What is it?
The cheek bone or maxilla is hollow. This keeps the bones of the face nice and light. The space inside any face bone is called a sinus. We sometimes call the sinus in the maxilla the antrum. The bone between the sinus and the inside of the nose is thin like egg shell. The sinus in the cheek bone has a little drain hole which leads into the upper part of the inside of your child's nose. Normally the hole lets in air. Infection may drain from the sinus into your child's nose. This hole often gets blocked if the sinus becomes infected. Sometimes just some swelling of the lining of the nose during a cold will block the hole. It causes unpleasant pains in the cheekbones and sometimes upper toothache - "sinus trouble". Usually antibiotics and sprays will control the infection and let the hole unblock itself. In your child's case, blockages are happening despite this treatment. It is necessary to wash out the sinus to get rid of the infection. This should give the tissues a chance to heal properly.
Your child will have a general anaesthetic and be completely asleep. A fine metal tube is placed in the nose and through the thin bone of the maxilla into the sinus. Salty water is flushed through the tube into the sinus. The salty water comes out of the little drain hole into the nose. Any pus or infected fluid will come out as well. A specimen of the infected fluid is taken to be examined so that the bugs causing the infection can be identified and then the rest is washed away. The metal tube is then taken out. The inside of the nose heals very quickly. There is no need for any stitches. If the little hole in the sinus is blocked by infection, or if the infection is very bad, the surgeon will make a bigger hole into the sinus to help drain the infection away. Because your child is asleep, he or she will not feel any pain at all during the operation. The operation can be done as a day case. This means that your child comes into hospital on the day of the operation, and goes home the same day.
If you leave things as they are, your child will get more and more sinus trouble. The infection can damage the lining of the sinuses so that they never get back to normal. Rarely, very serious infections can happen. More antibiotics, sprays, and other drugs will not help at this stage. Sometimes there is another cause for the sinus trouble. It is necessary to find out about this by washing out the sinus.
Before the operation
Sort out any tablets, medicines, inhalers that your child is using. Keep them in their original boxes and packets. Bring them to the hospital with you. On the ward, your child may be checked for past illnesses and may have special tests to make sure that he or she is well prepared and can have the operation as safely as possible. Please tell the doctors and nurses of any allergies to tablets, medicines or dressings. You will have the operation explained to you and will be asked to fill in an operation consent form. Many hospitals now run special preadmission clinics, where you and your child visit for an hour or two, a week or so before the operation for these checks. If your child has a cold in the week before his or her admission to the hospital, please telephone the ward and let the ward sister know. Usually the operation will be put off. Your child is given time to get better before sending for him or her again. Your child needs to get over the cold before the operation can be done because by having an anaesthetic the cold could turn into a serious infection in the chest.
After - in hospital
Usually there is a little soreness of the nose after this operation. Paracetamol suspension should easily control this discomfort. A general anaesthetic may make your child slow, clumsy and forgetful for about 24 hours. The nurses will support you to help your child until he or she feels better. If the surgeon needs to see your child again and check on his or her progress, the nurse will give you an appointment for the outpatient clinic about one month after you leave the hospital. Sometimes the check-ups are carried out by your own general practitioner.
After - at home
After three to four hours on the ward, your child should feel fit enough to go home. Before you leave, the nurses will check that your child's nose is comfortable and is not bleeding. If your child has been given antibiotics, you will be told how often to take the medicine, and how many days you will need to use it. If your child has been given nasal drops, you will be told how to use the drops, and for how long. Use paracetamol suspension every six hours to control any discomfort in the nose. Follow the instructions you were given on the ward carefully. Do not let your child blow his or her nose for the first 48 hours after the operation. Your child should take it easy for the rest of the day. Do not let your child do anything too energetic in case this starts a nosebleed. Your child should be able to go back to school after two days. Your child should not go swimming or diving until the nose has healed, usually after about two weeks.
As with any operation under general anaesthetic, there is a very small risk of complications related to the heart and the lungs. The tests that your child will have before the operation will make sure that he or she can have the operation in the safest possible way and will bring the risk for such complications very close to zero.
If you follow the advice given above, your child is unlikely to have any problems. There is a small risk that the nose may bleed when you get home. You and your child should not be concerned with a spot or two of blood. If the nose bleeds for more than about an hour, bring your child back to the ward.
There is a small risk of infection at the area of the operation. If your child develops increasing pain in the cheek bone or the nose, a headache or a temperature, it probably means that an infection is developing and he or she will need medical attention promptly. Taking antibiotics for a week or two usually solves the problem.
These notes should help you and your child through his operation. They are a general guide. They do not cover everything. Also, all hospitals and surgeons vary a little. If you have any queries or problems, please ask the doctors or nurses.