A second opinion on sinus surgery

Before we schedule

Call our office and let the team know you are requesting a sinus-surgery second opinion. We will explain how to provide records and imaging through an appropriate records-transfer method. A written CT report is useful, but access to the images themselves is especially important.

• Recent CT images and reports, plus older studies when available.
• Prior operative reports, pathology and culture results.
• A list of treatments you have tried, how long you used them, and what changed.
• The proposed procedure and the concern you want help understanding.

Dr. Fewins accepts most requests. If review suggests that another specialist or another next step would be more useful, the office will explain that before arranging an appointment. The aim is to make the visit worth your time.

Make the visit specific to your concern

Write down the decision you are facing: whether to have surgery, which areas need treatment, or why symptoms remain. Include what a successful result would look like to you. Easier nasal breathing, fewer infections and relief of facial pain are different goals, and may have different explanations.

If you do not have the records yet, call for instructions about obtaining them. Images, operative notes and a clear treatment history help Dr. Fewins use the visit to address your questions.

An independent assessment

The conversation starts with what is affecting you now: breathing, drainage, smell, pressure, infections, sleep or recovery after prior surgery. Dr. Fewins examines the nose and uses endoscopy when it adds useful information. He reviews your images in the context of those symptoms and the treatment you have already had.

When possible, he forms his own assessment before comparing it with the proposed plan. He then explains where the recommendations agree and where they differ. A difference may reflect reasonable choices about timing or extent of treatment; sometimes the findings support a different diagnosis or operation.

When additional imaging is needed, Dr. Fewins orders it through dedicated radiology facilities. He looks for the detail and views needed to assess the disease and plan treatment, and keeps the images available during surgery. Read about his approach to CT imaging.

What you may learn

• The original plan makes sense. You can return to your treating physician with greater confidence.
• Medical treatment or observation deserves more time. Surgery may not add enough benefit at this point.
• The proposed procedure needs adjusting. The source of obstruction or extent of disease may call for a different approach.
• More information is needed. Additional testing may clarify the cause before a decision.
• Another specialty can help more. Symptoms such as facial pain may need a different treatment pathway.

A second opinion does not automatically mean less surgery, more surgery, or transferring your care. The recommendation should follow the findings and your goals.

If a previous procedure did not help

Symptoms after sinus treatment deserve a fresh assessment. Persistent inflammation, recurrent polyps, scar tissue, a remaining structural blockage or a separate cause can each change the next step. Recurrence alone does not establish that the previous operation was inappropriate.

For example, opening sinus drainage pathways does not straighten a deviated septum. When obstruction remains, the septum, turbinates and nasal valves still need to be assessed. The useful question is which finding explains the problem you have today.

Read about revision sinus surgery or facial pain and sinus headache.

A recommendation you can understand

Expect an explanation of what treatment is intended to improve, its limitations, the alternatives, and what recovery would involve. Bring your questions and tell us what matters most to you. Dr. Fewins applies the same standard he would want for a member of his own family: a medically sound recommendation with a clear reason behind it.

Questions worth discussing

• Which examination or CT findings explain my symptoms?
• What would the recommended treatment change?
• Are there options worth trying before an operation?
• Would sinus treatment alone address my breathing problem?
• What care, medication and follow-up would continue afterward?

The value of the visit is a clearer understanding of the decision. You can take time to consider the explanation and discuss the next step with the care team.

Common questions