Sinus Surgeries
Dr. Anstead is one of the most experienced fellowship trained Sinus Surgeons in the Pacific Northwest, having performed thousands of complex sinus and endoscopic skull base surgeries, successfully treating patients from all over the world. Explore the sections below to review some of the specialized procedures Dr. Anstead performs.
Types of Sinus Surgeries
Read below to review some of the specialties Dr. Anstead provides patients.
Nasal Endoscopy
In clinic, Dr. Anstead can perform a Nasal Endoscopy, which is a procedure to examine the inside of the nasal cavity and the openings to the sinus passages. The procedure involves using an endoscope, which is a small probe with a camera and light attached, so that the sinus openings can be seen on a screen. Other terms for nasal endoscopy are rhinoscopy or sinonasal endoscopy, often used interchangeably. This is the recommended examination for nasal congestion/obstruction, headaches, facial pain, nasal polyps, nasal tumors, loss of smell (anosmia), and rhinosinusitis.
A nasal endoscopy may also be used as part of other procedures, such as a tissue sample or sinus culture, removing foreign objects from the nose, and treating sinus infections, tumors, and polys within the nose. The nasal endoscopy is a quick procedure, usually less than a minute to complete, and is performed in the office. For the patient’s comfort, the procedure is performed with topical anesthesia, and the nose is partially numbed with lidocaine along with a decongestant (Afrin/oxymetazoline) is used prior to the endoscopy.
Septoplasty
A deviated or crooked septum can make it more difficult to breathe and increase the risk of sinus infections due to poor drainage. A septoplasty helps to remedy this condition by straightening the bone and cartilage that is dividing the space between the two nostrils. The procedure is performed under general anesthesia for patient safety and comfort and involves trimming and/or repositioning the crooked cartilage or bone of the septum.
Inferior Turbinate Reduction
This is a surgical procedure that improves airflow in patients with chronic nasal obstruction. The surgery removes excess tissue around the turbinate bones, which are small hotdog shaped structures within the nose that warm and humidify the air as it passes through your nasal cavity on the way to the lungs. The turbinates can become inflamed and swollen from irritation from allergies, infections, or chronic Afrin (oxymetazoline) use. Inferior turbinate reduction is a common procedure and can be performed under general anesthesia as a same day/outpatient surgery.
Ethmoidectomy
Ethmoid sinuses are located between the eyes and the bridge of the nose and are a labyrinth of sinus spaces in bone. When they become blocked or inflamed, they can block the natural drainage of other sinuses and perpetuate sinus infections. An ethmoidectomy helps to relieve the blockage by removing infected tissue and bone in the ethmoid sinuses. The procedure is performed with an endoscope, which is a thin probe with a small camera and light attached at the end of it. This instrument helps identify the infected tissue and bone for removal.
Sphenoidotomy
A surgical procedure where an opening into the front wall of the sphenoid sinus is created. The goal of the procedure is to improve drainage and airflow through the nose and sinuses. It can also be used to remove lesions or tumors of the sphenoid sinus, as well as surgical treatment for conditions in the skull base and pituitary, or to relieve inflammatory disease of the sphenoid sinus.
Maxillary Antrostomy
This is a common surgical procedure that enlarges the opening of the maxillary sinus. When the maxillary sinus is blocked, it will no longer drain properly and can encourage an infection to develop. The surgery clears the sinus opening and is a common recommendation for people suffering from chronic sinusitis, especially if unresponsive to other treatments. Maxillary antrostomy is performed under general anesthesia and is an outpatient procedure.
Frontal Sinusotomy
Using an endoscope, the ENT surgeon goes through the nose to reach the anterior ethmoid sinus and the frontal sinus above. With surgical tools small enough to enter the nasal cavity and sinuses, the affected areas are opened and diseased tissue is removed. To better the natural function of the sinus, the natural opening is widened to allow drainage and clear mucus. The surgery can be performed to clear out a blockage due to polyps, tumors, bony overgrowth, or mucoceles and is minimally invasive due to no external incisions being made.
Modified Lothrop Procedure
The goal of this operation is to allow drainage and ventilation of a chronically infected frontal sinus. The surgeon uses an endoscope and specialized instruments to remove the tissue blocking the sinus and create a large window into the frontal sinuses. Due to the operation being performed through the nostril openings, there are no external scars.
About Endoscopic Sinus Surgery
What is endoscopic sinus surgery?
Endoscopic sinus surgery can help people who experience nasal congestion, pain, drainage, difficulty breathing, loss of sense of smell (anosmia) or other symptoms due to:
- Sinusitis (persistent or chronic sinus infections)
- Nasal polyps
- Nasal obstruction or blockage
- Sinus and nasal tumors
The goals of endoscopic sinus surgery include:
- Reduce the number and severity of sinus infections
- Improve sinusitis symptoms
- Improve the drainage of the sinuses
- Improve airflow through the nose
- Improve the sense of smell
- Allow access for nasal rinses to reach the sinus cavities for cleaning and medication delivery
Who may need endoscopic sinus surgery?
Anyone who suffers from symptomatic chronic sinus disease and/or nasal obstruction that fails to resolve with medical treatment.
What happens during endoscopic sinus surgery?
While the patient is under general anesthesia, the surgeon enters through the natural openings of the nose and opens the sinuses, removes polyps and/or tumors, and straightens the septum.
Postoperative Care
After surgery, the patient will wake up in the recovery room with a sling under their nose to catch any oozing. The patient should refrain from blowing their nose for two weeks after surgery. The patient should leave their nose alone and let it heal after surgery. The patient patient should keep their heart-rate and blood pressure within the normal range and not engage and vigorous physical exercise for at least 7-10 days after surgery.
Endoscopic Sinus Surgery Recovery
The patient will see their surgeon in clinic 7-14 days after the surgery. At this clinic visit the patient’s nose will be numbed with topical anesthesia and using a small endoscope the nose will be cleaned by the surgeon. This procedure is called a post operative debridement and is essential for the sinuses to heal open.
What to Avoid After Endoscopic Sinus Surgery
Do not blow your nose after sinus surgery. Do not stick anything (including plastic nozzles of nasal spray bottles, Q-tips, tissues, or fingers) into your nose after surgery. Do not take any blood thinning medication (eg. Aspirin, ibuprofen, Aleve) or supplements (eg. Fish oil, Garlic capsules). Do not engage in vigorous physical activity.
Endoscopic Sinus Surgery: Risks and Complications
In general sinus surgery is very safe. The most common complication is a post operative nose bleed. Your surgeon will review with you the possible complications and provide you with a written list at your preoperative clinic visit. Possible complications are:
- pain
- bleeding
- infection
- need for re-operation
- injury to the structures that surround the sinuses including the brain and eyes
- double vision
- scar formation
- loss of smell
- brain fluid (CSF) leak
- meningitis
- empty nose syndrome
- chronic crusting
- among others
When to Call the Doctor After FESS Surgery
You should generally feel better day by day after surgery. If you experience any worsening of symptoms, fever, excessive bleeding, double vision, neck stiffness, severe headache or any other unexpected symptom, please call your surgeon’s office, call 911, or go to the nearest emergency room.
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