Much like Balloon Sinuplasty, Endoscopic Sinus Surgery is performed through the nose without the need for facial or mouth incisions, which is required in traditional sinus surgeries. The nasal endoscope is a small-lit metal telescope that is inserted through the nose. This allows Dr. Rubenstein to see inside the sinuses via a video camera that is attached to the end of the endoscope. This procedure is less invasive than traditional methods as there is no nasal packing and only mild pain. Furthermore, the recovery time is much shorter compared to traditional procedures. Previously, this type of procedure was considerably more invasive requiring external incisions through the face and mouth and extensive nasal packing. This resulted in significant pain and discomfort, and a much longer recovery time. Obviously, this is a better option for patients seeking relief from their sinuses. Dr. Rubinstein will use endoscopic techniques for his balloon sinuplasty procedures so that he can more accurately visualize the blocked sinuses while improving procedure outcomes. He will also use endoscopic techniques for more traditional sinus surgery such is in nasal polyp removal.
Goals of Endoscopic Sinus Surgery
The primary goal of this procedure is to improve sinus drainage resulting in improved airflow through the nose. Surgery goals include:
- Improving symptoms associated with sinusitis
- Reducing the amount and severity of sinus infections
- Improving a patient’s sense of smell
- Improving airflow through the nose
What to Expect During the Procedure
Dr. Rubinstein will usually perform this procedure under general anesthesia (except in balloon sinus dilation procedures) allowing patients to return home following the procedure. Next, Dr. Rubinstein uses an endoscope, which is a thin camera rod containing a light at the end. This provides clear visualization and magnification of the sinus tissues that are being treated. Dr. Rubinstein will then use specialized instruments that safely and effectively eliminate the causes of the sinus blockage. The most common things that cause blockage are nasal polyps, scar tissue, and natural blockages that can’t always be effectively treated with balloon dilation techniques.
Additional specialized instruments are then used to straighten out the septum and even reduce the size of the turbinates if needed. Because this procedure requires no cutting through the skin, the risk of infection is low and patients can return home following its completion.
I couldn’t breathe properly and really needed to do something about it. Dr. Rubinstein looked at my nose and knew right away what was wrong. He recommended a nasal polyp removel procedure. I’m about two months out and feel so much better. I can finally breathe again! All of my expectations have been met. My procedure went so well. I give Dr. Rubinstein a 5/5 rating!
What to Expect After the Procedure
While the recovery time is short, there are a few things patients should be aware of following the procedure.
Pain: While pain is minimal, you can expect some sinus and nasal pressure in the first few days following the surgery. It may feel like a sinus infection or a dull sinus ache. Extra-strength Tylenol should treat the pain, but please avoid NSAID’s like Motrin, Aleve, and Advil. Also avoid aspirin.
Bleeding: Expect some bloody discharge within the first three to five days, especially after your sinuses are irrigated. If heavy bleeding should occur, simply hold your head slightly back and gently breathe through your nose. You can also dab your nose using a tissue, but try to avoid blowing your nose. You may also use Afrin spray, as several sprays will stop bleeding. If Afrin fails, then please call our office.
Nasal discharge and congestion: You will experience some nasal discharge and congestion in the first few weeks after the surgery. After two to three weeks, the nasal passage and breathing should return to normal. Final results can take up to 6 weeks.
Fatigue: You will feel very tired the first week following the surgery. Most patients plan on taking off work for one week for recovery. Some patients return to work even sooner.
Postoperative visits: During your postoperative visits, Dr. Rubinstein’s will clean the nose and sinuses of blood and fluid left after the surgery. This will assist in the healing process.
What to Avoid After Surgery
There are three primary things to avoid after surgery to ensure proper healing:
- Nose blowing and straining for 1 to 2 weeks.
- Aspirin or non-steroidal anti-inflammatory medications
- Steroid nasal sprays until after the first post operative visit.
- Vigorous exercise in the first two weeks.