Nasennebenhöhlenoperation

What is Sinus Surgery?

Sinus surgery is an operation performed on individuals who experience frequent sinus infections despite undergoing repeated treatment processes. However, it is important to note that this surgery is not performed on everyone who says “I have sinusitis.” In addition, except for some rare complications in the decision-making process, there is no need to rush. With certain preventive measures taken beforehand, it may be possible to manage sinusitis without surgery or to make the surgical process easier.

For a specialist doctor to decide on sinus surgery, it is very important to fully understand all aspects of the disease. Making a surgical decision based only on an examination or imaging results may be misleading. However, when the correct diagnosis is made with proper techniques and methods, sinus surgery can be beneficial.

What are the Symptoms of Sinusitis?

Not all sinusitis patients experience the same symptoms. Sometimes there may be postnasal drip complaints. During the infected period, yellow or green nasal discharge, headache, facial pain, and nasal congestion may occur. Intranasal problems causing sinusitis can be diagnosed through endoscopic examinations. With thin endoscopes, sinus channels can be opened and obstructive abnormalities can be detected. In patients who have undergone multiple treatments without improvement, a computed tomography scan can be used to map the nose and sinuses. The surgical plan is prepared according to this mapping.

Sinus treatment requires a highly technical approach. Expertise in sinus anatomy and endoscopic experience involves delicate and precise work. If there is no genetic abnormality, proper surgical application significantly reduces recurrence of sinusitis symptoms.

When is the Right Time for Sinus Surgery?

Sinus surgery is generally recommended when no improvement is achieved with medication. If there is no complication related to sinusitis, surgery is not performed during the acute infected phase. The most appropriate time is when blood circulation is reduced and the mucosal lining is calm.

Performing surgery during this stable period minimizes bleeding risk and allows a clearer surgical field due to reduced swelling. This increases the success rate of sinus surgery. In patients with nasal polyps, the ideal time for surgery is when polyps are reduced as much as possible using steroid sprays and medications.

How is Sinus Surgery Performed?

Sinus surgery is a sensitive procedure that requires technical skill and experience. The bones forming the sinus cavities and channels are extremely thin, almost like paper. Endoscopic sinus surgery is performed by cleaning these delicate structures to restore sinus function.

The procedure is carried out under endoscopic visualization using fine instruments. Structures called shavers are used for trimming, Holmium laser is used to reduce turbinates, and navigation systems may assist in advanced skull base interventions. Despite all technological support, experience and up-to-date sinus knowledge are essential. When performed correctly, the risk factor is extremely low and success rates under general anesthesia are high.

The operation duration varies between 45 minutes and 1–5 hours depending on the type of sinus involvement. After surgery, small absorbable sponges may be placed for patient comfort. Patients are usually observed in the hospital for one night and discharged the next day.

Postoperative Process

There is a risk of bleeding within the first 72 hours after surgery. During this period, heavy lifting and straining should be avoided as they may increase blood pressure. Extremely hot food and environments should also be avoided.

Medications prescribed by the doctor should be used regularly unless otherwise instructed. Saline sprays are recommended to keep the nasal mucosa moist until crusting resolves. If allergies or nasal polyps are present, corticosteroid sprays may be started from the second week.

Postoperative care plays a crucial role in the success of endoscopic sinus surgery. Within the first month, 3–4 follow-up visits may be required. During the first week’s detailed cleaning session, crusts in the nasal and sinus drainage pathways are removed and any anti-adhesion materials are taken out. Infection control is also performed. Regular follow-ups continue until full recovery, usually at intervals of 6–9 days depending on the patient’s condition.