Sinus

According to the CDC, 11% of adults in the US suffer from chronic sinusitis each year.  That is 29 million people! The amount of money spent on treating sinus issues and the disruption caused to patients’ work, school and home life makes this a serious public health issue. At Prime ENT, our goal is to provide long-lasting, comprehensive sinus care. This allows our patients to overcome the burden of sinus disease to achieve a better quality of life.  

What are sinuses, and how do they function?

Sinuses are hollow, bone and mucus lined spaces in the skull and facial bones that extend up to the forehead and lie to the left and right side of the nose. There are several different sinuses: 

  • 2 large maxillary (sometimes referred to as cheek sinuses) 
  • 2 frontal and sphenoid sinuses  
  • 2 ethmoid sinus cavities made up of several smaller air cells 

 

Sinus cavities warm, filter and humidify inspired air. In addition, these structures lessen the weight of the skull, act as a shock absorber to protect the brain from trauma and play a role in creating certain resonances for human speech. The sinus lining has millions of tiny hairs called cilia that serve to push fluid and foreign material out of the sinus. The sinus lining can swell leading to a buildup of fluid and potential infection. 

What are the symptoms of sinusitis?

  • Facial pain or pressure 
  • Nasal obstruction 
  • Thick and/or discolored nasal discharge 
  • Alteration to taste and smell 
  • Headache 
  • Tooth pain 
  • Foul smelling breath 
  • Ear pressure 
  • Cough

What is chronic sinusitis?

Chronic sinusitis occurs when the sinuses are swollen or inflamed, and one experiences symptoms of sinusitis for 3 months or longer. Common causes of chronic sinusitis include upper respiratory tract infections, nasal polyps, septal deviation, allergies and auto-immune disorders. Medical treatment for chronic sinusitis is normally a long-term course of antibiotics combined with a nasal steroid spray and/or an oral steroid. Sometimes medicated sinus rinses are prescribed. If the symptoms of chronic sinusitis continue despite medical treatment, endoscopic sinus surgery may be indicated.  Evaluation of the sinuses with an endoscope and a CT scan helps the doctor determine if surgery is indicated. 

In addition to the symptoms of sinusitis, many patients also have a condition called nasal polyps.  Nasal polyps can develop when a patient has allergies that cause inflammation in the nose.  The polyps fill the nose and block the sinuses. The common medical treatment for polyps is oral steroids and nasal steroid sprays.  This can shrink or prevent the polyps from getting larger for a period of time, but it does not cure the problem.  Most patients with nasal polyps require endoscopic sinus surgery to remove the blockage.  Allergy immunotherapy such as sublingual drops can also be helpful in combating the development and enlargement of polyps. 

What is sinus surgery?

Endoscopic sinus surgery, referred to as functional endoscopic sinus surgery (FESS) is a minimally invasive approach to open the sinuses.  The surgeon inserts an endoscope, lighted tube with camera, into the nose along with various instruments to remove structural blockages.  This is done with the patient under anesthesia in a hospital or outpatient surgery center.  

Balloon sinus surgery uses a fine “balloon” that is fed through the nose into the sinus opening. The balloon is inflated, causing the bones of the sinus opening to fracture, physically enlarging the natural opening of the sinuses without requiring removal of tissue. This procedure is typically done in the office with the patient awake.  The surgeon uses numbing gels and injections, much like a dentist, to ensure the procedure is painless.  There is limited recovery time and patients can resume their normal work/school activities the next day. 

The surgeons at Prime ENT are experienced in all aspects of sinus surgery and will work with you to determine the best course of comprehensive treatment for your sinus issues.