WHAT IS SINUSITIS?
Sinusitis is an inflammation of one or more of the nasal sinuses. The nasal sinuses are hollow cavities within the cheek bones found around the eyes and behind the nose. The primary functions of these sinuses are to warm, moisten and filter the air in the nasal cavity. They also play a role in our ability to vocalize certain sounds. Sinusitis can affect the nose, eyes, or middle ear, and may be indicated by plentiful, thick, colored nasal drainage, bad-tasting post-nasal drip, cough, head congestion and an accompanying headache. Symptoms may also include a plugged-up nose, a feeling of facial swelling, toothache and constant tiredness.
TYPES AND CAUSES OF SINUSITIS
Sinusitis can be divided into: acute, which is often caused by a bacterial infection. It usually develops as a complication of a viral respiratory infection, common cold, and symptoms last less than four weeks; subacute, with symptoms lasting from 4 to 8 weeks; chronic, which is symptoms last eight weeks or longer of varying severity and is often a chronic inflammatory disorder similar to bronchial asthma; and recurrent sinusitis, which is three or more episodes of acute sinusitis per year. Although colds are the most common cause of acute sinusitis, it is more likely that people with allergies will develop sinusitis. Allergies can trigger inflammation of the sinuses and nasal mucous linings. This inflammation prevents the sinus cavities from clearing out bacteria, and increases your chances of developing secondary bacterial sinusitis. Structural problems in the nasal cavity may also be a factor. Many patients with chronic persistent sinusitis have more than one factor involved, and each need to be addressed.
DIAGNOSIS OF SINUSITIS
Even if symptoms seem to be localized to the sinuses, the sinuses are not always infected. To make correct diagnosis, we will take a detailed history and perform a physical examination. Tests may be ordered. These tests can include allergy testing, immune studies and CT scans.
TREATMENT OF SINUSITIS
Sinus infections generally require a combination of therapies. In addition to an appropriate antibiotic, when the sinusitis can be shown to be caused by a bacterial infection, other medicines may be prescribed to keep the sinus drainage passages open by reducing obstruction and controlling allergies. For people with allergies, long-term treatment to control and reduce allergic symptoms can also be effective in preventing the development of sinusitis. This treatment may include immunotherapy (also called "allergy shots"). In some cases, a referral to an otorhinolaryngologist (ENT) may be suggested.
This information is provided with permission from the American Academy of Allergy, Asthma and Immunology (AAAAI).
Balloon sinuplasty is a less invasive alternative to traditional endoscopic sinus surgery for patients with mild to moderate symptoms. In the right patient, it is effective and safe and can treat a variety of sinus conditions by widening the sinuses and allowing drainage and aeration. It can be done in the office as it does not require anesthesia or the removal of bone or tissue from the nose. Patients generally experience minimal discomfort and require very little recovery time.
In refractory or advanced cases endoscopic sinus surgery with general anesthesia remains a great option.