Talk to me about sinus surgery.

In My Humble Opinion
1

After a persistent bout with sinusitis…including Augmentin and CT scans, it appears that I may be a candidate for some surgery.

My ENT is suggesting a septoplasty (I have a slightly deviated nasal septum) and endoscopic sinus surgery. He is talking about removing the “walls” of the ethmoid sinuses and “opening up” the holes in the left maxiallty sinus. He “may” need to do something with one of the frontal sinuses as well.

He explained the risks and what he hopes to achieve. I’ve done a bit of googling on the procedure also (I found one site that has a Real Media tutorial of the procedure :eek: )

I’m interested in first hand patient accounts though…any doper have this done or have any wisdom to share?

2

I had some work done on my sinuses about 5 years back - I had a benign growth (osteoma) in my nasal cavity that was causing additional problems elsewhere and I had to have it removed. They had to cut along the side of my nose and I have a very small, fine scar there and some reddening. Probably they won’t have to cut you but do it all internally. Be prepared for some pain and being swollen inside - the worst thing I found was that they put packing inside and took it out after about 3 days. That was agony - perhaps if you need something like that, you could suggest a local anesthetic (sp?)… I was in floods of tears after, the big baby that I am :stuck_out_tongue:

I also have a deviated septum and have suffered bouts of sinusitis too (best antibiotic I found was called Klacid - but it may be called something else in the US). I have a really large nasal cavity as it grew to accommodate the tumour and now and even more prone to nasal problems.

But my allerigies have decreased and I don’t breathe through my mouth hardly at all now (when I was a kid, I was a most definite mouthbreather - drove my family nuts but my argument was… what, ya want me to die :eek: - you can imagine my loving brothers answers to that :rolleyes: ).

Anyways - go for it … it probably will be uncomfortable for a time but nothing like constant bouts of sinusitis and the pain that that causes (ouchie!!).

Good luck with it!!

3

Thanks for the reply. My doc said that he doesn’t put packing in…but a small plastic “splint” that doesn’t really cause as manny problems. He did say that the first week is the roughest, that I would be at only 20% strength or so…

I also have seasonal allergies, so I’m sure that will be a factor to deal with.

4

Be prepared for a week of mouth-breathing while the packing is still in your schnozz.

I had a septoplasty done about 8 years ago for a deviated septum (I’ve got the CT image here, and it looked like a rollercoaster track) and bone spurs, and wasn’t prepared for being totally wrung-out for a couple days. Mine was done under general anesthesia, which is probably why I was so tired. I don’t know if these are ever done under local anesthesia. I don’t think I’d want to be awake for it anyway!

The packing sponges are a bit uncomfortable, but you’ll get used to it just about as soon as it’s time to have them pulled out. You will be amazed at how big it is and marvel at how the surgeon managed to stuff it all into your nose. You will also rejoice at being able to breathe again!

Stock up on Tylenol and Ocean saline spray. You’ll go through at least one or two bottles. Avoid meds like ibuprofen and aspirin as they will only prolong time before healing. You’ll bleed “like a stuck pig,” in the words of my surgeon, if you’ve been regularly using ibuprofen or aspirin within a week or so of surgery.

Be glad you’ve been recommended for the procedure. You’ll enjoy living without Augmentin!

5

Oh I forgot … I did get a small infection in the nasal cavity and had to do this weird thing of injecting salty water into my nose (whilst holding the other side) so much that my head was just full of water… then let it out and do the other side… helped healing too. I am sure that had a name lol… it was odd and I was a little fearful I’d drown in case I inhaled by mistake or something lol… but it was ok and the infection cleared up very quickly (nasty smell up my nose when it was there though ewwwwwwww).

The packing my doc used was like a big long ribbon (reminded me them removing a tape worm to be honest - which is one reason it grossed me out so much)… and it bloody hurt like you wouldn’t believe. Good for you he’s not using them !!!

You’ll probably be a bit knocked out by the anesthetic (cannot spell that word) but you’ll be fine… I was up and about the next day and stopped in the corridor by a nurse who was at the surgery… she couldn’t believe I was walking round (she said it was one of the most horrible things she had ever seen - I thought ohhhhhhh thats coooooollllllll lol)…

Anyway, I was a bit groggy but only for a day … you’ll be fine, get some good DVD’s/videos, books, magazines and stuff and you’ll be grand…

Might have a bit of bruising though - but hey war wounds get sympathy :stuck_out_tongue:

6

I had a septoplasty about 3 years ago, and it was a piece of cake. I had general anesthesia (I did not want to hear them drilling about in there!), went in early in the morning, left a few hours later. Slept most of that day and was out of commission for a few more days – a large part of that, though, was I didn’t really want to go out with my nose all swollen and yucky!

It was nearly painless, for me. The doc gave me pain meds (I don’t remember what), and I took them regularly – the next one had kicked in before the last one wore off. Even taking the packing out didn’t hurt. It was kinda gross, but also kinda cool, in that “it’s-only-cool-because-it’s-me-and-I-know-it-doesn’t-hurt” kind of way. I’m sure if anyone had been watching, they’d have been totally grossed out.

Even sneezing the first time a few days after didn’t hurt. It felt different, and I had been anticipating pain, but it didn’t hurt at all.

I say go for it. It was no problem for me, and I sleep better for breathing properly. (Plus, the doctor that performed the surgery was really hot!) :smiley:

7

I’ve had septoplasty and endoscopic surgery twice.

Ask about the follow-up. The first surgeon did NONE; he merely removed the splints and gauze and sent me on my way.

Take the pain medication in the prescribed dosage. It will help. When the splints and gauze are removed, have some nasal saline on hand. Ask the doctor when you can start using it, but it helps keep the membranes moist.

If you are prescribed allergy medications, take them in the prescribed manner, especially any nasal squirty kinds. They will prevent you from getting sinus infections.

That’s all the advice I have, but ask any question and I’ll try to answer. :slight_smile:

8

Oh and I wouldn’t have needed the second surgery if the first surgeon had done his job.

9

My ENT said that following the surgery, I will use Afrin for the first 2 days and then this stuff for the rest of the week until I see him again.

His opinion was that 8/10 people have noticable improvement in their symptoms a week or so after surgery. Another 10 percent need more followup care to notice improvement, and 10% don’t have significant improvement. He felt that most of that last category were due to significant polyp problems which he didn’t think I had.

Thanks for the feedback so far.

10

I had sinus surgery nearly eight years ago for an entire host of problems. (My doc at the time said she didn’t think she’d ever seen so many things wrong in a single MRI.) I had: deviated septum, large bone spur (or birth deformity, we weren’t sure) that nearly completely blocked the already contorted right passage, various cysts in various sinuses, and some thingy I can’t recall the name of. Then, when they actually went in, they found still more things (among them a missing membrane that they had to reconstruct) and the 2 1/2 hour surgery turned into a 4 hour one.

Short version: I was very uncomfortable for about two weeks, and badly sleep deprived for one. But–I went from a sinus infection every 4-6 weeks, to one every six months, to (as of now) 2 in the last 4 years. And I’ve not had bronchitis or pneumonia once since (before surgery, infection would spread throughout my respiratory tract).

Longer version: The worst pain in the first few hours wasn’t my nose, but my chest. The intubation left me with an achy, raw feeling that seemed to radiate through my lungs. The packing (spongey stuff, not gauze) practically completely blocked my nasal breathing, and those stupid tube things designed as essentially dual snorkels were practically no good. Mouth breathing was uncomfortable, so I went about a week sleeping an hour or two at a time before waking up again. By the end of the week, I was an exhausted mess. Once the doc removed the packing (after a week), I came home and took a four hour nap, followed by 18 hours of sleep that night.

Count on soaking your pillow. As my sinuses were swollen shut, all of my tears that normally flow through them poured out my eyes. I’d wake up looking like I’d been crying all night, and in a way, I had.

Removal of the packing definitely hurts. Curiously enough, it’s your teeth that hurt most as the roots go up into sinus cavities. It was a constant feeling of being clocked in the face with a basketball while he took those out.

For a while after, the mucosal membranes were in shock, so I had to keep a bottle of Ocean sline spray on hand constantly for about a month or so.

It was definitely a whole lot more than I bargained for, but the result has been practically miraculous. I can only speak for myself–but I have never, EVER regretted getting it done.

11

I had a polyp removed. I was told this would normally have been done without general anethesia, but I had a tonsillectomy done at the same time. Do not do this.

I think the sinus surgery by itself would have been relatively uneventful. I did get the packing, but for some reason it didn’t bother me much. I was shocked when he took it out how much was in there, because I really couldn’t tell. Then again, I didn’t know I had a polyp the size of a grape in there, either. It was kind of an add-on surgery, I went in to get my tonsils checked and he found a polyp too.

I guess I’m not a good example because I had lots of complications from the tonsillectomy, so I hardly noticed the sinuses. Later on, though, I could really tell what a difference it made, especially in the spring when allergy season came. I don’t spend winter with sinus infections anymore, and my allergies are much, much less bothersome. I also used to get migraines from the sinus pressure, and those are pretty much gone.

I know my surgery is different, but I’m glad I had mine done. The results in the end were worth it. I found so many things were better that I didn’t even know were caused by the sinus problems until it was fixed.

12

I just wanted to add that Augmentin is evil, nasty stuff. Wrecked my digestive system for weeks, to the point where I couldn’t tolerate any pain meds after my surgery. Lovely.

13

There was an episode of the show “Fresh Air” last week (or the week before; I don’t remember) whose guest wrote a book on the nose. You can read about it here. Yes, I know it’s about the nose and not the sinuses, but there was some interesting stuff nonetheless.

Robin

14

Polyp! That’s the word I was thinking of. I had polyps in a couple of the sinus cavities.

Carry on. :slight_smile:

15

I was thinking about it, and I’m pretty sure I had stints, too – that’s probably why it didn’t hurt when the “packing” came out. What I thought was packing was just cotton and gauze to absorb the blood, and I had to change that on a fairly regular basis. I went back to the doctor to have the stints taken out, and I think that hurt a little, but I don’t remember it very well, so it couldn’t have been that bad.

16

Jesus, I opened this thread out of curiosity but I think I’m going to pass out.

17

I may be wrong here, but it sounds like this sinusitis thing just started recently? If so, I think surgery might be a bit premature. I went through a period of time several years ago where I would no sooner get over one bout of sinustitis when another one would start. I was miserable. After awhile it settled down to once or twice a year. BUT…a year ago I discovered the “Neti Pot”, which is a natural remedy that works amazingly well. The same person who told me about THAT told me just yesterday about the system you mentioned above…this …and she says it works just as well as the Neti Pot and is much easier to use.

SO…I would recommend you buy the Sinus Rinse Kit and use it twice a day for a couple of weeks to see how that works out for you before committing to sugery. My friend actually had the surgery scheduled before she found the Neti Pot, and she cancelled the operation AND hasn’t had a sinus infection since she started using it!

Good luck…I feel for you. When your head hurts your whole boday hurts…at least mine does.

18

I did this almost exactly a year ago (along with a tonsillectomy - my third, if you can believe it.) I have nothing much to add to what everyone else has said, but I will say that my snoring has almost disappeared, I can breathe through my nose, I have no more “heaviness” in my head and my apnea - GONE!

Removal of the gel-packing was a shock, but only hurt for a minute. The night of (after) the surgery, though, I didn’t sleep a wink. Couldn’t breathe through my nose for the packing, and therefore couldn’t swallow at ALL. I spent most of the night upright in a recliner, getting up every couple minutes to swish water in my mouth and spit to get the “gummy” feeling out. Once the packing was out, I slept like the dead for more than half a day, only getting up to take pain meds, which were for the tonsils much more than the nose. I was almost myself again by day three.

Good luck!

19

**

Actually it’s been an ongoing issue for awhile. I have used the Saline Rinse for quite a number of months…have been on Augmentin and Rhinocort as well. I will still probably use the Sinus Rinse afterwards at least for awhile. My ENT is a big proponent of it (its also referred to as hypertonic saline rinse)

I (and the ENT) would love to have a non-surgical solution to this…unfortunately that appears to not be the case.

20

Do you mean it was your third sinus surgery or your third tonsillectomy? (How is it possible to have more than one tonsillectomy?) Was that episode of Seinfeld right…“Sometimes they grow back?”

: shudders at the thought of ever having another tonsillectomy :