A common and frustrating dilemma associated with sinus surgery is scarring between the middle turbinate and lateral nasal wall. • The most common adverse event associated with the procedure is failure to alleviate the initial presenting complaints. • After sinus surgery, mucociliary function of the paranasal sinuses is inhibited for 6-12 weeks. • Most sinus surgeons feel that aggressive debridement of the postsurgical sinus cavity is critical for success. • Postoperative debridement may decrease the rate of adhesions and synechiae. • Postoperative nasal saline irrigations reduce crusting and edema and improve nasal obstruction. • Intranasal corticosteroids play an integral role in the postoperative management of the surgically treated sinus cavities. • Because of the multiple side effects of long-term oral steroid use, short oral steroid bursts should be used judiciously, with nasal topical therapy being the preferred treatment. • In cases of extensive nasal polyps, an ideal solution would involve delivering a large amount of steroid to the diseased sinuses while minimizing systemic absorption. • Culture-directed antibiotic therapy is necessary for infectious exacerbations of chronic sinus disease, especially after sinus surgery.
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