Sinus Surgery: What It Is and When You Might Need It

Sinus problems affect millions of people each year, causing symptoms such as facial pressure, nasal blockage, headaches, and recurrent infections. For many patients these symptoms improve with medication, but for others they can persist despite repeated treatments.

When sinus symptoms continue to affect daily life, sinus surgery may be recommended to restore normal drainage and improve long-term sinus health.

As a Consultant ENT Surgeon specialising in rhinology, Mr Karan Jolly regularly assesses patients with complex sinus conditions and helps determine when surgery may be the most appropriate option.

What Are the Sinuses?

The sinuses are air-filled cavities located within the bones of the face and skull. They connect to the nasal passages through small drainage pathways and play several roles, including helping to humidify the air we breathe and contributing to the resonance of our voice.

There are four main groups of sinuses:

• Maxillary sinuses (in the cheeks)

• Ethmoid sinuses (between the eyes)

• Frontal sinuses (in the forehead)

• Sphenoid sinuses (deeper within the skull)

When these drainage pathways become blocked due to inflammation, infection, or structural problems, mucus can become trapped and symptoms develop.

What Is Chronic Sinusitis?

Chronic sinusitis occurs when inflammation of the sinuses lasts for more than 12 weeks.

Common symptoms include:

• Persistent nasal blockage

• Facial pressure or pain

• Thick nasal discharge

• Reduced sense of smell

• Headaches

• Recurrent sinus infections

In many cases, symptoms can be managed with medical treatment such as nasal steroid sprays, saline rinses, or antibiotics. However, when symptoms persist despite appropriate treatment, surgery may be considered.

What Is Sinus Surgery?

Modern sinus surgery is usually performed using endoscopic techniques, meaning it is carried out through the nostrils using small cameras and specialised instruments. There are no external cuts or visible scars.

The aim of surgery is to:

• open blocked sinus drainage pathways

• remove inflamed tissue where necessary

• restore ventilation of the sinuses

• allow medication to reach the sinus cavities more effectively

By improving drainage and ventilation, sinus surgery can significantly reduce symptoms and the frequency of infections.

Why the Approach to Sinus Surgery Matters

Sinus disease often affects multiple sinus cavities rather than just one. Successful outcomes depend on identifying the underlying process and comprehensively ventilating all the sinuses rather than minimal conservative approaches.

In specialist rhinology practice, sinus surgery involves carefully opening multiple sinus pathways, including more complex areas such as the frontal sinus.

This tailored approach helps ensure that surgery addresses the underlying cause of symptoms and reduces the likelihood of persistent disease.

What Happens During Sinus Surgery?

Sinus surgery is typically performed under general anaesthetic and usually takes between 90 minutes and two hours, depending on the extent of disease being treated.

Using a small endoscope inserted through the nose, the surgeon can visualise the sinus openings and carefully widen them using specialised instruments. Mr Karan Jolly has a specialist interest in complete sinus surgery and opens all the sinuses to achieve maximal symptomatic benefit, aligning with the latest evidence base. This is an area of particular interest for him.

Because the procedure is performed through the nostrils, patients usually have no visible scars.

Most patients are able to go home the same day.

Recovery After Sinus Surgery

Recovery from sinus surgery is generally straightforward.

Patients may experience:

• mild nasal congestion

• some blood-stained discharge

• temporary crusting within the nose

Most people return to normal daily activities within one to two weeks.

Follow-up care, including nasal rinses and clinic review, is important to ensure optimal healing and long-term success.

When Should You See a Specialist?

If you experience ongoing sinus symptoms that do not improve with medication, a specialist assessment may help determine the underlying cause and whether further treatment is needed.

Conditions that may require specialist evaluation include:

• persistent sinus infections

• nasal polyps

• chronic nasal blockage

• facial pressure that does not resolve

• symptoms following previous sinus surgery

A detailed consultation and examination can help determine the most appropriate treatment plan.

Book a Consultation

If you are experiencing ongoing sinus symptoms or recurrent sinus infections, a consultation with Mr Karan Jolly can help determine the cause and explore appropriate treatment options.