We offers premier nasal and sinus surgical treatment options for conditions that either require surgery or aren’t responding to other medical or procedural treatment plans. Most of these can be managed or cured using nonsurgical treatments. In some cases, though, our physicians may recommend surgical solutions. Whether or not you’ll require surgery depends entirely on your individual health and personal needs. Some examples of conditions that may require nasal or sinus surgery include:
- Nasal blockage
- Deviated septum
- Nose bleeds
- Enlarged turbinates
- Chronic breathing issues
- Chronic sinusitis
- Sinus or nasal trauma
- Nasal polyps
- Chronic stuffiness
Depending on your condition, insurance, lifestyle and symptoms, your ENT physician may recommend one or more surgical treatment options. Some of the most common procedures we perform in-house or at our outpatient surgery center include:
- Functional endoscopic sinus surgery (FESS) is used to improve nasal drainage and open up the nasal passageways. To perform this outpatient procedure, your doctor uses an endoscope (a small probe with a camera on the end) to enter your sinuses and remove problematic tissues and diseased sinus mucosa.
- Image guided surgery is another endoscopic surgery option for severe forms of chronic sinusitis or nasal blockage that can’t be treated using normal sinus surgery methods. It relies on a three-dimensional mapping system created from CT scans for extreme precision.
- Balloon Sinuplasty uses a small balloon catheter inserted into the sinuses then inflated to open up the nasal passageways. Once the sinuses reach the desired width, the balloon is deflated and removed, leaving more space in the passageway.
- Caldwell Luc operation improves drainage in the maxillary sinus by creating a window from this cavity to the nose. The surgeon enters the maxillary cavity endoscopically through the upper jaw above the molars.
- Septoplasty and septorhinoplasty procedures reshape, reduce or reposition portions of the septum’s bone or cartilage to open up the nasal passageway and improve drainage and breathing. These procedures are used to reduce blockage, fix a deviated septum, repair a broken nose and more.
- Turbinate surgery reduces airway obstruction and difficulties breathing caused by enlarged or swollen turbinates, which are small bones that clean and humidify air as it passes through your nose. There are several types of turbinate surgery, including the turbinectomy (full or partial tissue removal), the turbinoplasty (tissue repositioning), radiofrequency or laser ablation surgery (tissue reduction) and submucous resection surgery (partial bone or cartilage removal).
Endoscopic Sinus Surgery (FESS)
If you’re suffering from chronic sinusitis and have exhausted all medical treatment options, your doctor may recommend a surgical procedure known as functional endoscopic sinus surgery (FESS). This involves using an endoscope – a tube with a tiny camera attached – to guide a surgeon in removing extraneous tissue to open up the nasal passages.
Sinusitis is a common condition where the tissues that line the sinuses become swollen and inflamed. This traps fluid inside and promotes germ growth, causing an infection. Many factors can cause sinusitis including nasal polyps, deviated septum, respiratory tract infections, allergies, foreign objects in the nose and additional medical conditions.
Chronic sinusitis results in a variety of cold-like conditions including congestion, runny nose, facial pain and pressure, loss of smell, fever, fatigue and dental pain. It is considered chronic when symptoms last eight weeks or longer.
Treatment for chronic sinusitis involves medications such as decongestants, antihistamines, nasal sprays, oral steroids and antibiotics. Home remedies – using a humidifier, inhaling hot steam, a warm compress – often help relieve pain and discomfort. Sometimes, these treatments aren’t enough to clear up chronic infections. In those instances, your doctor might turn to surgery.
The goal of FESS is to open up the sinuses, allowing normal drainage of fluids to occur. Without proper ventilation, mucus builds up in the sinuses, leading to infection.
To determine if you are a candidate for FESS, your doctor will thoroughly examine your ears, nose and throat, looking for obstructions and other abnormalities such as nasal polyps. If the odds of a successful surgery look promising, it will be scheduled with one of our surgeons.
FESS is usually performed as an outpatient procedure under local or general anesthesia. An endoscope is inserted in the nose, and the camera is used to visually inspect the sinus openings. The surgeon relies on these images in order to remove excess obstructive tissue. The surgery is performed through the nostrils, making it a less intrusive procedure that won’t leave scars or cause facial swelling or bruising. Post-operative care includes flushing the nasal passages to keep debris from building up. In some cases, antibiotics or steroids may be prescribed in order to speed up the recovery process.
Commonly referred to as a broken nose, a nasal fracture is a break or crack in the bone in your nose. Contact with a fixed object, such as a door or wall can cause a break. Contact sports (like hockey and football) and motor vehicle accidents are common causes of a broken nose.
Pain when touched, swelling of the nose and bleeding from the nose are common symptoms of a nasal fracture. If you have a nose injury accompanied by difficulty breathing, unstoppable bleeding and a noticeable change in the shape of your nose, you should seek medical attention as it is probably broken.
To confirm a nasal fracture, your doctor will perform a physical exam. He or she will press on the sides of your nose and look inside your nostrils for signs of broken bones. Topical anesthetics may be applied before the physical exam to control the pain. An imaging test is usually unnecessary, but based on the severity of your injury a CT scan may be required if a physical exam is too painful to be performed.
The treatment for a nasal fracture depends on the severity. A minor fracture that has not changed the shape of your nose may not require medical attention at all and will heal on its own. Larger breaks will require your doctor to manually realign your nose. This procedure is performed with injected anesthesia. A nasal speculum is inserted into the nostrils and with the help of other specialty instruments your broken nose and cartilage are put back into place. An internal and external splint will be attached to help keep your nose in place while the bone heals. For severe breaks surgery may be needed.
Call (913) 663-5100 for more information or to schedule an appointment.