Your sinuses are air-filled spaces in the bones of your face, connected to the inside of your nose by small openings. They warm and filter the air you breathe and produce a thin layer of mucus that drains into the nose.
When those drainage pathways become blocked, whether by inflammation, infection, polyps or anatomy, mucus builds up. That is what causes the pressure, pain, congestion and repeated infections.
Endoscopic sinus surgery, often called FESS, opens those natural drainage pathways again.
Chronic sinusitis is not dangerous. If your symptoms are manageable, it is reasonable to continue without operating.
Medical treatment comes first, and surgery works best when it has already been optimised. High-dose nasal steroid sprays, saline rinses, antibiotics and allergy treatment resolve the problem for many patients. I would rather you had exhausted that before we discuss an operation.
For severe nasal polyp disease, injectable biologic medications can significantly reduce polyp size, and in suitable patients they may be considered before or instead of surgery.
Surgery becomes the right option when symptoms have not responded adequately to medical treatment. The common reasons are chronic sinusitis lasting more than twelve weeks, nasal polyps, or recurrent acute sinusitis.
A thin telescope is passed through your nostrils so I can see inside the nose and sinuses directly. Fine instruments remove diseased tissue, clear blockages, and open the drainage pathways so mucus can drain and air can circulate.
There are no cuts on your face. Everything is done through the nostrils, so there are no external scars and usually no bruising.
How much surgery is needed depends on which sinuses are affected and how badly. In some patients it is a day case; others stay overnight.
Opening the drainage pathways also means nasal sprays and rinses reach the sinuses afterwards, which is a substantial part of why the operation works.
The first two to three weeks. You will feel more congested rather than less, as the inside of the nose heals. This is the part that surprises people. The face can feel tender for a few weeks.
Four to six weeks. Real improvement in breathing and sinus symptoms usually arrives here.
Three to six months. The full result.
Most people take one to two weeks off a desk job. Physical work needs three to four weeks. You will be given a medical certificate at your first review.
Saline rinses continue throughout and they matter more than most patients expect.
Surgery significantly improves sinus drainage and reduces symptoms for most people.
But chronic sinusitis and nasal polyps can recur, particularly where the underlying allergy or inflammation is not managed. Ongoing nasal sprays and regular review are part of staying well afterwards, not an optional extra.
In a smaller group, particularly patients with severe polyps, marked inflammation or a history of asthma, revision surgery may be needed at some point.
I would rather set that expectation now than have you believe one operation ends the problem permanently.
Endoscopic sinus surgery is generally Medicare-eligible where the clinical criteria are met, and private health insurance covers the hospital fee, subject to your excess and any waiting periods.
There are three separate fees: the surgeon’s, the anaesthetist’s and the hospital’s. The cost varies with the complexity and extent of the surgery, so the figure is set out in a written financial consent after your consultation, showing all fees, rebates and expected out of pocket costs before you commit to anything.
Bleeding, infection, and recurrence of symptoms. Less commonly, changes to the sense of smell, and rarely, injury to the structures around the sinuses, since the eye and the base of the skull sit immediately adjacent.
Every operation carries risk and I will discuss the likelihood in your particular case before you decide.
Seek urgent review if you have heavy bleeding that will not stop with pressure, sudden severe headache or a stiff neck, changes in vision or swelling around the eye, or a high fever with worsening facial pain. Call 000 or go to your nearest emergency department.
You will need a referral from your GP. I consult from Westside ENT’s rooms in Indooroopilly, Springfield and Ipswich.
Sinus surgery opens the pathways of the sinuses and clears blockages to improve sinus drainage and ventilation.
Dr Chris Oosthuizen performs ‘functional endoscopic sinus surgery (FESS)’ for patients at the Mater Private Hospital Springfield and St Andrew’s Private Hospital Ipswich.
The procedure is carried out through the nostrils, so there is no incision on the face. Most patients have mild discomfort for a short time.
Sinus surgery is a helpful option for people with chronic sinus infection and inflammation, recurrent sinus infections or an abnormal growth in the nose or sinuses.
By removing the inflamed tissue within the sinuses and widening the natural openings of the sinuses, improved drainage and ventilation of the sinuses is achieved. Sinus surgery also provides increased access for nasal washes and sprays following surgery, which helps to control sinus inflammation.
Sinus surgery followed by ongoing medical management improves symptoms for many patients, and the sense of smell often improves. Chronic sinusitis and nasal polyps can recur, so nasal sprays and regular review remain part of staying well afterwards.
The cost of sinus surgery is different for each individual, depending on the complexity and extent of the surgery.
Costs will include specific fees for Dr Chris Oosthuizen, the anaesthetist and the hospital.
Sinus surgery is medically necessary surgery, and commonly covered in part by Medicare and private health insurance funds.
Our fees are set with reference to the guidance published by the Australian Medical Association.
You will be given a written quote setting out the surgeon’s, anaesthetist’s and hospital fees, with expected rebates and out of pocket costs, before you decide whether to proceed.
Please contact our office if you have an enquiry regarding fees.
Sinus surgery is performed to open narrow or damaged sinus passages and allow natural drainage and ventilation of the affected sinuses. It also allows for more effective use of medical treatments (sinus washes and sprays) afterward.
The sinuses are connected to the nose internally. Sinus surgery is performed by using miniature, high definition, cameras and fine instruments that are passed through the nostrils to give Dr Chris Oosthuizen an inside view of the nose and sinuses. Dr Chris Oosthuizen then uses these instruments to remove inflamed and infected tissues and widen the natural openings of the sinuses, improving sinus health.
There are no incisions on the outside of the face. Swelling or bruising of the face is uncommon after this type of surgery.
Most sinus surgery patients spend the first night after surgery in hospital and are able to go home early the following morning.
In certain instances, surgery can be considered as a day case procedure, depending on the extent of surgery and whether you have any other medical conditions. Up to two week’s rest right after returning home from surgery is recommended. A patient’s nose and the front of the face can be a bit tender for a few weeks.
All operations carry some element of risk in the form of possible side effects. These are the potential risks that you must know about before giving consent to Sinus Surgery, however many of these potential complications are very uncommon.
You should always discuss with your surgeon about the likelihood of problems in your case before you decide to go ahead with the operation.
Bleeding
Bleeding is a risk of any operation. It is very common for small amounts of bleeding to come from the nose in the days following the operation. Major bleeding is extremely uncommon and it is very rare for a transfusion to be required.
Eye Problems
The sinuses are very close to the wall of the eye socket. Sometimes minor bleeding can occur into the eye socket and this is usually noticed as some bruising around the eye. This usually gets better without any special treatment, although it is important that you do not blow your nose.
More serious bleeding into the eye socket sometimes can occur, however this is very rare. This can cause severe swelling of the eye and can even cause double vision or in very rare cases loss of sight. If such a serious eye complication did occur you would be seen by an eye specialist and may require further operations.
Spinal Fluid Leak
The sinuses are very close to the bone at the base of the brain. All sinus operations carry a small risk of damage to this thin bone with leakage of fluid from around the brain into the nose, or other related injuries. If this rare complication does happen you will have to stay in hospital longer and may require another operation to stop the leak. On very rare occasions infection has spread from the sinuses into the spinal fluid causing meningitis but this is extremely uncommon.
You can discuss this complication with your surgeon before the operation.
How often do complications happen?In general, complications are very rare. In a survey of all ENT surgeons who do this type of operation in England, minor eye complications happened in one in every five hundred operations and spinal fluid leaks happened in onecase in every thousand operations, so the risks are small.
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