Sinusitis is inflammation and swelling of the tissues that line the sinuses. This interferes with normal mucus drainage, leading to breathing difficulties, pain and pressure. When the condition persists for 12 weeks or longer, it is considered chronic.
Sinusitis is the number one reported chronic condition in the United States, affecting an estimated 37 million Americans. It’s most often caused by an infection brought on by a cold or allergies, but may also be the result of nasal polyps, a deviated septum, trauma to the face, hay fever, complications from immune system disorders or tumors.
In addition to a physical examination and a review of the patient’s medical history, the doctor will inspect the nasal passages for polyps and other abnormalities and check for inflammation and a buildup of fluid. Additional tests utilizing nasal endoscopy, CT scans, MRIs and allergy tests can be used to help confirm the diagnosis.
Individuals suffering from sinusitis experience a variety of cold-like symptoms such as nasal congestion and discharge, postnasal drip, sore throat, facial pressure and swelling, loss of smell and taste, headache, fever, fatigue and bad breath.
Treatments will vary depending upon the severity of sinusitis and whether it’s an acute or chronic condition. Saline nasal sprays and corticosteroids are useful for rinsing the nasal passages and relieving inflammation. Decongestants are a good short-term solution, but extended use can actually worsen the condition. Antibiotics are usually prescribed for bacterial infections.
Antihistamines, nasal steroid sprays, saline washes and oral steroids all provide long-term relief. More permanent solutions such as immunotherapy (allergy shots) or surgery can bring relief to those suffering from chronic sinusitis.
Depending on the patient, there are several surgical sinus procedures available. Below is a list of common sinus surgeries.
- Functional endoscopic sinus surgery (FESS). This operation, developed in the 1950s, involves use of a nasal endoscope to open the natural pathways to the sinuses. A thin tube with a camera attached is inserted into the nose, and any obstructive tissue is removed. In most cases, the procedure is completed entirely through the nostrils, so no external scars are left behind. Swelling is limited, and pain or discomfort is mild.
- Image guided surgery. This procedure relies on a 3D mapping system using CT scans and information about the exact position of surgical instruments through the use of infrared signals. This allows the surgeon to accurately guide instruments through complex sinus passages and is especially helpful for those with chronic sinusitis or when previous sinus surgery has changed the usual anatomy of the sinuses.
- Balloon sinuplasty. In this surgical procedure, a balloon catheter is inserted through the nostrils into the sinus passages, and gently inflated. This causes the sinus cavity to expand, allowing for easier drainage. The balloon is then deflated and removed. This operation is minimally invasive, provides immediate relief, and results in a much quicker recovery. Many patients are able to return to work the next day.
Each surgical procedure requires a different recovery period. Patients who undergo FESS or image guided surgery can expect to recover after three to five days. They should refrain from strenuous physical activity during this period and may need to change dressings and take pain medication. Balloon sinuplasty involves no cutting of tissue or bone, and patients generally recover more quickly.