Maxillary Sinus Puncture and Lavage (Perforation for Sinusitis)

Advanced sinusitis (inflammation of the maxillary sinus) is often accompanied by the accumulation of thick pus, which cannot exit naturally. This causes severe, throbbing pain in the area of the cheeks, forehead, and eyes, and also poses a huge threat, as the infection is very close to the brain. If antibiotics and the “Cuckoo” method do not yield results, ENT doctors at St. Luke’s Clinic use puncture (perforation) and lavage of the maxillary sinus.

This is the “gold standard” of ENT surgery, which allows for the removal of pus from the sinus, irrigation with an antiseptic, and direct delivery of medication to the site of inflammation in one procedure.

Debunking myths: why you shouldn’t be afraid of a puncture?

There are two common myths surrounding this procedure, due to which patients endure pain and bring themselves to severe complications.

• Myth 1: “It’s unbearably painful.” In fact, modern medicine has come a long way. At St. Luke’s Clinic, we use powerful local anesthetics. The doctor thoroughly numbs the nasal mucosa, so the moment of perforation of the thin bone wall is felt simply as pressure or a slight crunch, but without acute pain.
• Myth 2: “If you have a puncture once, you’ll have to do it always.” This is an absolute fabrication. Sinusitis recurs due to a deviated nasal septum, polyps, or a weak immune system, not because of a puncture. The microscopic hole from the needle completely and tracelessly overgrows with bone tissue within a few days.

When is maxillary sinus puncture prescribed?

The otolaryngologist decides on the necessity of the procedure based on examination, patient complaints, and the results of an X-ray or CT scan. The main indications are:

• Acute purulent sinusitis, accompanied by pulsating facial pain, which worsens when tilting the head down.
• Presence of fluid level (pus) in the sinus on an X-ray or CT scan.
• Lack of effect from conservative treatment (drops, lavages, antibiotics) for several days.
• High, unmanageable body temperature, general intoxication of the body.
• Suspicion of infection spread (threat of meningitis or orbital abscess).

How is the procedure performed at St. Luke’s Clinic?

The manipulation is performed on an outpatient basis in the ENT office and takes only 15–20 minutes.

1. Anesthesia: The doctor inserts a thin turunda (cotton swab) soaked in a potent painkiller into the nasal cavity. The mucosa completely loses sensitivity.
2. Puncture: Using a special thin Kulikovsky needle, the doctor makes a puncture in the thinnest part of the sinus wall bordering the nasal passage. This takes one second.
3. Lavage: An antiseptic solution is slowly introduced into the sinus through the needle. The liquid washes out all pus and mucus, which exit through the natural ostium of the sinus into a special tray (the patient tilts their head forward during this).
4. Medication administration: Anti-inflammatory drugs or antibiotics are introduced into the cleaned cavity.

Result you will feel immediately

The main advantage of a puncture is immediate relief. As soon as the pus that was pressing on the sinus walls is washed out, the unbearable headache immediately subsides, the temperature decreases, and the patient regains the ability to breathe freely through the nose.

Do not endure pain and do not risk your health. Schedule a professional appointment with experienced ENT doctors at St. Luke’s Clinic for safe and effective treatment of sinusitis.