Endoscopic sinus surgery

The dangers in children

Endoscopic sinus surgery is rarely done in children and can be quite dangerous. Before allowing your child to undergo such a procedure, it is wise to seek a second opinion from a pediatric otolaryngologist.

Purpose of the surgery

The purpose of endoscopic sinus surgery is to open the passages of the sinuses allowing for proper drainage to the nose. It is called an endoscopic procedure because the physician uses an endoscope (a small, flexible tube with a light and a camera lens at the end) to view the inside of the nose. Small incisions or cuts are made to allow the scope to pass. The cuts are usually made inside of the nose. The physician may create new passages or open existing ones by removing polyps, cysts, or thickened mucous membranes.

The surgery itself

• Endoscopic sinus surgery usually takes between one and three hours and is done in the operating room with the child under general anesthesia.
• Most young children spend the night in the hospital, but some older children may stay for only a couple of hours after surgery.

Depending on the surgeon's preference and the needs of the child, endoscopic sinus surgery may be performed at the same time as another operation such as septoplasty, tonsillectomy, adenoidectomy, or insertion of ear tubes.

What to expect after surgery

• Your child will have intravenous (IV) fluids until time of discharge. Clear liquids for your child to drink are available in the post anesthesia care unit (PACU), also called the recovery room.
• Your child may complain of a sore nose, not being able to breathe through the nose, and difficulty swallowing.
• A pain reliever may be given for pain. An antibiotic is occasionally prescribed to prevent infection.
• The head of the bed will be raised in the PACU to help with swelling, breathing, and drainage. At home you should have pillows or a recliner chair available to help your child stay comfortable with his/her head elevated above the level of the chest.
• There may be packing in the nose to prevent bleeding. Sometimes, this packing is dissolvable. The physician may remove this packing in one or two weeks or it may dissolve on its own. If the packing needs to be removed, it may be done in the physician's office for older, cooperative children, or may be done in the operation room under anesthesia.