Endoscopic sinus surgery is a keyhole procedure used to treat chronic sinusitis when other treatments have not brought enough relief.
If you have spent months, or even years, dealing with blocked sinuses, facial pressure and repeated infections, it is worth understanding what this surgery involves and whether it might help.
This article explains what chronic sinusitis is, when endoscopic sinus surgery is generally considered, what the procedure involves, and what recovery looks like within the Australian healthcare system.
It is general health information only, not personal medical advice, so speak with your GP or an ENT surgeon about your own situation.
If you are ever experiencing a medical emergency, call 000 or go to your nearest emergency department rather than relying on an article like this one.
What Is Chronic Sinusitis?
Chronic sinusitis is ongoing inflammation of the sinuses, the air-filled spaces around your nose and eyes, lasting twelve weeks or longer.
It can cause a blocked or runny nose, facial pain or pressure, reduced sense of smell, and repeated infections that do not fully clear.
Many people manage chronic sinusitis with saline rinses, nasal sprays or a course of medication prescribed by their GP.
Endoscopic sinus surgery is generally considered when these measures have not provided enough relief, or when imaging shows a structural issue contributing to the problem.
When Might Endoscopic Sinus Surgery Be Recommended?
Symptoms That Have Not Improved With Other Treatment
If you have tried an extended course of appropriate medical treatment and are still experiencing significant symptoms, your GP may suggest a specialist referral to an ear, nose and throat surgeon to discuss whether surgery could help.
Nasal Polyps or Structural Blockages
Some people with chronic sinusitis also develop nasal polyps, soft growths inside the nasal passages, or have a structural issue that narrows the sinus openings. These situations are often better addressed surgically alongside ongoing medical management.
Getting a Referral and Choosing a Surgeon
The typical pathway starts with your GP, who can arrange initial treatment and, if needed, a specialist referral to an ENT surgeon. General background on sinus conditions is available through Healthdirect Australia, and you can check that any surgeon you see is properly registered through AHPRA.
It is worth asking your surgeon about their experience with endoscopic sinus surgery specifically, and what results are realistic for your situation. Surgeons accredited through the Royal Australasian College of Surgeons have completed recognised specialist training pathways.
What Endoscopic Sinus Surgery Involves
Endoscopic sinus surgery is performed using a thin telescope, called an endoscope, passed through the nostrils, so there are usually no external cuts on the face.
The surgeon uses this to widen the natural sinus openings and remove any obstructing tissue, such as polyps.
It is generally carried out under general anaesthesia, often as day surgery or with a short overnight hospital stay depending on the extent of surgery needed and your individual health.
Your surgical team will explain what applies to your specific procedure during your pre-admission clinic appointment.
Possible Risks and What to Expect After Surgery
As with any operation, endoscopic sinus surgery carries some surgical risks, which your surgeon will discuss as part of gaining your informed consent. General risks that may be discussed include:
- Bleeding, which is usually managed with nasal packing or dissolvable dressings
- Temporary changes to smell or taste
- Infection at the surgical site
- A small chance of the sinus openings narrowing again over time
- Rarely, injury to nearby structures such as the eye socket or the base of the skull
These risks vary from person to person, and your surgeon can explain how likely they are in your specific case.
Post-operative recovery generally involves saline rinses and follow-up appointments so your surgeon can monitor healing inside the nose.
How Chronic Sinusitis Is Diagnosed Before Surgery
Before recommending endoscopic sinus surgery, your ENT surgeon will usually want a clear picture of what is happening inside your sinuses.
This typically involves a nasal endoscopy in the clinic, where a thin camera is used to look inside the nose, alongside a CT scan to map the sinus anatomy in detail.
This imaging helps your surgeon understand exactly which sinuses are affected and whether there are any structural factors, such as a deviated septum or nasal polyps, contributing to your symptoms. It also helps guide exactly how much surgery is likely to be needed in your case.
Lifestyle Factors That Can Affect Sinus Health
While endoscopic sinus surgery addresses the physical structure of the sinuses, ongoing sinus health is also influenced by everyday factors such as smoking, allergen exposure, and how well any underlying allergies are managed. Your GP or surgeon may discuss these alongside your surgical plan.
Smoking in particular can slow healing after sinus surgery and increase the chance of symptoms returning, so many surgeons will encourage quitting or cutting down before and after the procedure.
Managing allergies with your GP’s guidance can also reduce the chance of ongoing inflammation after surgery.
Recovery After Endoscopic Sinus Surgery
The First Few Weeks
Most people take one to two weeks off work or study, though this depends on the type of work you do and how you are healing. Congestion, mild discomfort and some bloody discharge are common in the first week or so as the nose settles.
Ongoing Care and Allied Health Support
Regular saline nasal rinses are usually recommended for several weeks to keep the nasal passages clear while they heal.
Some people also continue nasal sprays or other medication afterwards, and allied health support is occasionally recommended if smell is affected during recovery.
Costs, Medicare and Private Health Insurance
Endoscopic sinus surgery can be performed in the public system, usually via a public hospital elective surgery waitlist, or privately using private health insurance.
Coverage and waiting periods vary by policy, and privatehealth.gov.au is a useful independent government resource for comparing options.
Medicare provides a rebate towards eligible surgical and specialist costs, with current details available through Services Australia.
Before surgery, your surgeon’s rooms should provide informed financial consent, a clear written estimate of any out-of-pocket costs, so there are no surprises.
Conclusion
Endoscopic sinus surgery can offer significant relief for people whose chronic sinusitis has not responded to other treatment, by improving drainage and airflow through the sinuses.
It is a well-established procedure, but like any surgery it comes with risks and a recovery period that is worth understanding in advance.
If ongoing sinus symptoms are affecting your quality of life, the best next step is a conversation with your GP or an ENT surgeon about whether this procedure is right for you.
You can use surgery.com.au to find surgeons across major Australian cities and start exploring your options.
FAQs
1. How long does endoscopic sinus surgery take?
Surgery time varies depending on how much of the sinuses need treatment, but many procedures are completed within one to two hours. Your surgeon can give you a more specific estimate based on your imaging and symptoms.
2. Is endoscopic sinus surgery painful?
Most people experience mild to moderate discomfort rather than severe pain, which is usually managed with pain relief recommended by your surgical team.
Congestion and pressure are more common than sharp pain in the days after surgery.
3. How long is the recovery from endoscopic sinus surgery?
Many people return to normal activities within one to two weeks, though full healing inside the nose can take several weeks longer. Your surgeon will guide you on when it is safe to resume exercise and other activities.
4. Will chronic sinusitis come back after surgery?
Endoscopic sinus surgery improves drainage and airflow, but chronic sinusitis can sometimes return, particularly without ongoing management such as saline rinses.
Your surgeon can discuss factors that may reduce this risk in your specific case.
5. Is endoscopic sinus surgery covered by Medicare or private health insurance?
Endoscopic sinus surgery may be eligible for a Medicare rebate and can also be covered through private health insurance, depending on your policy and whether you are treated publicly or privately.
It is worth checking directly with Medicare and your insurer for current, specific details.