At a glance
- Purpose
- To open and clear diseased sinuses and remove polyps.
- Technique
- Endoscopic, through the nose, with no external incisions.
- Anaesthesia
- General.
- Duration
- About an hour in theatre.
- Hospital stay
- Day surgery or one night at the clinic, depending on extent.
- Back to normal
- Office work after about a week.
What are the sinuses?
The paranasal sinuses are air-filled spaces around the nose: in the cheeks (maxillary), between the eyes (ethmoid), in the forehead (frontal) and further back (sphenoid). They connect to the nose through very small openings. When those openings close because of swelling or polyps, mucus cannot drain, becomes infected, and sinusitis develops.
Symptoms that suggest chronic sinusitis
- Persistent nasal congestion or blockage.
- Thick mucus from the front of the nose or running down the throat.
- Pain or pressure in the face, forehead or around the eyes.
- Reduced or lost sense of smell.
- Repeated infections needing antibiotics several times a year.
Diagnosis
We examine the nose with video endoscopy, which shows polyps and the sinus openings. A sinus CT scan shows which sinuses are affected and each patient’s anatomy, and is essential to plan surgery. Allergy tests, a smell test or blood tests are added if needed.
Before recommending surgery we make sure that a complete course of medical treatment has been tried. Many patients improve without an operation.
Endoscopic sinus surgery
Using an endoscope, a thin camera passed through the nose, the natural openings of the diseased sinuses are widened, polyps and inflamed tissue are removed and drainage is restored. There are no cuts on the face. The extent of surgery follows what the CT scan shows: some patients need one sinus opened; others, with extensive polyps, need several.
If a deviated septum or swollen turbinates contribute to the blockage, they are corrected in the same operation.
Surgery is done under general anaesthetic in the operating theatre of the Clínica Sagrada Familia in Barcelona and takes about an hour. Depending on its extent, it is day surgery or includes one night at the clinic.
Recovery
- First few days: nasal congestion, slightly blood-stained mucus and tiredness. Take it easy and avoid blowing your nose hard.
- Saline rinses: several times a day for a few weeks. They are an essential part of the result.
- Check-ups: endoscopic cleaning at the clinic during the first weeks so that healing is correct.
- Back to activity: most patients are back to office work in about a week. Flying and strenuous sport when we advise.
Nasal polyps: long-term follow-up
Nasal polyposis is a chronic inflammatory condition, often linked to asthma or to intolerance of some anti-inflammatory drugs. Surgery does not cure it forever, but it allows medical treatment to work much better. For the most resistant cases there are now biological treatments, considered together with a respiratory or allergy specialist.
Risks
They are uncommon: bleeding, infection, adhesions or persistent symptoms. Serious complications involving the eye socket or the skull base are exceptional and are minimised by careful planning on the CT scan. We will explain the risks in your case before surgery.
Frequently asked questions
When does sinusitis need surgery?
When it is chronic (symptoms for more than 12 weeks) or recurs several times a year and does not improve with proper medical treatment: saline rinses, nasal steroids and, where appropriate, antibiotics. Also when there are complications or certain findings that need investigating.
Do nasal polyps come back after surgery?
They can, because polyposis is a chronic inflammatory condition. Surgery opens the sinuses so that nasal steroid treatment reaches them better, and symptoms stay controlled for much longer. Follow-up is part of the treatment.
Will I have scars or a swollen nose?
No. The surgery is performed inside the nose with an endoscope. There are no external scars and the shape of the nose does not change.
Will my sense of smell come back?
When loss of smell is caused by polyps or swelling blocking the smell area, many patients regain it partly or fully, although this cannot be guaranteed. We assess it with a smell test before surgery.
Can septoplasty and sinus surgery be done together?
Yes. If a deviated septum contributes to the problem, it is usual to correct it in the same operation.
You may also be interested in
- Septoplasty and functional rhinoseptoplasty
- Snoring and sleep apnoea surgery
- Second opinion before ENT surgery
- International patients
Before surgery you receive the informed consent document of the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC), which explains the technique, its alternatives and its risks.
Guidance written by the team of Dr. Carlos Magriñá, an ENT surgeon with more than 35 years of experience in Barcelona. Every case needs an individual medical assessment.