Frequently Asked Questions About Nasal and Sinus Surgery

Many patients with chronic nasal and sinus issues find that medicines do not help them get relief.  In these cases, nasal and sinus surgery can help provide some long term relief.  This page lists frequently asked questions about nasal and sinus surgery.  

Dr. Goyal is a fellowship trained Rhinologist who focuses on nasal and sinus surgery.  He performs hundreds of nasal and sinus surgical procedures each year.  We know that patients who are considering having surgery have many questions. Please remember that each patient’s medical condition and treatment is unique. The answers are meant to provide a general overview, but there are likely to be specific items that would not apply in any individual case.

You may also learn more about the symptoms of chronic sinusitis.

If you are interested in having an evaluation at our office for your nasal and sinus issues, please contact us.  You may request an appointment by calling, sending us a text message, or by requesting an appointment online. We are available by phone or text at 315-254-2030. Our office staff is available Monday – Friday, from 8:30 AM to 4:30 PM.

What is sinus surgery?

Sinus surgery is a procedure that can improve symptoms in patients with chronic sinus problems.  During surgery, the surgeon uses a little "scope" to look inside the nose.  Little by little, the surgeon opens different areas of the nose.  The sinuses have natural windows to allow mucus to drain out of the sinuses.  The surgeon will look for these windows and will then enlarge these windows.  This type of surgery is done through the inside of the nostrils using a tool called an endoscope.  This avoids the need for incisions or scars on the outside of the face or head.

How do I know if I would benefit from sinus surgery?

After an evaluation, we can talk about treatment options for your particular symptoms.  Patients who need nasal and sinus surgery typically have severe problems with their nasal symptoms. Most patients having surgery also have not had much relief with medications.

After reviewing your symptoms and history, a specialist will first need to diagnose your particular nasal issues.  In our office, Dr. Goyal can help diagnose chronic sinus problems by performing nasal endoscopy and by obtaining a sinus CT scan.

Nasal endoscopy allows us to look inside the nose using a special tool.  This tool is like a skinny flashlight and camera. It provides a magnified view of the inside of the nose, allowing the doctor to look for things like polyps.  A CT scan is a special type of x-ray that gives us a high resolution image of the nose and sinus areas. In our office, we can perform the endoscopy and obtain the CT scan all in one place.  This can be done at the time of your appointment with Dr. Goyal.

Where will my surgery be performed?

Almost all of our patients have their nasal and sinus surgery performed at a free-standing surgery center.  Dr. Goyal performs the majority of his procedures at the Specialty Surgery Center of Central New York. This is an independent surgery center in Liverpool, New York.  The center focuses on delivering outstanding care to patients needing outpatient surgery.

How soon can I schedule surgery?

Eileen coordinates surgery appointments and will work hard to find a time that could fit into your schedule.  If you would like surgery soon, Eileen can typically find a surgery appointment within one month. Of course, if you need surgery around a specific time frame, please let Eileen know so that she can try to work with your schedule.  Dr. Goyal has surgery time each week, so most of our patients do not have to wait for extended time periods to schedule surgery.

How long is the recovery after nasal and sinus surgery?

Each person has a different experience, but most of our patients find that the toughest part of the recovery is in the first week after surgery.  Most of our patients do not have a lot of pain. In fact, most of our patients do not need prescription pain medications after nasal and sinus surgery.  The most common symptoms our patients describe are fatigue, stuffiness, and lots of drainage. For the first week, there can be lots of drainage of mucus, bloody material, and clots.

Typically, the symptoms start to improve in the second week.  After a few weeks, most of our patients find that their nose feels better than where they started.  It usually takes a few more weeks for the nasal areas to really feel open and for the flow to improve significantly.

Depending on the type of work they do, most of our patients do take the first few days after surgery off from work.  Many patients take the rest of the week off so that they can give their body the time it needs to recover.

Keep in mind that everyone responds differently to surgery and to anesthesia, so there are differences in how quickly each person recovers.  But this information is a general guideline for how our patients do.

Will Dr. Goyal perform balloon sinus surgery?

Balloon sinus procedures are now being performed more commonly throughout the US.  These procedures are referred to by names such as balloon sinuplasty, balloon sinus dilation, or balloon sinus ostial dilation.  Many of our patients ask if that is the type of surgery they will have with Dr. Goyal.

Dr. Goyal can perform some procedures with the use of sinus balloon devices, but he rarely does.  He finds that the best way to open most of our patients’ sinuses is through what we might call “routine” endoscopic sinus surgery.  This type of surgery uses tiny forceps and a “shaving device” that allows the surgeon to enlarge the natural openings into the sinuses.  Making the openings larger in this way allows Dr. Goyal to monitor the healing and to help the openings stay open long term. If a patient has some sort of sinus flare up after surgery, these types of openings allow us to evaluate and suction inside the sinuses.  They also help us take cultures from the sinuses to help treat any sinus infections.

Balloon sinuplasty, balloon sinus dilation, or balloon sinus ostial dilation rely on stretching the sinus openings to try to make them larger.  For most of his patients, Dr. Goyal finds that enlarging the openings using the other types of tools is what allows the openings to be permanently bigger.

Of course, Dr. Goyal will also discuss if a balloon procedure is the best option for a particular patient.  This type of decision would be made on a case-by-case basis. If you have any questions about the type of tools that would be used in your case, please do not hesitate to ask Dr. Goyal.

Who will perform my surgery?  Are there students performing parts of the procedure?

Dr. Goyal performs all of his own surgical procedures.  There will not be any students, residents, or other trainees performing your procedure when you have surgery with Dr. Goyal.  

At the surgery center, an anesthesiologist or nurse anesthetist will administer your anesthesia.  There are also nurses and surgical technologists who will be involved in your care at the time of surgery.

When do I have to be seen after surgery?

Most of our patients need to be seen 1-2 weeks after surgery.  If you need follow up visit at a different time, our office will let you know.

How long do I need to stay away from sports or exercise?

You should stay away from sports, exercise, and any other physical activity for at least the first week after surgery.  You should also not blow your nose for the first week. Straining, physical activity, and nose blowing can increase the bleeding you will experience during the recovery period.

When you are seen in the office for your post-operative visit, Dr. Goyal will see how things are healing.  He can then let you know if your body is ready for your to increase your activity. Most of our patients are able to start slowly increasing their activity level about a week after surgery.  After about two weeks, most patients can get back to normal activity.

How much will surgery cost?

We know costs have become increasingly important because many insurance policies require that patients bear a portion of the cost for surgery.

The cost for surgery will really depends on your insurance plan, what it covers, and your deductible.  There are a few separate components to costs of surgery. These include:

  • Cost of the procedure performed by the surgeon
  • Cost for the services provided by the anesthesiologist
  • Cost for use of the surgery center facility
  • Cost for postoperative care after surgery

The last component is tricky because many patients are under the impression that the cost of surgery includes any care needed after surgery.  CMS (Centers for Medicare & Medicaid Services) and insurance companies determines what is included in payments for surgery. For sinus surgery, CMS has determined that the payment for surgery includes payment only for the services on the day of surgery.  They have required that the visits needed after surgery be billed and paid separately. For that reason, our office is required to submit one bill for the codes that describe what was done at the time of surgery. After surgery, the insurance company requires that separate bills be submitted for office visits and any associated care.

At our office, we do accept most major health insurance plans.  That means that the price paid to the surgeon, the anesthesiologist, and the surgery center are all determined by your insurance plan.  As a small medical practice, we do not have any say in determining the price insurance companies will pay for our services.

Our office does treat patients who wish to pay out of pocket for office visits, office CT scans, and surgery.  If you do not have insurance and need information about out-of-pocket costs, please let us know.

We also treat patients from Canada who are seeking medical care in the US because of Syracuse’s proximity to some Canadian cities.  We can provide estimates of costs of office visits and of surgery for Canadian patients who are paying for their care out-of-pocket.

As mentioned earlier, almost all of our patients have their procedure performed at a free-standing surgery center.  Costs of surgery at this type of surgery center are much lower than costs at a hospital based surgery center or within a main hospital itself.  This is particularly beneficial for our patients with high deductible insurance plans because it decreases the surgery center fee significantly over having surgery at a hospital based facility.

I have already had sinus surgery, but it didn't help.  Would another procedure help me?

Our office specializes in treating patients with complex nasal and sinus issues, so we hear this a lot!  It's important to remember that there are many different types of sinus surgery procedures.  Also, each individual doctor has different ways of performing surgery.  Even if you have had surgery in the past, your nasal and sinus areas may still have areas that are blocked.  If that is the case, Dr. Goyal may be able to help improve your sinus issues with additional revision sinus surgery.

As a Rhinologist, Dr. Goyal specializes in procedures like revision sinus surgery.  In fact, many of the patients who have surgery with us have had surgery in the past.  We can typically help improve the nasal and sinus openings so that the the sinuses can flow better and function more effectively.

The other good thing is that recovery after sinus surgery is better now than it was with older types of sinus procedures.  Most of our patients are pleasantly surprised that their recovery is not nearly as uncomfortable as it was with their prior surgery.

Other questions?  Want to schedule an evaluation?

You may also read more about sinus surgery recovery on our website. 

If you have other questions about scheduling surgery, having surgery, or the recovery after surgery, please feel free to contact us.  In addition to serving patients from the Syracuse, NY area, we treat patients from throughout the Upstate New York region. We treat many patients from Binghamton, Ithaca, Cortland, Utica, Rome, Auburn, RochesterBuffalo, and Watertown. Our office is located just a few minutes from the major highways in Syracuse, making it easy for patients from all regions of Upstate New York to reach us.

If you are interested in having an evaluation at our office for your nasal and sinus issues, please contact us.  You may request an appointment by calling, sending us a text message, or by requesting an appointment online. We are available by phone or text at 315-254-2030. Our office staff is available Monday – Friday, from 8:30 AM to 4:30 PM.