This may sound obvious but sinus surgery, more than any other type of surgery, lends itself to being “over done”. Frequently patients are subjected to having more of their sinuses opened than necessary. More tissue is removed from inside the nose than is required to relieve congestion or eliminate the risk of recurrent infections. Simply, more is done to patients than needs to be done and when that happens, it can cause permanent problems. These problems can be relatively minor and annoying such as chronic nasal crust formation. That said, more severe problems such as “empty nose syndrome” can occur. This syndrome can result in debilitating ongoing bacterial colonization inside the nose, and once it happens it is difficult, if not impossible to resolve. Hence, the key is to prevent “empty nose syndrome” from occurring by only doing the surgery that is justified by each patient’s anatomy and symptoms.