Endoscopic sinus surgery is offered to treat recurrent acute sinusitis and chronic sinusitis. It is a minimally invasive approach to address sinus disease and other nasal and sinus problems, and there are no external incisions such as cuts on the face, on the nose, or in the mouth. Traditionally, sinus surgery was performed with a headlight and a nasal speculum, which offered very limited views of the sinuses and required external incisions. Technological advancements in recent decades have allowed us to transform the way that endoscopic sinus surgery is performed. Now, we use a nasal endoscope (a long rod that essentially serves as a camera) that provides magnified and clear views of the inside of the nose and sinuses simply by placing it in the nostril. Combined with special instruments that have been developed for this kind of operation, we can now perform a variety of advanced procedures within your nose and sinuses simply by using these tools in your nose!

A large portion of my practice is revision endoscopic sinus surgery. In other words, I perform many surgeries on patients that are sent to me from other ENT surgeons, because their patients did not improve after sinus surgery. Many times, I am able to identify persisting problems in your nose and sinuses that still exist after sinus surgery. Revision endoscopic sinus surgery allows me to correct those issues and often translates into the relief that you were looking for initially.

Because I completed fellowship training in advanced endoscopic nasal and sinus surgery and practice in a tertiary academic setting (the University of Kentucky), I have the experience of treating complicated nasal and sinus problems that make it easier for me to feel comfortable addressing challenging areas of the sinus cavity. These are areas that might not have been fully addressed in your initial sinus surgery (because they are challenging areas that are difficult to access), and they may be the reason that your sinus problems persist! If your sinus problems persist even after sinus surgery, let me take a look!

Many people fear the dreaded packing after sinus surgery. I never place long sheets of gauze in your nose after sinus surgery. This is unnecessary, and no one enjoys seeing the magic trick of 6 feet of gauze being removed from their nose. It is uncomfortable and not required if the procedure is done carefully. I use dissolvable nasal packing that is small and hardly noticeable. It also comes out in a much more comfortable way during office debridements.

I find that if sinus surgery is done precisely and with very careful attention to detail, a very small amount of packing can be used. There are certain critical areas within your nose and sinuses that tend to scar together, and a small amount of packing can be used in these areas to prevent scar tissue from developing. If you’re noticing a theme here, this is very similar to my approach after septoplasty. I find that if your surgery is done meticulously, large amount of packing and nasal splints are simply not necessary.