What Is Sinus Surgery?

Healthy sinuses drain freely through narrow openings into the nose. When those openings stay blocked, mucus builds up, pressure follows, and infections can keep returning — that drainage problem, rather than the sinuses themselves, is what sinus surgery sets out to fix. The short film at the top of this page, "The Nose Knows: Sinus Surgery at DMC," runs for just under three minutes and comes from DMC Huron Valley-Sinai Hospital. It follows image-guided surgery used to open those passages and features two patients who have been through it, which makes it a useful first look before the step-by-step picture below.

Step one: pinpointing where drainage has failed

Treatment rarely starts in an operating theatre. It starts with working out why your sinuses are not clearing — long-standing inflammation, nasal polyps, a deviated septum, or anatomy that simply leaves very little room. An ear, nose and throat specialist may look inside the nose with a small camera and, where needed, use imaging to map the passages. That map matters, because the sinuses sit close to the eyes and the base of the skull, and a careful plan is part of doing this operation safely.

Step two: giving non-surgical care a fair chance

Surgery is usually considered only after simpler measures have not controlled the problem. Those measures can include saline rinses and medicines aimed at calming inflammation, chosen by your own clinician for your situation. If symptoms keep returning despite that care, or if imaging shows openings that are physically blocked, an operation to widen them becomes a reasonable conversation — not a first resort, and not a decision an article can make for you.

Step three: widening the openings from inside the nose

Modern sinus surgery is typically endoscopic, meaning the surgeon works through the nostrils with a thin camera and fine instruments, rather than through an external cut. The aim is conservative in spirit: remove tissue that is blocking drainage, open the natural pathways, and preserve as much normal lining as possible so the sinuses can clear themselves again afterwards. In image-guided surgery, the approach shown in the anchor video, the surgeon can track instrument position against your scans during the procedure. Some patients are also offered a gentler widening method for selected passages — this site's balloon sinuplasty and endoscopic sinus surgery video explains that option alongside the standard endoscopic approach.

Step four: the first days afterwards

Afterwards, congestion and a feeling of fullness are common while the lining settles, and follow-up visits matter more than people expect. The team will usually check how the openings are healing, clear crusting that could narrow them again, and advise on rinses or other aftercare for your case. Tell them promptly about heavy bleeding, eye swelling or vision changes, or a fever that is not settling — those are not things to watch at home. If your ENT questions involve a neighbouring part of the same system, our guide to tonsillectomy covers another common ear, nose and throat operation in the same plain-English style.

Step five: what success actually looks like

Success here is unglamorous, and that is the point. It looks like sinuses that drain, fewer flare-ups settling into long courses of treatment, and breathing that stops dominating your day. It does not guarantee you will never have sinus trouble again — the underlying tendency to inflammation still needs managing — so think of surgery as resetting the plumbing, with ongoing care keeping it working. Your specialist can explain what improvement realistically means for your scans and your symptoms.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician and researcher.

Frequently Asked Questions

Is sinus surgery done through the nose or through a cut on the face?
Modern sinus surgery is usually endoscopic and done through the nostrils, using a thin camera and small instruments, so there is typically no external cut. Your surgeon will confirm the planned approach for your case.

Does sinus surgery remove the sinuses?
No. The sinuses themselves stay in place. The operation widens the openings they drain through and removes tissue that is blocking those pathways, so mucus can clear more normally afterwards.

Will surgery cure chronic sinusitis for good?
It can help a great deal when blocked drainage is driving the problem, but it is not presented as a permanent cure. Ongoing care to control inflammation is often still needed, and your follow-up team will advise on what that involves for you.

Educational only — this article is general information about sinus surgery, not medical advice and not a recommendation for or against an operation. Whether sinus surgery is appropriate, and which technique, is a decision for your own ear, nose and throat specialist, who can examine you and review your imaging.