Surgical management of sinusitis

The majority of surgical procedures in the treatment of sinusitis were originally described in a pre-antibiotic era when rapid surgical intervention was often necessary to avert disaster. Today, although the operations remain the same, the indications for their use and the relative frequency with which they are required have altered. Acute sinusitis is now seldom a killer but chronic rhinosinusitis is common. Surgery for sinusitis aims to drain purulent secretions either by way of the natural ostium or more usually by the creation of an alternative drainage pathway which may be temporary or permanent. In so doing, complications are avoided and the sinus lining is given the opportunity to recover. When irreversible damage to the mucous membrane is deemed to have occurred, it may be removed completely and an attempt made to obliterate the sinus.