LYCOS RETRIEVER 
Sinusitis: Surgery
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Obstruction of the draining pathways of the sinuses is now thought to be the main cause of sinusitis. Examples of these pathways include the ostia of the maxillary sinuses and the hiatus semilunaris, where the anterior group of paranasal sinuses drains. Clearance of this obstruction is the aim of endoscopic surgery.
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When you have frequent sinusitis, or the infection lasts three months or more, it could be chronic sinusitis. Symptoms of chronic sinusitis may be less severe than those of acute; ... untreated chronic sinusitis can cause damage to the sinuses and cheekbones that sometimes requires surgery to repair.
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Functional endoscopic sinus surgery (FESS) has become the accepted standard approach and technique when surgical treatment of sinusitis is indicated. Surgery, or other invasive treatments, should only be considered when medical therapies have failed to improve the patient’s symptoms and quality of life.
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If your sinus infections are frequent or last more than three months, it could be chronic sinusitis. Symptoms of chronic sinusitis may be less severe than those of acute; ... untreated chronic sinusitis can cause damage to the sinuses and facial bone structure that may require surgery to repair.
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The most common type of surgery is probably endoscopic surgery for maxillary sinusitis (the sinuses behind the cheek bones). One surgeon acknowledged that "a significant number of patients have persistent maxillary symptoms after one or more endoscopic sinus operations," and identified 10 different reasons (see Top 10 reasons for endoscopic maxillary sinus surgery failure, by WJ Richtsmeier. Laryngoscope 2001;111:1952-56.)
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If you have taken antibiotics and other medicines for a long time but still have sinusitis symptoms, you may need surgery. You may ... need surgery if the infection is likely to spread or if you have other problems, such as a growth (polyp) blocking the nasal passage.
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