Sinus surgery carries the risk of several complications owing to the proximity of the sinuses to the brain. Postoperative bleeding, loss of cerebrospinal fluid, or CSF, vision loss and adverse reactions to anesthesia are some of the more serious complications. Doctors use sinus surgery as a last resort when they have exhausted all other medical management practices.
Postoperative Bleeding
After sinus surgery, a surgeon will pack the nasal cavity with gauze, which should be changed only as directed. During changes to the packing gauze, staff and patients can dislodge the blood clot that formed postoperatively. Treatment for any bleeding that occurs consists of pinching the bridge of the nose and applying ice for 15 minutes. If the bleeding has not subsided after 15 minutes, the patient should see a physician for possible cauterization of the source of the bleed. The physician also may simply choose to repack the nose with new gauze.
Anesthesia Reactions
Surgeries that require general anesthesia run the risks of heart and lung problems. Abnormal cardiac rhythms can occur during and after sinus surgery with anesthesia. Breathing difficulties, in which the patient's breathing becomes labored or too slow to provide the body with needed oxygen, may occur. An anesthesiologist monitors the patient's vital signs, heart rhythm and rate, and breathing patterns every five minutes during surgery. Postsurgical recovery room nurses also monitor vital signs and reactions to anesthesia, including the patient's breathing patterns and ability to be roused. The patient can be drowsy and slow to respond but must regain consciousness. Staff immediately report any abnormalities to the anesthesiologist.
Infection
Sinus surgery is most often an attempt to correct a chronic sinus infection that medications cannot cure. Surgery that takes place with an ongoing infection present increases the risk of contamination of the bloodstream. Because two sinus cavities---the ethmoid and the sphenoid---do double duty as the base of the skull, infection of the CSF---the fluid that surrounds the brain and spinal cord---is possible. According to the University of California at San Diego School of Medicine, any contact with the CSF poses the additional risk of the patient developing meningitis, which is an inflammation of the tissues of the brain and spinal cord.
Risks to the Brain
Also probable in the case of ethmoid or sphenoid sinus surgery is a leak in the CSF. Although correctable at the point of surgery, any loss of CSF puts the brain at risk for losing too much of its cushion against the hard skull. Symptoms similar to those experienced with a concussion, including blurry vision, headaches, nausea, vomiting and punch-drunk syndrome---slow thinking, impaired concentration and slurred speech---may occur, states Dr. Simeon Margolis in "The Johns Hopkins Complete Home Guide to Symptoms and Remedies."
References
- American Rhinologic Society: Complications of Nasal and Sinus Surgery
- University of California at San Diego School of Medicine: Endoscopic Sinus Surgery
- "The Johns Hopkins Complete Home Guide to Symptoms and Remedies"; Simeon Margolis, M.D., Ph.D.; 2004
