Complex Surgery: Septoplasty and Endoscopic Maxillary Antrostomy

Free nasal breathing and healthy sinuses are closely related. Very often, a deviated nasal septum blocks the natural ostium (opening) of the maxillary sinus. This disrupts ventilation, accumulates mucus, and leads to chronic sinusitis, cysts, or polyps.

To break this vicious cycle permanently, ENT surgeons at St. Luke’s Clinic perform complex surgery: septoplasty combined with endoscopic maxillary antrostomy. We solve two problems at once, under one anesthesia, restoring your health without unnecessary stress and additional interventions.

When is complex surgery necessary? (Indications)

The ENT doctor prescribes this intervention based on examination results and computed tomography (CT) of the nasal sinuses if the patient simultaneously has a deviated septum and the following pathologies in the maxillary sinus:

• Chronic purulent or polypous sinusitis that does not respond to medication and “lavage.”
• Maxillary sinus cyst: a fluid-filled sac that grows and presses on the sinus walls, causing constant headaches and cheek pain.
• Odontogenic sinusitis and foreign bodies: inflammation caused by dental problems (when a tooth root or filling material from the dentist has fallen into the maxillary sinus).
• Fungal infection of the sinus (mycetoma): a dense fungal mass that cannot be treated with any pills — it must only be surgically removed.

Advantages of endoscopic surgery (FESS) in our clinic

Previously, maxillary antrostomy (Caldwell-Luc operation) was considered very difficult: the surgeon made an incision under the upper lip in the mouth and used a chisel to break through the anterior wall of the sinus. This was accompanied by severe pain, prolonged facial swelling, and numbness of the cheeks.

Forget outdated methods! At St. Luke’s Clinic, we use FESS (functional endoscopic sinus surgery):

• No incisions on the face or under the lip: all manipulations (both septum straightening and sinus cleaning) are performed exclusively through the natural nasal passages.
• Microsurgical precision: the doctor works with a super-thin endoscope (video camera). The image is displayed on a monitor, allowing for precise expansion of the natural sinus opening and careful removal of cysts or pus without damaging healthy mucous membranes.
• Preservation of physiology: the sinus continues to function normally and clear itself after surgery.

How is the surgery performed and what about anesthesia?

1. Absolutely pain-free: Complex surgery is performed exclusively under modern general anesthesia (medication-induced sleep). You see nothing, hear nothing, and feel nothing.
2. Stage 1 (Septoplasty): The surgeon straightens the deviated cartilaginous and bony tissue of the nasal septum, opening the way for normal breathing.
3. Stage 2 (Maxillary Antrostomy): Through the nose, the doctor uses an endoscopic instrument to enter the maxillary sinus, remove pathological contents (cyst, filling material, polyps), and rinse it with an antiseptic.
4. Completion: Special silicone splints (inserts) are placed in the nose to keep the septum straight and prevent bleeding. They are significantly more comfortable than classic gauze tampons.

Rehabilitation: what to expect after surgery

Recovery after endoscopic surgery is significantly easier and faster. You will spend 1-2 days in the comfortable inpatient ward of our clinic.

• In the first few days, nasal congestion will be present due to swelling and the presence of splints. Slight numbness of the upper teeth or lip is possible (this is a temporary phenomenon that quickly passes).
• Removal of silicone splints (usually on day 2-4) is quick and practically painless. After this, breathing begins to recover.
• For 3-4 weeks, you need to rinse your nose daily with saline solutions according to the doctor’s instructions.

For successful healing, for 1 month, it is strictly forbidden to: engage in physical activity, visit saunas/baths, take hot baths, fly on airplanes, and blow your nose actively.

Solve two problems at once and breathe freely! Schedule an expert consultation with ENT surgeons at St. Luke’s Clinic to plan your surgery.