Revision sinus surgery

Why symptoms can return

Sinus surgery improves anatomy and access for treatment, but the lining still responds to your environment and immune system. Polyps can regrow, inflammation can persist, and healing can narrow an opening. These changes can occur after an appropriately performed operation.

Sometimes the prior treatment was intentionally limited, or did not address all of the disease. A balloon procedure, for example, does not remove polyps or open every diseased ethmoid compartment. The question is what your current findings show and what a further intervention could accomplish.

Reconstructing the whole picture

Bring prior operative reports, CT images and reports, pathology, cultures and your medication history. Dr. Fewins examines the postoperative nose with endoscopy and reviews current imaging when needed. Knowing what was done helps distinguish recurrent disease from a remaining anatomical problem.

If you are coming from another practice, our second-opinion process starts with record and image review before scheduling.

What improved, and for how long?

Describe the period after your last procedure. Did breathing improve while pressure stayed the same? Did smell return and then fade? Were you well between later infections, or congested every day? These details help connect the current examination with the course of your illness.

Include the sprays or rinses used after surgery and whether you could continue them. A treatment that could not be used consistently is different from one used as directed without benefit. The review brings those details together before another operation is proposed.

Planning around altered anatomy

Prior surgery can change landmarks, and scar tissue or extensive polyps can make the view more demanding. The sinuses lie beside the eyes and beneath the skull base. Careful CT review is central to planning.

The operation is directed at specific findings: clearing recurrent polyps, improving an opening, removing diseased tissue or addressing another obstruction. Unusually complex cases may benefit from referral to a rhinologist at UT Southwestern.

When another operation is not the next step

More surgery may add little if the cavities are open and the main problem is uncontrolled inflammation or a symptom from another source. Prescription rinses, other medical treatment, allergy evaluation or a headache assessment may be more useful. Biologic medication is an option for some patients with difficult polyp disease.

Dr. Fewins will explain what he expects another operation to improve and what would likely remain. You should be able to understand that difference before deciding.

Keeping an improvement

Recovery and follow-up depend on the extent of revision. Early visits may include cleaning crusts and mucus, assessing the openings and adjusting topical treatment. Regular saline care and prescribed anti-inflammatory treatment help maintain the result.

A meaningful improvement can be possible even when the underlying condition remains chronic. The plan is built around breathing, drainage, smell, infections and daily function—not a promise that inflammation can never return.

Agree on the goals before surgery

Identify the problems you most want to change, such as daily nasal blockage, loss of smell or repeated episodes of drainage. Dr. Fewins explains which findings the revision would address and what medical treatment would continue afterward. This gives you a practical basis for judging progress at follow-up.

Recovery may differ from your first operation because the areas treated and the postoperative anatomy are different. Follow the new instructions rather than assuming the same medication or activity schedule applies. Contact the team about heavy bleeding, worsening pain or fever; new vision changes or severe unusual symptoms need urgent assessment.