Maxillary Sinus Surgery

[J Walker]

My ENT has told me that he could help my sinus congestion and drippy nose with Maxillary Sinus Surgery. This is the only surgery left for me to have and I have a deep seated infection there that he has not been able to control with anti-biotics. This condition causes a lot of problems with sleeping with my bi-pap. Is anyone out there familiar with this surgery or had it that can tell me something about it. I have tried about everything else. The headaches, congestion, drippy nose and often dizzyness really are very uncomfortable. Thank you for any advice or suggestions. I have to make up my mind about this surgery and am uncertain what to do.

[rested gal]

Hi J Walker,

I'm not sure if that's the specific kind of surgery snork1 underwent, but you might want to do a search for posts by snork1 during the past 6 months. Extensive sinus and nasal surgery helped him a lot, I think.

[J Walker]

Thanks Rested Gal, I will make a search on him and see what I can find.

[sarlis]

Hello, J Walker,
Are you close to a large city?

I would seriously suggest that you be evaluated at a teaching hospital for your sinuses. Just like any surgery, you want the best procedure done on you. I have found a huge difference in expertise in ENTs. I had sinus surgery done by a locally well respected ENT in the early 90s only to find out a couple of years later that he did an outdated procedure on me. His bedside manner rated very high and that made people trust him.

I am hoping that you will be able to get a second opinion and go with the teaching hospital surgeon unless they can recommend you current doctor and his plan for you.

Let us know what you decide. And I wish you good luck.

[J Walker]

Thanks Lucky Linda. The ENT that that I am using is the second one to reccomend this surgery. He is at the Flowers Hospital in Dothan,Alabama. He specializies in sleep apnea surgery. I had surgery done on my septum in 1989 at Tallahasse Memorial Hospital in Tallahassee, Florida and they over did it. I don't know of any teaching hospital in the immediate area but I will check. Thanks again.

[<nawchem>]

I had endoscopic surgery 7 months ago for infection, congestion and drippy nose. It helped the congestion completely. The drippy nose is the same as I have vasomotor sinusitis. I have had about a dozen infections since the surgery the ENT said I still have a deep infection. On the down side my nose still hurts but I'm told it takes a full year to completely heal. I have also been told that my nose will be back just as bad in about 3 years. Since the surgery I am unable to smell ammonia or bleach and occassionally cannot taste or smell anything maybe due to the swelling.

[BillinSeattleW]

Well,

I can't speak for SNORK, but it seems to me that he did not have maxillary sinus surgery;
I think he had a turbinate reduction and septoplasty (as did I) to improve airflow compliance and use of his CPAP. Your surgery is in a slightly different location for different indications.

Most nasal surgery now is done using endoscopes....which is a big improvement over the stuff 15-20 years ago. I believe the answer is right, if you have a chronic infection with fluid, it should be drained (or it will get reinfected). A second opinion is important. Having it done in amodern facility likewise important (teaching hospitals are great for larger more exotic procedures...regional hospitals with MODERN facilities are good for these more limited procedures).

It shouldn't be that painful (your mileage may vary here), and there will probably be stuffiness for a week or two and annoying plastic stents or guaze packing of some ilk.

I hope that fixing this issue will help your nose-breathing and therefore your OSA.

Bill

[BillinSeattleW]

Thanks for the input. I am trying to find a teaching facility in the area. I do have an almost continous drainage problem. The headaches are with me when I get up in the morning and usually last a few hours. Until I get My sinus clear from congestion I have no relief. I know I need the surgery but am uneasy about it because of the problems I had with the deviated septum. The recovery from that lasted several weeks and had lots of problems. Don't want to go through something like that again. That was back in 1989 and I know that improvements in the surgery should make it better. I guess I am looking for some assurance that it is better. Thanks again

[snork1]

Well the new format seems to have changed me to plain old Thom, and I can't seem to get my snork1 handle back(or change to ANYTHING ELSE), so you will have to take my word that I am the same guy.

"maxillary" was one of MANY things on my laundry list of stuff that was done during the 3 hours of surgery. The ENT ran out of room on the form and I certainly couldn't remember all the procedures, but now that you mention it that was done along with the turbinates, and septoplasty and who knows what else I forgot.

My ENT was excellent, and works a lot with Apnea patients. She also doesn't recommend going any further with surgery than the minimum that will get CPAP working. She did an endoscopy exam and a sinus CT scan before she would even talk about surgery. If your doc does any less...run away.

CPAP was terrible and marginally working on me pre surgery. NOW I am finding out why CPAP is a good thing. Although some days are better than others still, the range of that variance is at the better end of the scale.

Recovery was a couple of weeks. I think it was after about week 3 that before I could even think of xc skiing and it was marginal then. Pain was less than expected, but "discomfort" lasted longer than expected. I did the nose flushing religiously and I am still doing the simple saline nose rinse long after recovery, but only because I want to keep clear and it helps allergies. During recovery I was blowing out blood clots the size of my liver, and disgusting stuff that was impacted in my sinuses for who knows how long. It was scarey seeing all that stuff flush out, but good to get it out.

I did have a nasty sinus cold, that was going around, soon after surgery recovery. Normally that would go on forever and the sinus infection would be a long battle. Instead I just kept saline flushing and found WOW it just purged out and I recovered quickly. That is unheard of for me.

Maybe I was lucky getting a good ENT on a referral.
The surgery was DEFINITELY worth it for me. I plan to take good care of this breathing tool this time. Hopefully it won't "go away" after a few years.

[JW Walker]

Hi Thom (snork1) Thanks for your input. I have wrestled with making a decision on this because the Doctor gave me all the warnings. He did a CT Scan and tried antibiotics for 30 days and then did another CT Scan. The infection was still there. I had a CT Scan in 1999 and the cronic infection was there then. I have had to deal with the sinus problems most of my life. I have been on cpap thearpy for a little over three years and just found out that my sleep doctor got certified at about the time I had my sleep test. I think I will find a new sleep doctor and move on from there. Your input is exactly what I was looking for. I have read enough here to see that you have really experienced the things I have been through. I will go back to the ENT and check about the endoscopic exam. I have an appointment with him the 15th of March.
I do a lot of reading on this site and have been helped by the information I have found here. The doctors don't take the time to really explain things and really doesn't have the patients experience. Anyway a good doctor is normally a busy one.
Thanks again and I will probably schedule the surgery soon. Thanks also to all the others who have offered their help.

[BillinSeattle]

Hey Thom & JW,

Snork, I'm gonna miss looking for your name. I had problems getting my "SeattleBill" name to post as well.

Anyway, Thom, my experience with nasal surgery concurs with yours. (I had hoped for your result, but didn't quite get there. As it turns out, I just needed more done.)

JW, I think ( at least I'd hope) that most ENTs now use endoscopic techniques. Visualization is just far better that way. Ct scan is standard too..so that is a good indicator. With maxillary sinus stuff, you may have more congestion than we did, and you may have more refered pain in your teeth (strange but true). There will be saline irrigations, etc...but nothing too awful. My guess is recovery will take 1-2 weeks.

An interesting side-effect of my nasal surgery last September was that my seasonal allergies didn't kick up this year. I also noticed this for a couple years after my first (non-OSA related) endoscopic sinus surgery in the 1990's.

Bill