I am scheduled for bilateral endoscopic sphenoethmoidectomy with bilateral Caldwell-Luc (whatever all that is) surgery at the end of this month. I had surgery three years ago for a deviated septum. That surgery was wonderful, but now I'm back to constant sinus infections. I like my doctor and I trust him, but I am a little nervous. I really would like to hear about other people who have had this surgery and see how it went and how they felt afterwards. Do you have any stories of people who have went through this?

Allyson

You may not realize this, but what you are asking for is known in the advertising business as a testimonial. Testimonials are enormously effective because they appeal to our emotions. Testimonials are the stock-in-trade of the TV infomercial. ("Just one of these little Lard-Incinerator pills with each meal, and I lost 150 pounds in just two weeks!!!")
Testimonials are also enormously unscientific. You would be delighted if I were to share with you something like this: "Why, I did this very same procedure to a woman one year ago, and she says it never hurt a bit, and her life has been transformed!" But you must realize that testimonials are worthless. The effectiveness of a procedure in one person has NOTHING to do with the effectiveness of a similar procedure in a different person.

Here's what I can do for you: I can tell you what "bilateral endoscopic sphenoethmoidectomy with bilateral Caldwell-Luc" means, and I can give you some idea of what is in store for you.

First, "bilateral" means the procedure will be done on both the right and left sides. "Endoscopic" means that your doctor will be operating within your nose using special fiberoptic telescopes known as endoscopes. Next, "sphenoethmoidectomy" refers to a procedure in which the natural drainage ducts of the ethmoid and sphenoid sinuses are enlarged. Finally, the Caldwell-Luc procedure involves an incision in the gum just below the cheekbone. The bone overlying the maxillary sinus is very thin in this area, and the sinus can be entered with a drill or chisel. Caldwell-Luc refers to any operation on the maxillary sinus involving this approach.

These operations are usually performed under general anesthesia. Your time in the operating room will depend on a number of factors, such as the skill of your surgeon and the difficulty of the operation. (The same operation may be simple in one patient and extraordinarily difficult in another, due to differences in anatomy, bleeding tendencies and so forth.)

Most people will be able to go home after endoscopic sinus surgery. However, if your surgeon is really going to do bilateral Caldwell-Lucs, he may keep you overnight, since this is a more invasive operation than endoscopic sinus surgery.

The pain from endoscopic sinus surgery is usually fairly mild. The Caldwell-Lucs may be more troublesome to you. Persistent facial pain or numbness, as well as pain or numbness of the teeth near the gum incision, are some of the possible complications.

You will certainly need to see your doctor several times during the recovery period. At these visits, he will examine your sinus cavities and may need to remove debris (such as dried bloody crusts) in order to speed healing. He may also ask you to irrigate your nasal cavities several times each day and/or use nasal sprays.

Will the operation relieve all of your problems? After making a number of assumptions (that you have been correctly diagnosed, that your surgeon correctly executes the operations, that you comply with your surgeon's post-operative instructions and so forth), I can only assure you that MOST folks are glad that they have had this operation. Sinus surgery is not a panacea, however. If you expect this operation to permanently relieve all of your sinus and nasal problems, you will probably be disappointed.

One last word. The Caldwell-Luc approach is not the only approach to the maxillary sinus. There is also an endoscopic approach, via the nasal cavity. This approach has less chance of long-term complications. Your doctor probably has excellent reasons for preferring the Caldwell-Luc. Nevertheless, if it were me, I would carefully question him as to why he decided on this particular approach.