Timeline to Recovery: Balloon Sinuplasty v ESS
When it comes to sinus surgeries, recovery can be the most strenuous part of the ordeal. The blood vessels and soft tissue in the sinuses need time to properly recover. Chronic sinusitis is commonly treated by endoscopic sinus surgery, or ESS. It involves a small catheter being guided into the sinuses that cuts out any infected tissue. Due to the removal of tissue, recovery for endoscopic sinus surgery can take a few weeks or even months. Special care must be taken to manage bleeding and inflammation, and prevent a recurrent infection.
As damage is inevitable with ESS, doctors aimed to develop an alternative solution that keeps as much tissue intact as possible. One solution was adapting surgical balloons to reopen blocked sinus openings. This procedure is called balloon sinuplasty. It has similar outcomes as ESS with many improvements to recovery and longevity of treatment.
Recovery for both surgeries requires similar maintenance, such as managing bleeding, avoiding strenuous work, and using nasal rinses. Below we compare the considerations and timeline of recovery for both procedures.
Endoscopic Sinus Surgery
24-72 hours – ESS is usually performed with general anesthesia so the patient will need someone to help with recovery for the first day. Bleeding will last 24 to 72 hours, and can be reduced by using nasal rinses every three to four hours. Do not blow your nose. This will aggravate the blood vessels and worsen bleeding. Patients are also recommended to sleep in an elevated position to help the sinuses drain more easily.
1 week – After a week of recovery, most patients are able to work with a reduced workload. You should still avoid strenuous work such as lifting objects greater than 10 pounds. Most patients have their first follow up at this point. Here the doctor can confirm that you are healing properly. It’s likely that your doctor will wait until your next follow up for any images needed. Your doctor will also advise you on what sorts of maintenance you can stop and what you need to continue.
3 weeks – At three weeks you can begin to return to your normal work and exercise routine. You’ll want to slowly ease back into your routine to avoid any complications. If your blood vessels are healed properly, you can also begin to take NSAID medicines like ibuprofen or naproxen again. The inflammation caused by the surgery itself should begin to subside now. At this point you’ll begin to feel more of the benefits of the procedure.
1 month -If your sense of smell or feeling were affected, sensations should begin to come back around this time. Total sensation may take up to one more month to fully recover. Your doctor will likely have another follow up at this time to take images of your sinuses. They will then compare them to the images from before surgery. This gives them a good idea of how your sinuses handled surgery and a prognosis of how your sinusitis should resolve in the future.
24 hours – After 24 hours of bed rest and recovery, most patients can return to work. However, they should still avoid strenuous work or exercise such as lifting items 20 pounds or more. Patients are recommended to engage in light exercise such as walking to help with fatigue and circulation. You shouldn’t blow your nose for the first 24 hours at least, though your doctor may recommend waiting longer. There may be some bleeding for the first 24 hours. If it lasts more than two days you should call your doctor to make sure you’re healing properly.
1 week – For the first week you should be using a nasal rinse every three to four hours. This will keep your sinuses moist and help remove debris that can prevent proper healing. You will typically have your first follow up with your doctor after the first week. This tends to be the only follow up you need due to the minimally invasive nature of the procedure. Usually the doctor only needs to view the sinuses and take some images. Unless there are any complications, recovery tends to complete at this time.
Special Considerations – The recovery for balloon sinuplasty is much easier, though it can’t remove malformations like polyps or tumors. It also can’t correct issues with the ethmoid bone that is out of reach for the balloon catheter. If you have symptoms of sinusitis for more than 12 weeks, you should talk to your doctor to see if either of these options is right for you.