1. The most common causes of sinus problems are nasal allergies, a deviated or crooked septum and chronic sinusitis, which can be caused by a combination of infection and allergic reaction, says the Sinus Center's Mark A Zacharek, M.D., associate professor of otolaryngology at U-M. This means your doctor needs to do a full evaluation of your symptoms, understand your medical history and attempt to treat any underlying allergies that may be wreaking havoc in your sinuses, before recommending surgery.
2. While your doctor may order a CT scan to get a better picture of what's going on inside your sinuses, abnormalities are quite common and most don't require surgery, says the Sinus Center's Melissa Pynnonen, M.D., associate professor of otolaryngology at U-M. Your doctor can't just look at your CT scan and know that you need sinus surgery, Pynnonen says. Your doctor needs to talk with you, evaluate your symptoms and consider a course of medical therapy before considering sinus surgery.
3. If you have severe headaches, sinus surgery is not likely to help, Pynnonen says. Most often, severe headaches are caused by migraines or other headache conditions.
4. After diagnosing chronic sinusitis, your doctor should offer what is known as maximal medical treatment, Zacharek says. This may include a combination of extended antibiotic treatment, oral steroids, sinus rinses and nasal steroid sprays, he notes.
5. If you have chronic sinusitis that has failed to respond to these medical treatments, then surgery would be a logical next step, says Jeffrey Terrell, M.D., director of the Michigan Sinus Center.