Is surgery the right step?
Sinus surgery is usually considered only after medical treatment has been tried properly: daily saline rinses and a steroid nasal spray, used with good technique for several weeks or more. If you have not had this treatment, Dr Kana may suggest it first, and it can often be started at home with your own doctor before you travel.
Surgery is considered when symptoms continue despite this, when polyps block the nose, or when infection spreads beyond the sinuses. Not everyone who enquires needs an operation, and the consultation is there to decide that with you.
Before you travel
Write to the practice through the enquiry form. Describe your symptoms, how long they have lasted and the treatment you have had, and mention any scans and letters you have. The practice will tell you how to send them.
A CT scan of the sinuses is needed before surgery. If you have had one recently, send it, ideally as a link to the full images rather than only the written report. If not, it can be arranged in Johannesburg.
From what you send, you will receive an outline plan: whether surgery is likely, how long to stay, and estimates of the fees. In South Africa the surgeon, the anaesthetist and the hospital each give a separate estimate. If you have international insurance, ask your insurer early whether they need approval beforehand and whether they can pay the hospital directly. Check visa requirements with the South African embassy or high commission in your country; the practice can provide a letter confirming your appointment.
Your first days in Johannesburg
Most international flights arrive at O. R. Tambo International Airport. Travelling patients are usually seen at Netcare Milpark Hospital in Parktown West, which is close to hotels in Rosebank and Melrose.
At the consultation Dr Kana asks about your symptoms, examines your nose with a thin endoscope, which takes a few minutes, and goes through the CT scan with you. If surgery is the right choice for you, he explains what it involves, how recovery goes and what the risks are, before you decide. When surgery is planned, it is usually a day or two after the consultation.
The operation
Functional endoscopic sinus surgery (FESS) is done through the nostrils under general anaesthetic. There is no cut on the face, and the shape of the nose does not change. Using an endoscope, Dr Kana widens the natural drainage openings of the sinuses and removes polyps. A bent septum is often straightened in the same operation.
Before surgery, follow the anaesthetist’s instructions about eating and drinking, and tell the practice about every medicine you take. Do not stop blood thinners or aspirin unless a doctor tells you to. Most patients go home the same day or the next morning.
The week after
Plan to stay in Johannesburg for about a week. Expect a blocked nose, some blood-stained discharge and tiredness, rather like a heavy cold. Saline rinses several times a day help the lining heal, and you will be shown how to use them.
Bring a family member or friend if you can. You should not be alone for the first night out of hospital, and it helps to have company for the first few days. Before you leave hospital you will be told which warning signs need urgent attention, such as heavy bleeding, swelling around the eye or a change in vision.
A follow-up visit about a week after surgery lets Dr Kana clean the nose with the endoscope and check healing. Flying home is usually possible after this visit. He will confirm it for you, so book a flexible ticket if you can.
Back at home
You will take home a written report for your own doctor, describing the operation and the treatment to continue. Most people keep using saline rinses and a steroid spray for months or longer, because the lining of the nose takes time to settle and polyps can return.
Most people go back to desk work after about a week and to strenuous exercise after two to three weeks. The nose often keeps improving for several weeks as it heals. If you have questions during your recovery, you can write to the practice.
This page is general information, not medical advice for your situation.
