Founder and director of Smell & Taste Treatment and Research Foundation ( Chicago, USA), Dr. Alan Hirsch says that septoplasty is perhaps the most over-sold form of surgery. As a person who had sinus surgery twice (one septoplasty and one endoscopic sinus surgery), and as a practicing naturopath, I want to assure you that it is very unlikely to create relief which will last more than one year after any form of sinus surgery. In most cases relief disappears after the 6th month. Then, you suffer a return of your chronic sinus problems, pains, pressure and all of the discomfort that goes with it.

As a matter of fact our sinus treatment plan eliminates the need for sinus surgery on most occasions. However, if your doctors tell you that you definitely need surgery for your sinus problems, please heed my advice on one point: Choose local anesthesia rather general.

Cardiac and pulmonary complications related to general anesthesia are well-known, and an anesthesiologist will take care of them when he or she talks with you to find out which type of anesthesia is appropriate for you. But there is one other disadvantage of general anesthesia which applies to sinus surgery and this is one which is often overlooked.

General anesthesia suppresses the immune system considerably, and this can create subsequent complications following the surgery. This is particularly true if you have a fungal infection in your sinuses. If fungal colonies cannot be totally eradicated during the surgery, your suppressed immune system cannot fight against the remaining fungi. Fungi then find their way to the brain causing meningitis - which may cause fatality. Last year, we lost a person who was very dear to us, after a sinus surgery aimed to remove fungal balls in her sinuses. I learned that she visited the hospital hoping to find a relief from her constantly-blocked nose, and she left it in a burial case. She was just 39 years-old, and a mother of two young children.

In short, it may be of vital importance to have a strong immune system if you plan to have sinus surgery - and this is not possible with general anesthesia.

However, there is one thing I have learned in the past few years. Although most sinus surgery could be done with local anesthesia, a significantly higher than necessary amount is performed under general anesthesia. This is because having sinus surgery under local anesthesia can be rather uncomfortable and some patients cannot stand it. This discomfort is not due to pain; you do not feel pain with local anesthesia, but you almost kind of 'feel' what is being done in your nose. The incisions, hammers striking in septoplasty, bone spur removal and bone or cartilage removals can all be felt to some degree. And this may be extremely annoying, particularly if the surgery lasts longer than half an hour, which becomes the case if some large tissue or structure is to be removed.

Some female patients or children cannot bear this annoyance and may start shouting in the middle of surgery "Hey, stop this and make me sleep. I want general anesthesia". Doctors who have previous experience of this tend to suggest general anesthesia to their female or young patients - even if there is no physical need for it.

Doctors may sometimes endorse general anesthesia so much that the patient may feel obliged to accept it. I know that this happens, and therefore I want to make a strong suggestion, particularly to women who are about to have sinus surgery: Choose local anesthesia - even if the doctor suggests a general one. If your doctor states a serious necessity for general anesthesia, you should, of course, take it. But this is rarely the case. So, if your doctor gives you the option of which type to take, choose local anesthesia.

If your doctor endorses general anesthesia, try to find out why. Ask them their reasons for advising it. If you find that they do not have a clear reason for it, just thank them for their suggestion, and then say that it is your final decision to have local anesthesia during surgery.

When the surgery time comes around, be psychologically prepared. You will feel uncomfortable touches inside your nose and sinuses. But the operation would not be any different if you were unconscious under general anesthesia. Be as patient as you can, stand firm, and grit your teeth if necessary. Everything will be over within a short amount of time.