With atmospheric pollution rising alarmingly in India, there is a spurt in nasal allergies and other related nasal conditions. Sinusitis is one such condition that affects millions in the country and is indeed an annoying and painful one. This has called for a situation where sinusitis surgery in India is being performed in almost every hospital in the country to make sinus drainage better and permanently effective.
In basic terms, sinusitis surgery in India is done to remove blockages in the maxillary, sphenoidal and frontal sinuses to drain excess mucus that accumulates over a period of time and causes allergic rhinitis and pain. It involves removing infected, damaged or swollen tissue; even bone to create wider openings to drain out infected sinus mucus; extraction of polyps or small tissue lumps from the interior of the sinuses or nose or even removing any foreign object blocking the sinus or nasal passage, which is more common in children.
Sinusitis surgery in India is done mainly when all medical routes of treatment including the use of antibiotics, nasal decongestants & anti-allergic sprays prove futile in providing relief to the patient. The procedure earlier on was to place the patient under general anesthesia and perform a nasal washout. A narrow steel tube fixed to a rubber Higginson’s syringe was inserted into the maxillary sinuses to insert warm saline solution into the sinuses and the mucus was subsequently sucked out through the exit arm of the syringe. Antibiotics were given after the procedure to prevent relapse of infection.
The latest surgical treatment of sinusitis is FESS or Functional Endoscopic Sinus Surgery, particularly in the case of chronic sinusitis. It is minimally invasive, cost effective and has fewer post-operative complications. A fibre-optic endoscope is inserted through the nose and guided towards the affected sinus to remove small obstructive bone or any other material that blocks the openings of the sinus and also to polyps or small grape-like growths. A powerful camera inside the endoscope records a crystal clear image of the sinus which gets projected on a large wall-mounted monitor so that the surgeon can clearly see where he is headed and what he needs to extract and remove.
Sinus surgery become imperative when there is infected pus accumulation in the sinus which may critically affect facial bones and where there is a life-threatening brain abscess. This may require even open surgery by way of a Caldwell-Lucs operation where an opening is made into the sinus by cutting open the upper jaw or mandible or by incising the face from the outside.
Most Indian ENT surgeon’s advice surgery of the sinuses when the "total medical treatment" spanning four to six weeks fails. Moreover, after this if a CT scan or MRI shows nasal polyps blocking the sinus from normal draining, surgery becomes the only choice. Moreover fungal infections of the sinus don’t respond to antibiotics and surgery is the only way out. Chances are also there that the infection may spread to other parts of the brain, ear and throat and may even lead to meningitis, a life threatening condition. The surgery is usually done under general anesthesia.