What to Expect at a Sinus Surgery Consultation on Fifth Avenue

Patients who arrive for a sinus consultation often have a long history behind them — antibiotics, nasal sprays, allergy treatment, perhaps a prior procedure elsewhere. Many have been told the next step is surgery without a clear explanation of which surgery, or why. A useful first consultation reverses that order.

Part one: a structured history

The first portion of the visit is a structured conversation. Dr. Mourad asks about the pattern and duration of symptoms, the response to medical therapy, prior imaging or surgery, allergy history, and the way the condition affects sleep, work, and daily life. This is not paperwork; it is the foundation of the diagnostic plan.

Part two: examination and endoscopy

A complete head-and-neck examination is followed by office-based nasal endoscopy. A narrow flexible scope is passed gently through the nostrils to inspect the septum, turbinates, sinus ostia, and any polyps or anatomical variations. Topical anesthetic is used during the examination.

Findings are reviewed in real time on the monitor with the patient. This is often the first time a patient sees what is actually happening inside their own nose — a useful step in deciding what to do next.

Part three: imaging review

When prior imaging is available, it is reviewed during the visit. When it is not, a sinus CT may be ordered before any surgical recommendation. The imaging plan is matched to the clinical question, not requested by default.

Part four: the decision tree

Only after examination, endoscopy, and (when needed) imaging is the conversation about treatment options appropriate. For some patients, optimization of medical therapy is the right next step. For others, a targeted intervention is indicated — and the technique is chosen to match the specific anatomy.

• Endoscopic sinus surgery (FESS) for established chronic disease or significant polyps
• Balloon sinuplasty for selected patients with recurrent obstruction in specific anatomical patterns
• Septoplasty or turbinate reduction when an obstructive component is contributing
• Conservative management with continued medical therapy when surgery is not yet indicated

Procedures used in this practice include endoscopic sinus surgery and balloon sinuplasty; the recommendation is matched to anatomy rather than chosen by default.

Insurance and practical planning

Sinus procedures with a documented functional indication are frequently covered by insurance. Benefits are verified before any procedure is scheduled. The Manhattan office is at 923 Fifth Avenue on the Upper East Side; out-of-town patients can begin with a virtual consultation before traveling to the practice.