March 2026 Sinus

Do I Need Sinus Surgery? Signs It May Be Time to See an ENT Specialist

If you have had sinus symptoms lasting more than 12 weeks despite medication, nasal sprays, and antibiotics, you may benefit from endoscopic sinus surgery. A CT scan showing persistent inflammation, polyps, or structural blockage is often the clearest indicator that surgery should be considered. An ENT specialist can assess whether surgery is the right step for you.

How Common Is Chronic Sinusitis in Australia?

Chronic sinusitis is one of the most common long-term health conditions in Australia. Research from the Australian Institute of Health and Welfare suggests that roughly 1 in 10 Australians experience chronic or recurrent sinusitis at some point during their lives. That makes it more prevalent than asthma in some age groups.

The condition involves persistent inflammation of the sinus lining, typically lasting more than 12 weeks. Symptoms include a blocked or stuffy nose, facial pressure or pain, thick nasal discharge, post-nasal drip, and a reduced sense of smell. For many patients, these symptoms fluctuate but never fully resolve.

Most people with chronic sinusitis start with conservative treatments prescribed by their GP: saline rinses, steroid nasal sprays, and sometimes courses of antibiotics. For the majority of patients, this is enough. But for a significant subset, medical therapy alone fails to provide lasting relief.

When Medications Stop Working

There are several clinical scenarios where an ENT surgeon would recommend considering sinus surgery:

Symptoms persist beyond 12 weeks despite appropriate medical therapy including steroid sprays, saline irrigation, and at least one course of antibiotics.
CT scan confirms disease. A sinus CT scan shows mucosal thickening, blocked sinus drainage pathways, or nasal polyps that are not responding to medication.
Recurrent acute infections. You are experiencing four or more sinus infections per year, each requiring antibiotics.
Structural issues. A significantly deviated septum or concha bullosa is blocking sinus drainage and preventing medications from reaching inflamed tissue.
Complications. Sinus disease has spread beyond the sinuses, causing orbital (eye) swelling, severe headaches, or other concerning symptoms.

If any of these apply to you, a consultation with an ENT specialist is the logical next step. Your GP can provide a referral to Central Sydney ENT, where our surgeons will review your imaging, examine your nose with a nasoendoscope, and discuss whether surgery is appropriate.

What Does Endoscopic Sinus Surgery Involve?

Functional endoscopic sinus surgery (FESS) is the standard surgical approach for chronic sinusitis. It is a minimally invasive procedure performed entirely through the nostrils, with no external incisions.

During the procedure, the surgeon uses a thin endoscope (a small camera) and specialised instruments to:

Open the natural drainage pathways of the sinuses
Remove polyps, thickened mucosa, or diseased tissue
Correct structural abnormalities such as a deviated septum
Improve the delivery of post-operative nasal medications to the sinus lining

The procedure is performed under general anaesthesia as a day-case or short overnight stay. At Central Sydney ENT, our rhinology surgeons: including Dr Rahuram Sivasubramaniam, Dr Alexander Zhang, and Dr Jareen Ebenezer: have extensive fellowship training in advanced endoscopic sinus and skull base techniques.

Recovery After Sinus Surgery

Most patients take one to two weeks off work after endoscopic sinus surgery. During the first week, you can expect nasal congestion, mild blood-stained discharge, and some facial pressure. Pain is generally mild and well controlled with over-the-counter medication.

Key points for recovery:

Saline rinses are started within a day or two of surgery to keep the nasal passages clean.
Avoid heavy lifting and strenuous exercise for two to three weeks.
Post-operative appointments at one and four weeks allow your surgeon to clean the sinuses and monitor healing.
Full improvement is usually felt within four to six weeks as swelling settles and the sinus lining heals.

For patients with nasal polyps, ongoing medical management with steroid sprays and saline rinses is often necessary after surgery to reduce the risk of polyp recurrence.

When to See an ENT Specialist

You should consider a referral to an ENT surgeon if:

Your sinusitis symptoms have lasted longer than 12 weeks
You have been diagnosed with nasal polyps
You keep needing antibiotics for sinus infections
Your sense of smell has reduced or disappeared

Central Sydney ENT has six FRACS-qualified ENT surgeons across seven Sydney locations, including our main practice in Burwood. Ask your GP for a referral, or call our reception team on (02) 9747 3199 for more information.

Frequently Asked Questions

How do I know if I need sinus surgery? +

You may need sinus surgery if you have chronic sinusitis symptoms lasting more than 12 weeks that have not responded to nasal sprays, antibiotics, and other medical treatments. A CT scan showing persistent sinus disease, nasal polyps, or structural blockages can confirm whether surgery is appropriate. An ENT specialist can assess your case and recommend the best approach.

Is endoscopic sinus surgery painful? +

Endoscopic sinus surgery is performed under general anaesthesia, so you will not feel pain during the procedure. Afterwards, most patients experience mild to moderate congestion and discomfort rather than sharp pain. Over-the-counter pain relief is usually sufficient, and most people return to work within one to two weeks.

What is the success rate of sinus surgery in Australia? +

Endoscopic sinus surgery has a success rate of approximately 85 to 90 percent for improving chronic sinusitis symptoms. Most patients report significant relief from facial pressure, nasal blockage, and post-nasal drip. Some patients with nasal polyps may require ongoing medical management after surgery to maintain results.

Can sinus surgery be done through the nose without external cuts? +

Yes. Functional endoscopic sinus surgery (FESS) is performed entirely through the nostrils using a small camera and specialised instruments. There are no external incisions, no bruising, and no visible scarring. This minimally invasive approach allows faster recovery compared to older open surgical techniques.