Sinus Surgery
The sinuses are open air filled cavities that are located in four different areas within the facial bones and skull. They are almost always found in pairs and are named for their location in the different facial bones. They have nature openings that open into the nose. This area of natural opening is called the osteomeatus. Most people have four sets of sinuses:
Sinusitis is an inflammation of the sinuses. This inflammation may be confined to one sinus cavity by itself, but more commonly involves all of the sinuses cavities.
Sinusitis usually implies infection of at least one of the sinuses and can be brought on by any condition that causes obstruction of the natural openings of the sinuses into the nasal cavity.
Conditions that may lead to or cause sinusitis include viral infections such as:
- Common cold
- Nasal allergies
- Nasal polyps
- Various fungi
- Hay fever
- Cystic fibrosis
- Other anatomical variations of the nose and sinus cavities
Types of Sinusitis:
Sinusitis can be either Acute or Chronic
Common Symptoms
Sinusitis can be diagnosed based on signs and symptoms along with a physical examination.
Acute sinusitis sufferers usually look very sick, and have a fever, chills, headache, runny nose, upper respiratory infection, and facial pain. These patients usually respond very well to oral antibiotics.
Chronic sinus problems can be tougher to diagnosis and evaluation nearly always requires some type of x-rays, usually a CT scan.
The CT scan has become the gold standard in the evaluation and work-up of patients with chronic sinus problems. The CT scan allows one to look at the anatomy of the sinus cavities. It is difficult to evaluate chronic sinus problems without the help of the CT scan.
Treatment for Sinusitis:
The treatment of sinus problems usually involves the use of antibiotics, surgery, or both.
The Surgery
Most sinus surgery today is preformed endoscopically. This involves using tiny telescopes to look up into the nose and into the sinus cavities. These small telescopes along with small microsurgical instruments can be used to actually open and go into the sinus cavities and clean the sinuses out.
Puss, polyps, and the like can be removed and sent to pathology for examination. This type of sinus surgery is usually reserved for cases that do not respond to conventional methods of treatment with antibiotics or allergy treatment.
The advantages of this type of surgery is that it enables the surgeon to look directly into the sinus passageways and remove any abnormal findings as well and to correct any bony or anatomical abnormalities.
This type of surgery causes little pain to the patient after the procedure, and there are no incisions or black or blue marks on the face or eyes. It can take as long at 4 hours, or be as short as 30 minutes, depending on the degree of sinus involvement.
Caring for your Child after Surgery
After endoscopic sinus surgery you can expect a stent that will dissolve inside your child’s nose. This will help to assure proper healing. Your child will have a little blood-tinged drainage from the nose and may wear a small dressing under the nose. Doing too much too soon may increase the amount of drainage.
A stuffy nose may last for a few weeks as the sinuses heal. Pain varies from child to child but it is often more of an ache in the nose and sinus areas rather than sharp pain.
What to Do after Surgery
Learning to care for your child is a vital part of your child’s healing. These steps may guide you during your child’s first days.
- Your child may feel sick to his or her stomach from the anaesthesia. Begin with clear liquids and advance to solid foods as your child is able to handle it.
- Your child may sleep with his or her head on 2 to 3 pillows for the next week or so if this makes them more comfortable.
- Cold packs to the nose and sinus areas may help give extra comfort. Apply the pack every 3 or 4 hours for 20 to 30 minutes as needed. They work best if used during the first 48 hours after you go home.
- Be sure your child takes all of the antibiotics prescribed to help prevent infection.
- If told to do so, use the steroid nasal spray to help decrease inflammation.
- Your child should drink a lot of water and other fluids.
- A vaporizer or humidifier at your child’s bedside may help increase drainage from the sinuses. An ultrasonic or cool-type are the best. Be sure to clean the machine often using the manufacturer’s directions.
- Pain medicine will be ordered to help lessen the pain. Do not give your child any medication without first talking to your family doctor or another qualified medical professional.
Cautions and Restrictions after Surgery
- No nose blowing for two weeks. This could cause bleeding.
- Do not hold back a sneeze. If your child sneezes, have him do so with his mouth open.
- No competitive sports, running, hard biking, exercising, swimming, or aerobics for 2 to 3 weeks. Your doctor will discuss with you when your child may resume her normal activities and sports.
- If your child gets a bloody nose doing any activity, please have him stop and rest.
- Your child may return to school when she feels up to it, often within 2 to 3 days.
- Your child should not bend over and pick up heavy objects off the floor for 2 weeks.
- Do not give decongestants or antihistamines unless prescribed by your doctor.
- Keep your child away from cigarette smoke and noxious fumes that may irritate the nose.
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Avoid air travel for a few weeks to avoid pressure changes and the drying effects of airplane air.
