What are the risks of sinus surgery?

Sinus surgery is generally a very safe successful procedure, resulting in significant improvement in symptoms and quality of life. Fortunately, adverse events during or after surgery are unusual. However, as with any procedure, there are risks that you should know about and consider prior to surgery. Please do not hesitate to ask your surgeon about any of these risks if you have any questions or concerns.

• Bleeding Fortunately the risk of significant bleeding during surgery is small (less than 1%) and blood transfusions are rarely necessary. If significant bleeding occurs, the procedure may need to be terminated, nasal packing may need to be placed, and a blood transfusion may be necessary.
  
  A small amount of nasal bleeding is typical during the first few days following surgery. Excessive bleeding following surgery may require a visit to the emergency room and additional measures to stop bleeding.
• Infection As the term implies, chronic sinusitis tends to be a chronic problem, and sinus infections can occur in the post-operative period or even months or years after surgery. In the presence of a sinus infection, there is a small risk of developing a more complicated infection like an abscess or meningitis.
• Cerebrospinal fluid (CSF) leak All operations in the sinuses and nose carry a rare chance (about 0.1%) of creating a leak of CSF (the fluid that surrounds the brain). Should this rare complication occur, it creates the potential pathway for infection, which could result in meningitis (inflammation around the brain) or brain damage. CSF leaks are typically repaired at the time of sinus surgery if recognized, and require hospitalization after surgery for observation.
• Visual problems Although extremely rare (about 0.07%), there are occasional reports of visual loss after sinus surgery. Temporary or prolonged double vision has also rarely been reported after sinus surgery. Finally, excessive tearing of the eyes may result if the nasal portion of the tear duct is affected by sinus surgery.
• Scarring Scarring occurs after any surgery. If sinus surgery is done with as little trauma as possible and thorough post-operative care is performed, this risk is usually minimized. If significant scarring occurs, it can close off the sinuses and revision surgery may be needed to re-open them.
• Nasal congestion/pain/crusting/dryness These symptoms can occur after sinus surgery and usually indicate an ongoing problem in the nose/sinuses and may require further treatment.
• Anesthesia risks As general anesthesia is typically required, you would be subject to the rare but possibly serious risks involved. Adverse reactions to general anesthesia may be further discussed with the anesthesiologist.
• Nasal septum reconstruction risks If nasal septal reconstruction or septoplasty is done, you could experience numbness of the front teeth, bleeding or infection in the septum, or creation of a septal perforation. A perforation is a hole through the septum, which may cause difficulty breathing through the nose, whistling, or crusting. Since the cartilage in the septum has "memory," it may shift post-operatively and result in a renewed deviation. There is also a small risk of a change in the shape of the nose.
• Decreased sense of smell and taste Permanent loss or decrease in the sense of smell occasionally occurs following sinus surgery. However, in many patients, sense of smell is already decreased prior to surgery and improves with surgical intervention. However, this improvement is not guaranteed.
• Voice changes One of the functions of the sinuses is to affect resonance, so vocal professionals should be aware of potential changes in their voice after sinus surgery.
• Other risks Other risks of sinus surgery include temporary numbness or discomfort in the upper front teeth, temporary swelling, bruising, or numbness of the upper lip, and temporary swelling or bruising around the eyes.

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