

There are four groups of sinuses:

  • Frontal sinuses (in the forehead)
  • Ethmoid sinuses (between the eyes)
  • Maxillary sinuses (cheekbone area)
  • Sphenoid sinuses (behind the eyes)

Sinuses are hollow cavities in facial skeleton and communicate via narrow passages called Ostia. They naturally produce mucus, which is transported  into the nasal cavity. In certain conditions, (e.g. infection, nasal polyps or structural abnormalities) the entrance to a sinus may become blocked then mucus builds up within the affected sinus. If it remains there for a long time period, it becomes infected resulting in “ sinusitis”. If this does not resolve properly it will destroy the normal function of your nose creating a condition known as “chronic sinusitis”. After failure of conservative treatment, endoscopic surgery can be performed to reopen the door of the affected sinuses. The operation takes about 1 to 2 hours usually under light sedation.  No incision is made on your face and there are no black eyes after the surgery.

What can you expect after the surgery?

The Endoscopic sinus surgery is highly successful at improving the symptoms of sinus ventilation and removal of the nasal polyps. However to avoid  reoccurrence  strict protocol will be provided, how to irrigate your nose and which medication should be taken.  Even after successful surgery, a patient will be prone to bouts of sinus trouble more than the average person, but frequency is usually less than before surgery. Such recurrences can be brought under control medically (rather than surgically) using various antibiotics, sprays/drops, decongestants or anti-inflammatory steroid

Before your surgery

We advise that you stop smoking as soon as possible and avoid extensive sun exposure. Also, there are certain foods to be avoided, as they affect the development of blood clotting, like: Aspirin, Vitamin E,  dietary supplement, Otrivine, NSAID, garlic, ginseng, at least 2 weeks prior of the surgery.

In the Hospital - first six hours

You may wake up with some packing in your nose to stop any bleeding. This should be left alone and will be removed by your doctor when appropriate.

  • Do not blow your nose for 7 days
  • If you experience any pain, it can easily be managed by regular painkiller

The first week at home

  • You may get a blood stain / pinkish discharge for a few days. The bleeding gets less and less as the days go by, but there may still be a little “spotting” on your handkerchief even up to a few weeks after the surgery. This is common.
  • If slight more bleeding occur after the surgery, please use nasal decongestant spray to stop bleeding
  • Avoid all moderate and heavy physical activity, including sport for ten days after the operation. Avoid bending down to pick things up, especially heavy weights. Active sport should not be commenced for two weeks after the surgery, and even then, it should be increased gradually
  • It is normal for the nose to be feel blocked for several days  and up to two weeks after the surgery, as the swelling settles.
  • You must irrigate your nose frequently “douching” at least 3 times a day with the saline solution provided to clear away scabs and crusting which occurs after the operation.
  • Avoid smoky and dusty atmospheres if possible, as this may irritate the nasal lining.
  • Avoid very hot baths and showers.
  • If you take aspirin, please discuss this with Dr. Levente, as you may need to avoid taking it, since it could potentially increase the risk of nasal bleeding.
  • It is  advised not to drive for 48 hours, because of the effects  of the general anesthetic.


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