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  • Writer's pictureDr. Koralla Raja Meghanadh

The Pros and Cons of Sinus Surgery: Is It Worth It?

Updated: Dec 20, 2023


Sinus surgery has its own set of pros and cons. On the one hand, it can alleviate severe and chronic symptoms, improve airflow, and enhance the patient's quality of life. On the other hand, just like any medical procedure, it has risks and potential complications, such as bleeding, infection, and reactions to anesthesia. Moreover, with few types of sinus surgery is no guarantee that the surgery will cure sinusitis completely. In this article, we will explore the pros and cons of sinus surgery to help individuals weigh the benefits and drawbacks of this treatment option.

The Pros and Cons of Sinus Surgery: Is It Worth It? Risks and Benefits of Sinus Surgery

Please note that surgical intervention for fulminant fungal sinusitis differs entirely from surgery for other sinusitis types.


Understanding Sinus Surgery

Various factors, such as allergies, anomalies in sinus drainage pathways, or a weakened immune system, can cause sinus infections. When the sinuses become infected, the inflammation causes blockage in sinus drainage pathways. If the mucus cannot drain properly, it becomes trapped and stagnates, providing a fertile breeding ground for bacteria and fungi.


Over time, the stagnant fluids can create a cycle of chronic infections, sinus pressure, and pain. When medications like antibiotics, antiallergic medication, and decongestants don't work, doctors may suggest sinus surgery as an option.


During the procedure, the surgeon will make a small incision and use specialized tools to remove any blockages in the sinus drainage pathways. Surgery aims to create a clear pathway for the sinus fluids to drain properly and prevent future infections.


After the surgery, patients typically experience a significant improvement in their symptoms. The risk of recurrent infections is reduced by removing the blockages and allowing the sinus fluids to drain correctly. Additionally, improved drainage can relieve sinus pressure and headaches and help patients breathe more easily.


Pros and Cons of Sinus Surgery

Sinus surgery Benefits

  • TFSE sinus surgery with top technologies can provide life-long relief from sinusitis and its symptoms.

  • Treatment can prevent acute on chronic sinusitis attacks that affect daily life.

  • Chronic sinusitis complications, including hearing loss, voice box problems, and asthma, can be entirely prevented. If already present, the condition can be prevented from worsening.

  • Surgery is highly low-risk or zero-risk when used with navigation systems.

  • Endoscopes eliminate facial scars or facial disfigurement

  • Recovery time is relatively short, allowing individuals to resume work within 2 to 24 hours for people doing WFH, with a worst-case scenario of 5 days.


Risks of sinus surgery

  • FESS sinus surgery is the most popular option but has a high failure rate of 70% after three years.

  • Sinuses are located in a critical area close to the brain, eyes, nerves, and blood vessels. Without navigation technology, there is a slight risk of damaging vital parts during surgery. In rare cases, patients have lost eyesight due to sinus surgery, becoming the talk of the town among ENT surgeon circles.

  • The success rate for sinus surgery is closely related to the technology and technique used, which can be costly. For example, the top-notch sinus surgery cost in India is as much as 3.5 Lakhs INR.

  • Other potential risks and complications of sinus surgery include bleeding and infection. Post-operative care and follow-up visits are essential to minimize these risks.


Verdict: Is sinus surgery worth it?

Our author, Dr. K. R. Meghanadh, carefully weighs the pros and cons. Surgery is avoided if the patient's condition is mild and can be treated with antibiotics. However, in cases where the infection is high, the patient is experiencing complications, and his daily life is hindered due to repeated "acute on chronic" sinusitis attacks, sinus surgery is worth it as the patient can get rid of their problems. The surgery is also nothing severe and the patient can recover within a week and continue with their daily activities.


Dr. Meghanadh strongly advocates using TFSE surgery accompanied by debriders, navigation system, and EBS, despite its higher cost, due to its impressive success rate - three times higher than that of FESS. While FESS may provide temporary relief and prevent the progression of complications, patients who undergo this procedure are at a high risk of experiencing a recurrence of the disease within three years. They may need to visit the same hospital or another with similar complaints. In the worst case, they may learn to live with the disease and its complications, such as hearing loss and asthma.


If you're seeking a lasting solution to your sinus issues, Dr. Meghanadh's recommendation is clear - opt for TFSE for the best chance at success and long-term relief.


FAQs

What are the negative effects of sinus surgery?

While sinus surgery can significantly relieve sinus issues, it's essential to note that, like any medical surgery, it comes with its share of risks and possible complications. These negative effects of sinus surgery include the risk of bleeding, infection, potential damage to vital structures, etc. Still, we can minimize these risks by having sinus surgery with the best technology and following Post-operative care and follow-up visits.


Can sinus surgery cause nerve damage?

Yes, sinus surgery does carry a potential risk of nerve damage, although it is rare. Damage to the optic nerve may lead to vision loss, and facial nerve damage can cause facial paralysis. The surgeon carefully reviews the patient's CT scan before the operation to identify unique sinus structures. Despite precautions, manual errors can occur, but they are infrequent, and overall, the risk is low. The use of navigation systems has significantly reduced this risk, with some machines virtually eliminating it by triggering alarms when close to critical structures. While nerve damage is a concern, it should not deter patients from considering sinus surgery, as the benefits often outweigh the possibility of risks.


What is the success rate of sinus surgery?

Generally, sinus surgery can have a success rate ranging from 30% to 99.9%. This success rate varies depending on the specific procedure performed and the technologies employed.

 

Functional Endoscopic Sinus Surgery (FESS) achieves a success rate of approximately 30%, whereas Total Fronto Spheno Ethmoidectomy surgery (TFSE) boasts a higher success rate of 90%. Along with TFSE, if we utilize advanced medical technologies, such as navigation systems, debriders, and endoscopic balloon sinuplasty, the success rate can increase by an additional 9.9%, resulting in an overall success rate of 99.9%.


What is the downside of sinus surgery?

The downsides of sinus surgery include potential risks and complications post-surgery, such as bleeding and infection, which can be avoided or minimized if we follow the post-operative care provided by the doctor. Moreover, the sinuses are located near critical structures like the brain, eyes, nerves, and blood vessels. If we don't use any advanced technologies, there is a risk of causing damage to these structures during the surgery. Using such technologies can be expensive.

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