Chronic sinusitis is a long-lasting inflammation of the paranasal sinuses that persists for more than 12 weeks. Patients usually experience persistent nasal congestion, nasal discharge, facial pressure or headaches, sleep disturbances, and a reduced sense of smell. When medications no longer provide relief, surgery may be the best option.

Chronic Sinusitis: With and Without Polyps (EPOS 2020 Classification)

According to the EPOS 2020 Guidelines (European Position Paper on Rhinosinusitis and Nasal Polyps), chronic rhinosinusitis is divided into two main types:

Important: Chronic sinusitis with polyps almost always requires a combined approach: surgery + long-term medical therapy, as polyps are prone to recurrence.

When Is Sinus Surgery Recommended?

Not every sinus infection requires surgery. ENT specialists recommend sinus surgery only when:

• Symptoms last 12+ weeks despite medical treatment.
• Nasal polyps completely block the nasal passages.
• Complications develop: recurrent sinus infections (sinusitis, frontal sinusitis, ethmoiditis).
• Sense of smell is severely reduced or lost.
• The patient suffers from sleep apnea or loud snoring.
• Sinusitis worsens asthma or allergic conditions.

If medications (nasal sprays, saline rinses, antibiotics, corticosteroids) do not improve symptoms, surgery becomes the most effective solution.

Types of Sinus Surgery

Modern sinus surgery techniques are minimally invasive, aiming for quick recovery and fewer complications.

1. Functional Endoscopic Sinus Surgery (FESS)

The gold standard for chronic sinusitis.

• Performed entirely through the nose, no external cuts.
• An endoscope with a camera provides a magnified view.
• The surgeon removes diseased tissue, polyps, or cysts, and reopens blocked sinus passages.
• Minimally traumatic, preserves healthy tissue.

2. Balloon Sinuplasty

• A minimally invasive alternative.
• A tiny balloon catheter is inserted into the sinus opening and inflated to widen it.
• Restores normal drainage and ventilation.
• Best for localized obstruction with less severe changes.

3. Caldwell-Luc Surgery

• A classic approach, now used rarely.
• Involves creating a new drainage opening into the maxillary sinus through the upper jaw.
• Reserved for complex or advanced cases where endoscopic surgery is not feasible.

Preparing for Surgery

Before surgery, patients undergo:

• ENT consultation and nasal endoscopy.
• CT scan of the sinuses for detailed anatomy.
• Blood tests, ECG, anesthesiology assessment.
• Discontinuation of blood-thinning medications (5–7 days prior, under medical supervision).

On the day of surgery:

• For general anesthesia — come fasting.
• Arrange for someone to accompany you home.

How Endoscopic Sinus Surgery Works

FESS is the most common and effective procedure for chronic sinusitis.

Step 1. Endoscopic assessment – The surgeon examines nasal passages and sinuses with a camera.
Step 2. Opening the sinuses – Small amounts of obstructing tissue are removed to restore airflow and drainage.

Step 3. Removing diseased tissue or polyps – Polyps and inflamed mucosa are carefully excised.
Step 4. Restoring drainage – Natural sinus openings are widened, preventing mucus buildup.
Step 5. Additional corrections (if needed) – Adenoid removal (in children), septoplasty, or turbinate reduction may be performed.

• Anesthesia: General anesthesia is usually used.
• Duration: 60–180 minutes, depending on the extent of disease.
• Support: Soft nasal packing or silicone splints may be placed for stability.

Recovery After Sinus Surgery

• First days: swelling, congestion, mild bloody discharge.
• Tampons/splints: removed in 2–5 days.
• Light activities/work: after 3–5 days.
• Breathing and smell function: restored within 3–4 weeks.
• Full results: assessed in 2–3 months.

Restrictions:

• Do not blow your nose for 2 weeks.
• Avoid strenuous exercise, sauna, or swimming for 1 month.
• Sleep with your head elevated for the first few nights.

Possible Complications

Although sinus surgery is generally safe, rare risks include:

• Nosebleeds,
• Adhesions (scar tissue/synechiae),
• Rarely: empty nose syndrome,
• Recurrence of polyps (especially with CRSwNP).

Modern techniques allow management of most complications. For example, synechiae can be corrected with endoscopic radiofrequency procedures.

Patient Stories

• Victor, 28: Constant right-sided blockage and headaches. After FESS, breathing normalized and headaches disappeared.
• Alexander, 14: Frequent sinus infections and loud snoring. Post-surgery, he breathes freely and sleeps better.
• Natalia, 45: Suffered from sleep apnea. After surgery, sleep became deeper and uninterrupted.

Life After Sinus Surgery

Most patients notice:

• Free nasal breathing,
• Disappearance of snoring,
• Fewer sinus infections and colds,
• Improved sleep quality and well-being,
• Restored sense of smell.

Sinus Surgery at KindCare Medical Center

At KindCare Medical Center (Dubai), we provide a full spectrum of sinus surgeries, including endoscopic FESS, balloon sinuplasty, and advanced laser/radiofrequency techniques.

We offer:

• Accurate diagnosis (endoscopy, CT, labs),
• Tailored surgical solutions,
• Modern minimally invasive technologies,
• Fast recovery under expert supervision.

Dr. Maryna Kryshtopava — ENT specialist (PhD, Associate Professor) with 23+ years of experience, expert in endoscopic, laser, and radiofrequency sinus surgery.