The main symptoms of sinusitis include:
-
pain, swelling and tenderness around your cheeks, eyes or forehead
-
a blocked or runny nose
-
a reduced sense of smell
-
green or yellow mucus from your nose
-
a high temperature
Other symptoms include:
-
a headache
-
toothache
-
bad breath
-
a cough
-
a feeling of pressure in the ears
Young children may also be irritable, have difficulty feeding and breathe through their mouth.
Surgery for sinusitis and nasal polyps
Surgery to treat chronic sinusitis is called functional endoscopic sinus surgery (FESS).
FESS is carried out under general anaesthetic.
We can widen your sinuses by either:
-
Removing some of the blocked tissue
-
Inflating a tiny balloon in the blocked sinuses before removing it
Functional endoscopic sinus surgery (FESS) - Read more below.
NASAL POLYPS
Symptoms of Nasal polyps include:
-
A blocked nose
-
A runny nose
-
A feeling that mucus is slowly dripping down the back of your throat
-
A reduced sense of smell or taste
-
Snoring
Nasal polyps can sometimes feel like a cold but colds tend to clear up within a few days, whereas nasal polyps will not get better unless they're treated.
If your Nasal polyps block your sinuses (the air pockets around your nose) you may also have symptoms of sinusitis.
Treatment
We will initially treat the Nasal polyps with medication however if there's no sign of improvement after about 12 weeks, we may suggest surgery to remove them.
Most people who have surgery see an improvement, but it's common for polyps to grow back, usually within a few years.
Surgery to treat Nasal Polyps is called functional endoscopic sinus surgery (FESS).
FESS is carried out under general anaesthetic.
We can widen your sinuses by either:
-
Removing some of the blocked tissue
-
Inflating a tiny balloon in the blocked sinuses before removing it
FUNCTIONAL ENDOSCOPIC SINUS SURGERY (FESS)
Why have the operation
This is an operation to open up the sinuses and their drainage pathways.
The main aim of surgery is to improve the long-term control of your symptoms when treatment with medication has not been completely effective. With the sinuses opened with surgery, it will improve symptoms of nasal blockage and discharge, and also allow nasal sprays and rinses to reach parts of your nose and sinuses that were previously blocked.
This is a general anaesthetic procedure, frequently carried out as a day case. An endoscope is used during the operation so we can visualise inside your nose and sinuses. A microdebridor (electric shaver) is used to remove polyps and swollen sinus lining, enlarging the natural openings into your sinuses. Trapped mucus and pus are drained from the sinuses.
Does it hurt
It can be slightly unpleasant after the operation due to the nasal congestion. Pain is not a main symptom.
After the operation
You will be observed for a few hours to make sure you have recovered from the anaesthetic and that no excessive bleeding has occurred. The majority of the patients are able to go home on the same day. You will experience nasal congestion type symptoms for the next few weeks while the inside of the nose heals. It is also not uncommon to see some blood- stained mucus for the next few days. It is advisable to perform nasal douching (rinsing the nose with salt water using a syringe, or a sinus washout boKle) to keep the nasal cavities clean.
You should experience gradual improvement of your nasal airway when the internal swelling subsides with time. This can take as long as 3-6 months in some cases.
How long do I have to be off work
It is advisable to have 2 weeks off work.
Possible complications
Common complications include nose bleeds, some of which might need hospital admission and nasal packing. Infection can be best avoided by preforming regular saline rinse and also reducing social contact with others. Adhesions can form when the lining stick together during healing, forming scar tissue. It is not always an issue, but can be trimmed away if necessary.
Endoscopic sinus surgery has some rare but serious complications. Injury to the eye happens in 1 in 10,000 patients. It can cause double vision, bleeding in the eye socket and leading ot loss of vision. Watery eye can happen if the tear duct is affected during surgery (<1%). The risk of injury to the brain causing CSF leak, or meningitis, is 1 in 1000. A repair procedure might be needed, with antibiotics treatment.
Is there any alternative treatment
Before considering surgery, you would have been treated with saltwater douches (sinus rinse) and steroid drops or sprays. Some patients may need a course of steroid tablets. Steroids are used because it can shrink the swollen nasal lining (including any polyps). In certain cases, a long term course of antibiotics can also help to reduce swelling in the sinuses. This medication regime may be sufficient to treat your nasal symptoms. Steroid sprays and drops work well in the nose and have fewer side effects than steroid tablets.
If you responded well to medication, or only have mild symptoms, then a sinus operation is not needed for you. This is also true if you have other conditions that make it risky to have surgery or a general anaesthetic. It is important to continue using your steroid spray or drops with salt water rinsing, as patients who do so have better control of their symptoms. Steroid sprays and rinses are not usually absorbed by the rest of the body and can therefore be taken for long periods of time.
However if polyps are also present, the polyps tend to return if steroids are stopped, even after an operation. An operation should be considered when medication has failed to achieve a significant period of symptom relief.
Post-operative care instructions
-
Do not blow your nose for about a week, or it might start bleeding.
-
If you are going to sneeze, sneeze with your mouth open to protect your nose.
-
You may get some blood-stained watery fluid from your nose for the first two weeks or so – this is normal.
-
Your nose will be blocked both sides like a heavy cold for 10-14 days after the operation.
-
You should start to rinse your nose with saline rinse from Day 2 onwards
-
Please continue to use your steroid nasal drops or sprays. The operation is more successful with ongoing use of steroid spray and saline rinse.
-
Refrain from physical exercise, heavy housework or gardening for 2 weeks
-
Refrain from flying for 2 weeks
-
Try to stay away from dusty or smoky places.
-
It may take up to three months for your nose to settle down and for your breathing to be clear again.
LOCATIONS
NUFFIELD HOSPITAL
Nuffield Hospital,
Kingswood Rd,
Tunbridge Wells,
TN2 4UL
KIMS HOSPITAL
KIMS Hospital,
Newnham Ct Way,
Weavering,
Maidstone,
ME14 5FT
FOURWAYS DENTAL & AESTHETIC CLINICS
4 Sevenoaks Rd,
Borough Green,
Sevenoaks,
TN15 8BB
SERENITY THERAPIES
Serenity Therapies,
42 High St,
Tunbridge Wells,
TN1 1XF
Correspondence Address: Nuffield Health Tunbridge Wells Hospital, Kingswood Road, Tunbridge Wells TN2 4UL
OUR AFFILIATIONS