After years of suffering from chronically inflamed and infected sinuses, I decided to do what 500,000 other Americans do every year – have sinus surgery.

It wasn't an easy decision. I had to balance my need for a fix against both my fear of surgery and research that raised questions.

But, I was miserable. My sinuses had become clogged by scar tissue and the build-up of thickened mucus from decades of infections and inflammation. My nose drained so poorly that nearly every time I got a cold, I got a bacterial infection on top of the viral one.

I had already tried everything short of surgery. I was religious about rinsing out the sinuses with salt water every day. I had acupuncture. I took endless decongestants, antihistamines and nasal steroids, contributing to the $5.8 billion a year that Americans spend on sinus treatments, according to the American Academy of Otolaryngology-Head and Neck Surgery Foundation.

For 80 percent of people with chronic sinusitis, these treatments keep sinusitis under control. For me, they didn't, which meant bout after bout of sinus infections with all the attendant facial pain, post nasal drip, congestion, and – my most-hated symptom – fatigue that would often last for weeks.

But I was a wuss about the surgery, which removes swollen tissue so the sinuses can drain. Sure, the risk of going blind in one eye was teeny, and the risk of the surgeon puncturing my brain was about 1 percent. But these risks weren't zero. Nor did I relish the idea of the less-dramatic, more-common risks: infection, bleeding and post-op congestion.

Besides, I wasn't sure whether the surgery would work: It doesn't help everyone.

A review of three randomized controlled trials published this year by the Cochrane Collaboration, an international, not-for-profit group that evaluates health-care data, was not encouraging. It found that a common type of sinus surgery was no better than medications.

My doctor was planning a somewhat different procedure than the ones examined in the review. Besides, the studies did say that the surgery was safe, which allayed my fears.

Still, I waffled until early this year, when I saw a new analysis of 28 observational studies of 3,427 patients published online in the journal The Laryngoscope.

The study showed that the operation reduced fatigue significantly in 80 percent of people, said Dr. Neil Bhattacharyya, one of the authors and an ear, nose and throat specialist at Brigham and Women's Hospital. That makes sense, he added in an e-mail, because if nasal mucus containing viruses and bacteria can drain correctly, the body does not have to spend so much energy fighting lingering infections.

That did it. I hate feeling tired, so I went back to the ear, nose and throat specialist I had seen intermittently for years, Dr. Ralph Metson, a sinus surgeon at the Massachusetts Eye and Ear Infirmary. He ordered a CT scan of my head, and together we looked at it.

Even my untrained eye could see how blocked my sinuses were.

"It's a big surgery," said Dr. Marilene Wang, a professor in the division of head and neck surgery at UCLA. "Any type of surgery within the head is big. A lot of patients are surprised by the amount of fatigue after sinus surgery. I tell patients to take a week or two off work."

Sinus surgeons, not surprisingly, believe the procedure often reduces the duration and frequency of sinus infections, but whether the surgery is worth it is an individual matter.

I was swayed by technology, in particular a new image guidance system that, because of the complexity of my case, would be available to me. The key is an infrared camera system through which a sensor on an instrument placed inside the nose creates an image on a video screen in the operating room.

"This technology has revolutionized surgery," Dr. Metson told me. "The infrared camera tracks the movement of the surgical instruments."

So I went for it. As in most cases, my operation took about an hour and half. It went well, and I had surprisingly little pain afterward. There was also almost no bleeding. As promised, the post-op fatigue was considerable.

Sinus surgery isn't for everyone. And it's too soon to tell whether I'll get any significant benefits long term.

But I'm optimistic. At least now I know I've done everything possible to make myself feel better.