Are You Dreading Sinus Surgery?

by Kenneth M. Hodge, MD

To know that complications from sinus and ear infections were the leading cause of death in United States community hospitals in 1900 is to appreciate how much our world has changed due to medical advances. Fortunately, these deadly cases are rare today. Although the vast majority of “sinus headaches” are not really sinus related, and only three percent of illnesses causing nasal congestion, facial pressure, and nasal discharge are actually sinus infections, there are still many of our Ohio Valley citizens with these problems that will need to consider nasal and/or sinus surgery.

Often one of the first things the modern sinonasal surgeon will need to do is to correct some misconceptions which have caused many patients, who would otherwise be potential success stories, to delay or avoid surgical options. Fortunately, this is no longer your “Aunt Ethel’s horrible operation.”

Prior to the mid-1980’s sinus operations were, in fact, very difficult to endure. Many required significant incisions, traumatic tissue manipulation, and tight pressure packing. Recent advances have changed how the vast majority of our patients feel about their operation and its results.

The CT Scan and fiber-optic nasal examination allow for more accurate diagnosis and are great educational tools for communicating with the patient. The CT Scan also allows for 3D Imaging of sinus problems in the operating room when the surgeon requires an enhancement of surgical visualization in selected cases. Allergic and immune system diseases must also be critically considered and evaluated when necessary. Some centers offer all of these services under one roof, often in the same visit.

Improved surgical equipment was also allowed patient management changes that make the operation easier to tolerate. Modern instruments make surgery faster, less traumatic, and produces less blood loss. Therefore, it is rare for most surgeons to place any packing in the nose whatsoever. The most memorable experience of most patients from “the early days” was the intolerable pressure from packing and its unpleasant removal. Advances from our Anesthesia colleagues have also allowed patients to choose from a deep, monitored sedation coupled with thorough local anesthesia or a general anesthetic.

Despite all of our advances, some things in medicine should never change. You should only consider surgery when you feel comfortable that your problem is not responding adequately to other treatment options. After a comprehensive assessment, an individualized and detailed plan should be explained in language you can understand in order to make an appropriate decision. In fact, your commitment to the treatment plan is a big key to its success.

So, if you need surgery, you do not need to dwell on bad stories from outdated techniques. Develop a relationship with a doctor who earns your trust, confidence and loyalty with thorough evaluation and thoughtful discussion. Then, if you need surgery, you will not doubt your decision. In all likelihood your recovery will go more smoothly than you might have imagined.