Sinus surgery is most commonly performed to increase the size of the sinus openings into the nasal cavity to resolve chronic sinusitis. Surgeons typically utilize a functional endoscope, a slim fiber-optic instrument placed in the nose that enables visualization of the nasal cavity. Using delicate surgical instruments, the surgeon removes small areas of bone and tissue to open the sinuses, facilitating unobstructed drainage. Although most patients undergoing sinus surgery recover uneventfully, side effects and complications may occur.
Bleeding
The sinus tissues contain many small blood vessels, which may bleed after sinus surgery. The risk for postoperative bleeding increases in patients taking aspirin, ibuprofen and other medications and supplements that may interfere with the normal blood clotting process, reports the American Rhinologic Society. Sterile gauze packing may be placed into the nose at the time of surgery to minimize bleeding. The surgeon typically removes the nasal packing at the first postoperative office visit.
A rare but potentially life-threatening complication of sinus surgery is an accidental injury of the internal carotid artery. This injury can cause massive bleeding and requires emergency repair, reports Dr. Alberto Fernandez of Baylor College of Medicine.
Infection
Infection is a risk with any type of surgery, including sinus surgery. The surgeon may prescribe antibiotics to decrease the risk of infection. The University of Maryland Medical Center reports that nasal antibiotic sprays may be particularly helpful in patients who develop a postoperative sinus infection.
Visual Disturbance and Blindness
The eye rests in close proximity to the sinuses. Irritation of the eye nerve, or optic nerve, disturbance of the eye muscles or minor bleeding into the eye socket during sinus surgery may cause temporary double-vision after surgery, notes the University of North Carolina at Chapel Hill. A much more serious and rare complication of sinus surgery is accidental damage to the optic nerve or severe bleeding into the eye socket, leading to permanent visual damage or blindness.
Spinal Fluid Leak
Bones of the base of the skull form the roof of some of the sinuses. Accidental fracture of these bones can cause a spinal fluid leak into the sinuses, reports the American Rhinologic Society. Such leaks require repair to prevent possible infection of the spinal fluid, leading to meningitis or abscess formation in the brain. Most spinal fluid leaks are detected and repaired during surgery. Occasionally, a leak is not discovered until after surgery. Clear watery drainage from the nose suggests the possibility of a spinal fluid leak. Chemical testing determines whether nasal fluid drainage represents a spinal fluid leak.
References
- American Rhinologic Society: Complications of Nasal and Sinus Surgery
- Baylor College of Medicine: Complications on Endoscopic Sinus Surgery: Prevention and Management
- University of Maryland Medical Center: Sinusitis--Surgery
- UNC Otolaryngology/Head and Neck Surgery: Functional Endoscopic Sinus Surgery
- American Rhinologic Society: Endoscopic Sinus Surgery
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