Our Summary

This research paper discusses the development and growth of paranasal sinuses, which are complex structures in our bodies. These sinuses have been studied using various methods, including analyzing cadavers and using modern 3D imaging. Understanding how these sinuses normally develop in children helps us identify when a disease might be affecting this process. Conditions like cystic fibrosis, chronic sinusitis, a deviated nasal septum, and cleft lip and palate can all impact the development of these sinuses in different ways.

The paper also discusses a common surgery known as functional endoscopic sinus surgery (FESS). It’s important for doctors to understand the layout of the sinuses and when they grow quickly during childhood before performing this surgery. Some people have raised concerns about whether this surgery could affect facial growth, but the evidence so far doesn’t show any major changes in face measurements or symmetry after the surgery.

FAQs

  1. What methods have been used to study the development and growth of paranasal sinuses?
  2. Which conditions can impact the development of sinuses in children?
  3. Does functional endoscopic sinus surgery (FESS) affect facial growth or symmetry?

Doctor’s Tip

A helpful tip a doctor might give a patient about sinus surgery is to follow post-operative care instructions carefully to ensure proper healing and minimize the risk of complications. This may include instructions on how to care for the surgical site, medications to take, and when to follow up with the doctor for a post-operative evaluation. It’s important to communicate any concerns or changes in symptoms to your doctor promptly to ensure the best possible outcome from the surgery.

Suitable For

Patients who are typically recommended sinus surgery include those with chronic sinusitis that does not improve with medications, recurrent acute sinusitis, nasal polyps, sinus tumors, sinus infections that spread to the bone, and structural abnormalities of the sinuses such as a deviated septum. These conditions can cause symptoms such as facial pain, pressure, congestion, headaches, and difficulty breathing through the nose. Surgery may be recommended to alleviate these symptoms and improve the function of the sinuses.

In cases where medications have not been effective in treating sinus issues, surgery may be the next step to provide relief and improve quality of life for the patient. The decision to undergo sinus surgery is typically made after a thorough evaluation by an ENT specialist, who will assess the severity of the condition and determine if surgery is the best course of action.

It is important for patients to discuss the risks and benefits of sinus surgery with their doctor before undergoing the procedure. While complications from sinus surgery are rare, they can include bleeding, infection, damage to surrounding structures, and changes in sense of smell or taste. Overall, sinus surgery can be a safe and effective treatment option for patients with chronic or recurrent sinus issues.

Timeline

Before sinus surgery:

  1. Patient experiences symptoms of chronic sinusitis, such as facial pain, pressure, congestion, and difficulty breathing.
  2. Patient undergoes a thorough evaluation by an ENT specialist, including physical examination, imaging studies (CT scan, MRI), and possibly nasal endoscopy.
  3. Treatment options such as medications (antibiotics, steroids), nasal saline irrigation, and allergy management are tried first.
  4. If symptoms persist or worsen, surgery may be recommended as a last resort.

After sinus surgery:

  1. Patient undergoes pre-operative preparation, including cessation of certain medications (such as blood thinners) and fasting before surgery.
  2. FESS is performed under general anesthesia, where a thin, flexible tube with a light and camera (endoscope) is inserted into the nose to remove blockages and improve sinus drainage.
  3. After surgery, patients may experience mild pain, congestion, and nasal drainage, which can be managed with medications and nasal irrigation.
  4. Follow-up appointments are scheduled to monitor healing, remove nasal packing or stents, and assess the effectiveness of the surgery.
  5. Most patients experience significant improvement in symptoms within a few weeks to months after surgery, with long-lasting relief from chronic sinusitis.

What to Ask Your Doctor

  1. What specific sinus issues do I have that require surgery?
  2. What are the potential risks and complications of sinus surgery?
  3. How long will the recovery process be, and what can I expect during that time?
  4. Will I need any follow-up appointments or additional treatments after the surgery?
  5. How will sinus surgery improve my symptoms and quality of life?
  6. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  7. How experienced are you in performing sinus surgeries, and what is your success rate?
  8. Can you explain the procedure in detail and walk me through what will happen during surgery?
  9. Will my facial structure or appearance be affected by sinus surgery?
  10. Are there any lifestyle changes or precautions I should take before or after the surgery to ensure a successful outcome?

Reference

Authors: Lee S, Fernandez J, Mirjalili SA, Kirkpatrick J. Journal: Clin Anat. 2022 Sep;35(6):745-761. doi: 10.1002/ca.23888. Epub 2022 Apr 26. PMID: 35437820