Brad Marple, M.D. Answers Questions On: Sinus Surgery

No. Surgery typically is a last resort when it comes to treating sinonasal issues.

The vast majority of patients with sinonasal disease can be effectively treated with medications, so it’s rare that people need to have sinonasal surgery. Many patients referred to me are those for whom medical management hasn’t worked.

Medical management for sinonasal conditions often includes the use of nasal irrigation – flushing out the nose and sinuses with water, using devices such as the neti pot – and topical antihistamines and corticosteroids

We try to minimize the use of antibiotics and oral steroids.

For patients who do require sinus surgery, there are two primary causes. The first is developmental/functional abnormalities of the nose or sinuses – conditions such as a deviated septum, a sinonasal mass, or issues caused by nasal trauma.

The second key reason people require surgery is that they have chronic nasal inflammatory disease – such as nasal polyposis – that has responded minimally or not at all to medical management.

In addition, some patients have undergone primary sinus surgeries but have not experienced adequate relief of their symptoms. Such patients frequently are referred to me and my team for evaluation, and revision surgeries are sometimes necessary.

In the vast majority of patients who have chronic sinonasal disease – conditions such as sinusitis and nasal polyposis – surgery is just one component of a greater overall management plan. The role of surgery is to enhance the medical management.

Successful treatment of these chronic conditions involves ongoing, comprehensive, and often, multidisciplinary care. The most important way we manage chronic sinonasal disease is not with surgery, but with medical management before and following surgery.