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  • Writer's pictureDr. Koralla Raja Meghanadh

When do you need Sinus Surgery?


When do you need Sinus Surgery?

What is Sinus Surgery?

Sinus surgery is a process where the stagnant fluids are drained out from the sinuses while preserving the mucus membrane in the sinuses and fixing the anatomical anomalies in the sinus drainage pathway that were responsible for the fluid buildup in the first place.


The results can vary, and the difference can be huge based on the technologies and techniques used. Although the initial results for most techniques are the same, the difference can be seen after three years of surgery. This difference can range from a success rate of 30% to 99.9%.


To learn more about sinus surgery techniques, check the below article.



When to have sinus surgery?

In most cases, sinus surgery is not the initial course of action for sinusitis treatment. Typically, antibiotics and home remedies can effectively address sinusitis. However, there are specific situations where sinus surgery becomes necessary, and an ENT specialist's expertise guides this decision.


Here are the instances where sinus surgery might be recommended:

  1. Severe sinusitis

  2. Medication not effective

  3. Complications

  4. Fungal sinusitis


1. Severe Sinusitis Symptoms - Repeated Attacks

If you suffer from chronic sinusitis and find yourself experiencing frequent "acute on chronic" attacks, which means having four or more severe episodes each year, each lasting over five days and requiring antibiotics to clear the infection, it might be time to consider surgery for sinusitis. These recurring attacks can significantly disrupt your daily life and even lead to complications. Sinus surgery is recommended in such cases to treat the current infection and prevent these repetitive sinus infections in the future.

2. Medicines not working

The general norm for treating sinusitis is the use of antibiotics as per the stage of sinusitis. In case of allergy, antiallergic medications are added.


ENT doctors who have prescribed the antibiotics have few expectations for antibiotic response. For example, in acute sinusitis, the starting stage of infection, 50% of the symptoms of sinusitis are supposed to reduce within 48 hours of starting the course. They either try adjusting the course or go for minor surgery to facilitate the recovery.


Sometimes, even after completion of the course, the sinus infection might not subside. The course can go up to 6 months for chronic sinusitis, and the infection might not vanish. Doctors will suggest surgery for a sinus infection.


3. Complications

Complications of sinusitis might tilt an ENT towards the surgery, especially if the complications are not resolving or to avoid the reoccurrence of the complications.


Especially for complications like orbital cellulitis, orbital abscess, meningitis or encephalitis.


4. Fungal Sinusitis

Fungal growth can take root within the sinuses when fluids stagnate in cases of long-standing sinusitis. This particular form of infection, where the fungus remains confined to the sinuses, is known as non-invasive fungal sinusitis and is the most commonly encountered type of fungal sinus infection. This presence of fungus can be identified through a CT scan. However, surgery becomes a necessary course of action once the fungus is detected on a CT scan.


Antifungal medications are often ineffective at reaching the fungus residing within the sinuses. Therefore, surgical intervention is imperative to drain the fluids containing both bacteria and fungus. On the other hand, antifungal treatment can suffice when dealing with invasive fungal sinusitis, where the fungus infiltrates the sinus tissues.


Recognizing that invasive and non-invasive forms of fungal sinus infections can coexist within a patient is crucial. Each necessitates a distinct approach for effective treatment.



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