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Forum Name: Surgery Topics

Question: Septoplasty and Nasal Reduction Surgery


 cufflink13 - Mon Oct 23, 2006 7:35 pm

Can anyone provide their experience with septoplasty and/or nasal polyp reduction surgery? My ENT recommended both. I began experincing tinnitus about 2 yrs ago and a sinus CAT revealed nasal polyps. The doctor didn't say if the polyps were causing to the tinnitus or not. I have been on both nasacort and flonase (not at the same time) but the polyps have remained the same size. I've had the deviated septum my entire life (38 yrs). I can live with not being able to breathe so well through my nose but I'd like some relief from the tinnitus and the more frequent sinus pain/headaches I have been experiencing for a few years. Maybe the sinus problems are related to the polyps?

Just wondering if anyone else has had relief from septoplasty and nasal polyp surgey.

Thanks
 Dr. Tino Anthony Solomon - Tue Oct 24, 2006 1:59 pm

Hello there,

Yes nasal polyps can certainly cause your symptoms and are most likely to be doing so. The exact causes of polyps are still open to debate but are thought to be due to chronic allergic rhinitis, chronic sinusitis, and, less commonly, underlying disease such as cystic fibrosis. There may even be a genetic link, but this is unproven. Symptoms often described are nasal obstruction, persistent nasal discharge (rhinorrhea), and a loss of the sense of smell (anosmia). Nasal polyps themselves, by blocking the nasal airways, can also block drainage, creating stagnant secretions that stay in the sinus cavities and may lead to infections which can cause sinusitis. Nasal polyposis has been noted in association with chronic or recurrent acute sinusitis in as many as one out of every 20 patients referred to ENT clinics.

The aim of the intranasal steroid sprays you have been prescribed is to reduce polyp size, increase airway patency and decrease inflammatory chemical release in the nasal tissues, thus reducing inflammation and potential for infection. Tinnitus (ringing in the ears), with or without ear blockage and a sensation of fullness in the head can occur and may be related to involvement of the eustachian tube. If medical treatment is not relieving your symptoms, as is evident, then your ENT surgeon has decided to progress to surgical correction.

Endoscopic sinus surgery is the procedure of choice. With the advent of endoscopic sinus surgery, surgical treatment for sinus diseases has become safer, and the outcome has improved. The procedure can be carried out under local anaesthesia with light sedation or a general anaesthetic. You will need to be made aware by your surgeon of the risks of surgery. Rare examples include post-surgical cerebrospinal fluid leakage and possible bleeding from related sinus arteries. However, detailed pre-operative planning can avoid any unnecessary risks. There is also a real possibility of polyp recurrence despite surgical removal, therefore close follow-up after the procedure combined with adherence to your surgeon’s instructions is a must to reduce this risk. As you may have gathered, this is a very specialised area that is best dealt with by an ENT specialist who will inform you further. I hope this has been of some help nevertheless.

Kind regards,

Dr Tino Solomon
BSc (Hons) MBBS
Senior House Officer in Surgery
 cufflink13 - Sat Oct 28, 2006 6:20 pm

Thank you for response, it was very helpful.

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