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Part III: Traditional Sinus Surgery

Understanding Traditional Sinus Surgery

Despite the newly heralded FESS and balloon sinuplasty procedures, there are instances wherein the facts and circumstances concerning your condition do not fit into what the majority of the population experiences. Abnormalities exist across all ages and races of people, and the medical field must consistently respond with a solution to accommodate those of us whose symptoms and ailments deviate from what is expected or anticipated.

As a result, you and your surgeon together may decide instead that traditional sinus surgery is more suited to your needs. This type of operation occurs when your doctors must gain direct access to the sinus itself. This is done via a direct incision that is made into either the inside of the mouth or through the facial skin. Fortunately, with other more advanced techniques, this type of surgery is becoming rare.

Through this incision, your doctor is able to gain access into the sinuses. The location of both the primary incision and opening depend upon which of the four sinuses require surgery. Traditional sinus surgery affects the four facial sinuses – frontal sinuses (above the eyes, located in the frontal bone, behind the bone on the forehead), maxillary sinuses (under the eyes), ethmoid sinuses (located between the nose and eyes within the ethmoid bone) and sphenoid sinuses, (under the pituitary gland)

How the doctor removes the infected tissue depends on not only which four of the paranasal sinuses are inflamed, but also the extent of the inflammation and whether or not more than one of the four are infected. Whether the infection is bacterial or fungal is also important. Note that draining the sinuses after removing the blockage may require more extensive procedures if the infected sinus is too difficult to reach through the incision.


Advantages and disadvantages of Traditional Sinus Surgery

Due to the invasive nature of traditional sinus surgery, it is often seen as a “last resort” behind failed medical managment and a FESS procedure. It is mainly used for tumor resection where access to the tumor in the sinuses is important to control the disease. Traditional sinus surgery allows surgeons to operate on all paranasal sinuses, if necessary, as well as conduct more invasive procedures to help patients who suffer from more complicated and intricate conditions.

Specifically, patients who undergo this type of surgery experienced limited results with prescription medications and their chronic sinusitis persists. Traditional sinus surgery is also an option for patients who have already undergone a FESS operation, with failed results, or for patients who have experienced severe complications of sinusitis, such as:

  • The presence of a mucocele in a frontal sinus
  • An infection of the facial bones
  • A brain abscess
  • A tumor of the sinuses


Effectiveness of Traditional Sinus Surgery

Traditional surgery can be an effective route to treat a seemingly tenacious and obstinate case of chronic sinusitis. Due to the revolutionary advances in medical technology, its success rate has increased, however it is important to note that the FESS procedure surgery has surpassed traditional sinus surgery due to a less invasive nature and overall faster recovery rate.  However, it is also important to consider that traditional sinus surgery may be the best surgical treatment method available for patients that experience abnormal and rare sinus conditions.


Risks of Traditional Sinus Surgery

Traditional sinus surgery differs from other type of chronic sinusitis treatment in that it involves a greater likelihood of mor serious risks, including:

  • Heavy bleeding from the nose
  • Scarring of skin incisions
  • Possible leakage of the fluid contained in the brain and spinal cord.
  • Inflammation of the brain membrane
  • Partial loss of sight or blindness.
  • Death


What to expect after Traditional Sinus Surgery

After traditional sinus surgery, your surgeon will pack your nose with gauze in order to prevent bleeding and to absorb drainage. You may be required to change the packing multiple times depending upon the amount of drainage or blood. Your doctor will ask that you leave the packing in your nose for a few days, until he or she is ready to remove it at your follow-up appointment.

You may also be requested to use a saltwater nasal washes to irrigate and moisten your sinuses. It is important not to blow your nose, engage in physical exercise or sports, and in some instances, use a humidifier in your bedroom to prevent dry air form irritating your sinuses.

Final thoughts on Traditional Sinus Surgery

Although FESS surgery is now the modern treatment methods of chronic sinusitis, traditional sinus surgery remains an important alternative for those who have particularly severe cases of the condition, involving multiple variations of infection in more than one of the paranasal sinuses. It is still regarded as an effective treatment for those who have extremely damaged sinuses and need a more aggressive approach to restoring the health of his or her sinuses.

As mentioned above, traditional sinus surgery differs from FESS in that FESS is universally held by the medical community to be a far more precise and not as invasive a method of treating the sinuses and nasal cavities to pinpoint the source of chronic infection. Additionally, due to the invasion nature of traditional sinus surgery, the risk of infection and recovery time is increased over patients undergoing a FESS operation.

If you haven’t read them already read the other guides in the series about choosing the right sinus surgery:


Part 1 : Functional Endoscopic Sinus Surgery (FESS)

Guide to Choosing the right Sinus Surgery : Functional Endoscopic Sinus Surgery (FESS)


Part 2 : Balloon Sinus Surgery

Guide to Choosing the right Sinus Surgery : Balloon Sinus Surgery