Chronic rhinosinusitis (CRS) is a major health issue, impacting between 5% and 12% of the general US population. While many patients find relief through medications and lifestyle changes, some may require surgical intervention. This blog aims to provide patients with essential information on when to consider surgery for chronic sinusitis, the types of procedures available, and what to expect during the process. 

What is Chronic Sinusitis? 

Chronic sinusitis is a prolonged inflammation of the sinuses lasting more than 12 weeks despite treatment. It can be caused by infections, inflammation, and nasal polyps, , leading to symptoms such as: 

• Nasal congestion 
• Facial pain or pressure 
• Reduced sense of smell 
• Thick nasal discharge 
• Post-nasal drip 

Initial Treatments 

Before considering surgery, doctors typically recommend non-surgical treatments, including: 

• Nasal corticosteroid sprays: Reduce inflammation in the nasal passages. 
• Nasal saline irrigation: Clears mucus and allergens from the nose.
• Oral corticosteroids: Help with severe inflammation, though usually short-term due to side effects.
• Antibiotics: Prescribed if a bacterial infection is present.
• Allergy medications: Address underlying allergies contributing to sinusitis. 

When to Consider Surgery 

Sinus surgery may be recommended if: 

1. Symptoms Persist Despite Treatment: If your symptoms do not improve with medication or other therapies, surgery might be necessary. 
2. Anatomical Blockages: Structural issues like a deviated septum or nasal polyps may require surgical intervention to improve sinus drainage. 
3. Recurrent Infections: Frequent sinus infections that do not respond to treatment might be alleviated through surgery. 
4. CT Scan Findings: Imaging showing blocked sinuses or other abnormalities can indicate a need for surgical evaluation. 
5. Quality of Life Affected: If chronic sinusitis significantly impacts your daily life, work, or sleep, surgery may offer relief. 

Types of Sinus Surgery 

Several surgical options are available for treating chronic sinusitis: 

Functional Endoscopic Sinus Surgery (FESS) 

FESS is the most common procedure for chronic sinusitis. It involves using an endoscope (a thin tube with a camera) to visualize the sinuses and remove blockages, such as polyps or infected tissue. The goal is to restore normal drainage and ventilation of the sinuses. 

Balloon Sinuplasty 

This minimally invasive procedure   uses a small balloon to open blocked sinuses. Once the balloon is inflated, it gently expands the sinus opening, allowing for better drainage without the need for extensive tissue removal. This option is often suitable for patients with less severe disease.



Septoplasty 

If a deviated septum contributes to chronic sinusitis, a septoplasty may be performed in conjunction with other procedures to improve airflow and drainage. 

Nasal Polypectomy 

For patients with significant nasal polyps contributing to their symptoms, a nasal polypectomy may be performed to remove these growths and improve sinus function.