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Chronic Sinusitis

If you suffer from sinusitis, you are not alone. Sinusitis is a common problem. A majority of people experience 1-2 episodes of sinusitis each year. Symptoms of sinusitis can vary. Common symptoms include pain or pressure in the facial area and upper teeth, nasal congestion, reduced sense of smell and taste, discolored nasal drainage, headache, cough and fever. People who have frequent episodes of sinusitis or persistent sinusitis may have underlying issues contributing to sinusitis.


Chronic sinusitis can be caused by allergic rhinitis, immune issues, or anatomical obstruction. In many instances, multiple factors play a role in chronic sinonasal issues. Medical therapy includes treatment with antihistamines, topical nasal steroids, topical nasal antihistamines, immunotherapy (allergy shots) and therapy to improve the immune system. Healthy sinuses require adequate ventilation. Narrow sinus openings, sinus lining swelling, and polyps can cause obstruction.


If you suffer from ongoing chronic sinus issues despite maximal medical therapy, you would from and evaluation by an otolaryngologist. The evaluation begins with a complete exam including sinonasal endoscopy. Sinonasal endoscopy is a well tolerated procedure which can be performed at time of initial evaluation. Nasal anatomy can be evaluated for septal deviation and enlargement of inferior turbinates which can cause nasal obstruction. The health of the nasal mucosa can also be determined. In addition, signs of chronic sinusitis including discolored mucus at sinus drainage sites can be identified. Polyps which can cause sinus obstruction can be visualized as well. After evaluation, if indicated, your otolaryngologist may recommend a CT scan of the sinuses to further evaluate sinus anatomy.


If the cause of your sinus problems is due to obstruction, your will benefit from endoscopic sinus surgery. Endoscopic sinus surgery is a procedure in which a surgeon addresses obstruction using rigid endoscopes to visualize the anatomy of the sinuses. Various instruments are used during the procedure including specially designed forceps, micro shaving devices, and balloon catheters similar to those used by cardiologists to relieve obstruction in blood vessels of the heart. Navigational systems that create a 3D mapping system can be utilized to allow surgeons to precisely address areas of obstruction found on CT imaging. In many cases, nasal obstruction is also corrected at the same time to improve nasal airflow.

Endoscopic sinus surgery is usually performed on an outpatient basis. After the surgical procedure, the patient performs saline nasal irrigations several times a day. The recovery period is typically one week.

Endoscopic sinus surgery is highly effective in relieving obstructive sinus disease. The results are long lasting. If you have other factors contributing to your chronic sinus issues including allergies or immune problems, you must continue to treat these conditions as well in order to achieve the maximum benefit from sinus surgery.