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What Are the Complications of Sinus Surgery?

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Updated April 04, 2012

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Question: What Are the Complications of Sinus Surgery?
Sinus surgeries are often complex -- rarely involving surgery to just one sinus or one area of the nose. Instead, several structures are operated on during the a surgery. Among the procedures that may be included under the term "sinus surgery" are the repair of a deviated septum, also called a submucousal resection, ethomoidectomy, maxillotomy, sphenoidectomy, turbinate (concha bullosa) reduction, and the removal of nasal polyps. In some cases these procedures are done at the same time as an adenoidectomy, tonsillectomy, UPPP or the insertion of ear tubes.
Answer:

Sinus surgery is becoming more common as newer and improved procedure methods make this surgery safer with a shorter recovery time. The benefits can change a person's life, but all surgery has risks. This article is intended to explain potential complications of sinus surgery, however, you should always discuss the risks versus benefits of having sinus surgery with your doctor before making a decision.

Before we get started let me say that there are also expected complications of sinus surgery, (personally I don't consider these "complications" since they are normal and expected, but if you do some research you will see them listed as risks or complications in most literature). For example, it is normal and expected after sinus surgery to have pain (usually a headache or a slight burning sensation), to bleed from the nose continually for about 24 hours afterward, to feel congested and swollen for a few days, and to have bad breath. On the other hand, there are complications which are not expected, only occur in a relatively small number of cases, and can be serious. These are the potential (serious) complications you should know about before deciding to have sinus surgery.

  • Hemorrhage - Bleeding is normal, but in rare cases there is a point when the bleeding can become excessive or prolonged and pose a serious threat to your health.
  • Infections - Most of the time post-surgical infections are not serious and can be cleared up with antibiotics, but in rare cases the infection could enter the bloodstream and become life threatening. It is also possible to become infected with an antibiotic-resistant germ, such as MRSA, which could be timely and costly to cure.
  • Changes in your sense of smell and/or taste.
  • Because of the location of the sinuses there is a possibility that surrounding tissues could be damaged. These tissues include the brain and the eyes, (obviously this is very rare). Black eyes or bruising around the eyes after sinus surgery is NOT normal and should be reported to the surgeon immediately.
  • You may have numbness in the face, lips and nose. This is usually temporary but rarely, if there is actual nerve damage, this could become permanent.
  • Cerebrospinal fluid rhinorrhea - a rare complication in which brain and spinal fluid (cerebrospinal fluid or CSF) leaks from the brain and runs out the nose. Cerebrospinal fluid rhinorrhea can usually be cured with surgery.

It is also worth noting that some of the structures removed or altered during sinus surgery can regrow or move back to their original position necessitating more sinus surgery. There is no way of determining if this will be the case ahead of time. My daughter has had four sinus surgeries while her brother was cured after only one.

You also need to be aware that general anesthesia comes with its own set of potential risks and serious complications, including malignant hyperthermia and even death. You may be at a higher risk if you've had an immediate family member who had a serious reaction to general anesthesia or if you have muscular dystrophy.

OK, now that I've scared you to death, (keep reading before running to the telephone and canceling your procedure), let me tell you the good news. While exact numbers are difficult to find, as I said earlier, serious complications are rare and sinus surgery is really no more risky than hundreds of other surgeries that people have each day.

In 10 years of working in a surgical center that performs dozens of sinus surgeries each day I've only ever seen two cases where any serious complications occurred; both were excessive bleeding and both patients were later found to have undiagnosed underlying bleeding disorders (similar to hemophilia). Both patients were treated appropriately and discharged 1 to 2 days later. I'm so confident in the safety of this surgery, (and in the skill of our surgeon), that my spouse and two children have all had it. All three of them had a big improvement in overall health after their surgery, including less congestion, a decrease in headaches, and cure or improvement in sleep apnea.

Of course your personal medical health also plays a role in determining how safe this surgery is for you, which is why having sinus surgery is a personal decision between you and your physician.

Source:

American Rhinologic Society. Complications of Sinus Surgery. Accessed: March 29, 2012 from http://care.american-rhinologic.org/complications_ess

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