Before these advances, if a patient's ailment couldn't be cured through medication and surgery was the only option, the methods used were crude by today's standards. If an area was infected, they would scrape that area, remove it and open ventilation. This would damage landmarks inside and make it harder for future operations to be effective. They tried to improve what Mother Nature gave them and that was a mistake. In fact, it is a last resort.
Surgery is considered only after all other possibilities are explored.
This includes a detailed history, allergy inquiry and nasal examination. Further inquires an lead to sinus X-rays. Cruz stipulates that every possible means of healing is attempted before going in. However, when medical management has failed, he is thankful for the latest advance in technology, endoscopic sinus surgery. Since many of the patients that require surgery have undergone previous operations, they have had several landmarks distorted inside the nose.