Overview of Sinusitis
Sinuses are four air-filled sacs in your skull. They are thought to humidify the air you breathe, enhance your voice, and affect movement and balance.
Sinusitis, categorized as either acute (sudden) or chronic (long-term), is a painful inflammation of the sinuses that sometimes requires sinus surgery to alleviate.
“Acute” is usually caused by a viral infection and generally resolves on its own with self-care treatments such as nasal sprays or corticosteroids, decongestants and/or pain relievers.
“Chronic,” which may last 12 weeks or more, necessitates a more complicated and varied course of treatment, including antibiotics. If these prove unsuccessful, sinus surgery may be required.
Symptoms That May Indicate Chronic Sinusitis
Acute and chronic sinusitis are characterized by similar symptoms, although in chronic cases, they last much longer. Signs of chronic sinusitis include thick, discolored drainage down the back of your throat or through your nose; difficulty breathing through your nose; and swelling in your facial region.
Treatment of Chronic Sinusitis
If you suffer from chronic sinusitis, you are probably all too familiar with the ongoing discomfort of pain and pressure in your head and face that can affect the way you feel for weeks, or longer.
The goals of treatment are to eliminate the underlying cause; reduce inflammation; decrease the number of flare-ups; and improve drainage of the nasal passages.
The first line of therapy may include an extended course of antibiotics, sinus irrigation, and/or steroidal medications, and skin allergy testing. Should none of these be effective, your otolaryngologist may see you as a possible candidate for sinus surgery.
Possible Causes of Chronic Sinusitis
Chronic sinusitis may be due to:
- A crooked/deviated nasal septum (bone and cartilage separating the two nasal cavities) blocking the wall between your nostrils
- Growths/polyps obstructing your nasal or sinus passages
- A viral, bacterial, or fungal respiratory tract infection
- Allergies such as hay fever
- Medical conditions such as cystic fibrosis, GERD/gastroesophageal reflux, or immune system-related diseases
To acquire a definitive diagnosis, your otolaryngologist will use a nasal endoscope, a thin flexible tube mounted with a fiber-optic light and video camera; when inserted into your nose, magnified images are produced and projected onto a screen for recorded documentation.
Imaging studies such as CT or MRI scans may also be used to detect thickened or fluid-filled membranes, the presence of tumors, and the existence of inflammatory disease. If sinus surgery is indicated, the images also provide a well-defined depiction of the region’s anatomy.
Chronic Sinusitis That May Require Sinus Surgery
If you do not respond to medical treatments, your otolaryngologist may recommend sinus surgery for removal of one or more of the following:
- Bone (to enlarge an opening for drainage)
- Damaged, infected, or swollen tissue
- Growths (polyps) inside nose or sinuses
- A foreign object (usually in the case of children)
Sinusitis Surgery Choices
Sinus surgery has evolved over the years. At one time, it required external incisions on the face and in the mouth. Significant pain, possible scarring and a long recovery period were part of the package.
Since the advent of the nasal endoscope, otolaryngologists today perform endoscopic sinus surgery entirely through the nose, without facial or mouth incisions. It has the advantages of being less invasive and less expensive, requiring less time with a lower rate of complications and minimum scarring and bleeding.
Postoperatively, discomfort, congestion, and drainage usually improve within a few days, with only milder symptoms sometimes lasting several weeks. Your otolaryngologistwill prescribe the necessary medications to keep you comfortable, and because surgery is just one step in treating your chronic sinusitis, possibly saline rinses, nasal steroid sprays, and antibiotics as well.