Endoscopic Sinus Surgery

In-office Endoscopic Sinus Surgery

Endoscopic Sinus Surgery Los Angeles In-office endoscopic sinus surgery is a minimally invasive procedure for patients suffering from recurrent sinus infections and chronic sinusitis. The procedure alleviates sinus pain, pressure, and discomfort despite conventional treatment measures (antibiotics, steroids, nasal sprays, decongestants, and allergy medications).

In-office endoscopic surgery is also recommended for patients with a deviated septum, extensive nasal polyps, or other defects of the nose that block the nasal passages.

What Is Sinusitis?

Sinusitis is a sinus infection that comes and goes. The condition occurs when germs and bacteria accumulate in the sinuses, causing them to swell with mucus. Swelling eventually gives way to infection and inflammation.

Other causes of sinusitis include allergies, mild respiratory conditions, such as the common cold or flu, and autoimmune reactions. Sinusitis symptoms can be acute or chronic. They can also be broken down into the following classifications based on how long symptoms last.

Acute sinusitis is the most prevalent of all sinus infection types. Acute sinusitis symptoms are usually mild and resolve within 2-4 weeks of onset.

Subacute sinusitis is similar to acute infections. However, symptom duration is longer. Most cases resolve within 4-12 weeks.

Chronic sinusitis causes sinus symptoms that last much longer than other types of sinusitis. Not only are symptoms notoriously challenging to treat without medical attention. Advanced treatment is necessary to alleviate the symptoms and duration of symptoms.

A critical distinction between acute and chronic sinusitis is chronic infections never truly go away. Symptoms can wax and wane and recur quite frequently. But, the underlying infection and inflammation remain. Chronic sinus infections are those that last longer than 12 weeks.

Recurring sinusitis is similar to chronic sinusitis, but symptom duration varies.

Sinusitis Treatment or Sinusitis Surgery

Most sinusitis cases are relatively mild and often go away within a couple of weeks without medical intervention. However, sinus treatment or surgery may be necessary to open the airways for persistent or severe cases to allow adequate airflow, drainage, and alleviating symptoms. There are several procedures that treat sinusitis. In-office endoscopic sinus surgery is one of several procedures that successfully treat sinusitis.

What can I do if my sinusitis is chronic?

It’s necessary to see an ENT for an evaluation to determine if there is an underlying cause like bacteria or abnormal nasal tissues and learn suitable treatment options. Chronic sinusitis treatments range from self-care and over-the-counter and prescription medications. In some cases, sinus surgery may be necessary to remove blockages to widen the sinuses or correct other structural abnormalities.

Does insurance cover nasal endoscopic sinus surgery?

Most medical insurers provide coverage for nasal endoscopy sinus surgery. To determine if your procedure qualifies for medical reimbursement, contact your insurer to inquire.

What types of conditions can be treated with endoscopic sinus surgery?

Endoscopic sinus surgery is routinely prescribed for patients suffering from unresponsive sinusitis infections, lost sense of smell, nasal congestion, polyps, tumors, and infected or damaged nasal tissues. The procedure effectively treats nasal issues that impair sinus health and function.

How long is the recovery after nasal and sinus surgery?

In-office endoscopic sinus surgery patients can expect to experience mild soreness, congestion, and discharge for the first two weeks after their procedure. Though most patients feel well enough to resume their usual activities much sooner, complete recovery can take a few months. To ensure recovery is swift and uneventful, patients should see Dr. Cohen for follow-up care.

Frequently Asked Questions About In Office Endoscopic Sinus Surgery

Does sinus surgery require a hospital stay?
Conventional sinus surgery requires patients to spend a few days in the hospital before. Modern sinus surgery/in-office endoscopic sinus surgery does not. Endoscopic surgery is performed in a clinical outpatient setting. The procedure takes up to 4 hours depending on the patient’s circumstances and does not require hospitalization. Patients are discharged home shortly after treatment.
How serious is endoscopic sinus surgery?
In-office endoscopic sinus surgery is a surgical procedure that, like all other types of surgery, carries risks. Because endoscopic sinus surgery is a minimally invasive procedure, complication risks are low. In-office endoscopic sinus surgery is safe and highly effective in treating sinus problems.
How much does it cost for endoscopic sinus surgery?
Treatment costs vary and depend on various factors, such as clinic location, anesthesia, surgeon fees, etc. However, in-office endoscopic sinus surgery is more cost-effective than traditional sinus treatments because it provides permanent relief of symptoms, is less invasive, and requires minimal downtime for patients.
Is endoscopic sinus surgery painful?
The techniques used to perform the procedure can cause discomfort, which is why patients receive either an anesthetic to minimize any pain and pressure they may feel. After treatment, patients should expect some minor soreness, achiness, and bruising that resolve within the first several days.
When is endoscopic sinus surgery necessary?
Not everyone who suffers from chronic sinusitis requires endoscopic surgery. However, the procedure is highly recommended for those with chronic or acute sinusitis symptoms that don’t respond to remedies, antibiotics, or medications.
Can nasal endoscopy be done in the office?
Nasal endoscopy can be performed in-office, at a surgery center, or in a hospital. The procedure is minimally invasive and does not require incisions or sutures. Dr. Cohen inserts a thin, flexible probe known as an endoscope into the nose to perform the procedure. The endoscope has a small camera with a light attached so the ENT specialist can visually examine the nasal cavity and sinus passages.
How long does an endoscopic sinus surgery take?
On average, endoscopic sinus surgery takes anywhere from 30 minutes to several hours, depending on the amount of work necessary to improve the patient’s condition.
What can I expect on my surgery day?

On the day of surgery, patients are expected to do the following:

  • Refrain from eating or drinking until after their procedure.
  • Continue taking all required medications with a small amount of water.
  • Wear comfortable clothes.
  • Arrange for someone to accompany them to the clinic and take them home.
  • Follow all instructions provided to prepare for the procedure adequately.
  • Discuss any concerns with the Dr. Cohen.

After surgery, patients can expect the following:

  • Spend a short stay under observation.
  • Go home and adhere to post-operative instructions to prevent complications and optimize recovery.
  • Return to the clinic for aftercare.
What do I need to know before having endoscopic sinus surgery?

Endoscopic sinus surgery is one of several procedures we offer for those suffering from nasal congestion and sinus problems. There are circumstances where alternative treatment considerations are necessary. 


At the Southern California Sinus Institute, we are committed to providing comprehensive and advanced medical treatment for patients suffering from sinus problems, congestion, and other sinonasal conditions. In addition to in-office endoscopic sinus surgery, we offer minimally invasive procedures: balloon sinuplasty for chronic sinusitis, turbinate reduction for nasal congestion, and nasal polypectomy.

Considered by his patients and his peers to be one of Los Angeles’ best sinus surgeons, Dr. Alen Cohen, has performed countless in-office balloon sinuplasty procedures and has often combined it with in-office endoscopic sinus surgery to address scar tissue or disease within the sinuses or along the drainage pathways of the sinuses.

As such in these hybrid cases under local anesthesia, Dr. Cohen will begin by ballooning open the frontal, sphenoid and maxillary sinus ostia and then he will use a microdebrider to remove polyps, scar tissue or infection along the ethmoid sinuses or osteomeatal complex regions for permanent relief from chronic sinusitis.

This may be done under Fiagon image guidance or not depending on the complexity and severity of the case. This makes Dr. Cohen unique among nose and sinus surgeons in the country to combine techniques used in the OR in the office setting for permanent relief in nose and sinus conditions.

The recovery in these cases may be 48 hours instead of the typical 24 hours but is worth a lifetime of improvement. Patients routinely state the Tylenol or Advil takes the discomfort associated with these procedures away. They also state they love the fact that there is no packing, just some dissolvable gel in their nose after the procedure and they leave the office with just mild congestion.

As such Dr. Cohen will determine if scar tissue, bacterial or fungal infection, polyps or simply allergies are the cause of your problems and then decide if you would benefit from In-Office Balloon Sinuplasty, Minimally Invasive Image-Guided Endoscopic Sinus Surgery (MIGSS™) or simply medical management for sinusitis.