Sinusitis is an uncomfortable medical condition in which the sinuses become inflamed or infected due to interference in the natural drainage of mucus. Your sinuses are located behind your nose, around your eyes, and in your cheekbones. When you develop sinusitis, you may experience pain, nasal discharge, ear fullness, and a cough.
Sinusitis can come on suddenly and subside quickly, or it can develop more gradually and linger for many weeks. No matter what type of sinusitis you might have, a visit to an ENT for a proper diagnosis and treatment is the first step to finding relief from this often-painful condition.
Causes of Blocked Sinuses
There are a variety of reasons why the sinuses might become blocked:
Colds & Other Infections – A cold may cause your sinus and nasal lining to swell, causing sinus openings to become blocked so that mucus backs up. This becomes the perfect environment for bacteria to grow, leading to an infection.
Allergic Reactions – Sensitivity to some substances can lead to the release of histamine, which makes your sinus and nasal linings swell and in turn clogs your sinuses and prevents cilia from sweeping away mucus.
Polyps – These growths inside the sinuses consist of a sac of swollen tissue. A polyp may block the middle meatus, where most of your sinuses drain. The blockage can lead to pain, inflammation, and infection.
Deviated Septum – This occurs when the central partition inside your nose, known as the septum, isn’t centered. The deviation may block the middle meatus, affecting the ability of the sinuses to drain properly and can be caused by genetic factors or external trauma.
By diagnosing the cause of the blocked sinuses, we can treat sinusitis at the source. This approach offers the greatest odds of full symptom relief and lowers the risk of a recurrence of the condition.
Are You at Risk for Sinusitis?
Some people are at higher risk for sinusitis than others. Risk factors for the condition include:
- A chronic condition like asthma, which may impact the ability of the sinuses to drain properly
- An allergic condition that leads to inflammation of the sinuses
- Deformities or abnormalities of the nasal cavities, such as polyps or a deviated septum
- Persistent exposure to pollutants, including cigarette smoke, some perfumes, and chemicals
- Disorders affecting the immune system, such as cystic fibrosis or HIV
If you know you have an increased risk of sinusitis, you can seek treatment at the first sign of the condition for fast relief from painful symptoms.
Types of Sinusitis
Sinusitis can be either acute, meaning it is short-lived, or chronic, which refers to sinus pain and pressure that lasts for weeks or tends to recur frequently. There are basic differences between the two:
Acute Sinusitis – This condition is often associated with a viral or bacterial upper respiratory infection that spreads to the sinuses. Acute sinusitis is usually treated with antihistamines and decongestants to reduce inflammation and decrease fluid production. The bacterial infection can be treated with antibiotic medication.
Chronic Sinusitis – This condition is characterized by a sinus problem that keeps coming back or won’t go away. This is often caused by long-standing allergies, obstructions, or irritants. Chronic sinusitis can be treated with medications to relieve congestion and reduce fluid secretion, irrigation to clean out old mucus, and antibiotics to treat any bacterial infections.
Chronic sinusitis might be characterized by the following symptoms:
- Facial pain & pressure
- Headache & sinus pain
- Nasal congestion
- Postnasal drip
- Reduced smell & taste
- Persistent cough
- Sore throat
- Ear fullness
- Green, yellow or bloody drainage from the nose
- Frequent headaches in the forehead, between the eyes, cheeks, or upper teeth
If you experience any of symptoms of sinusitis, an appointment with our office will ensure your condition is accurately diagnosed and the best treatment is recommended. There are different ways to address sinusitis, depending on its severity, longevity, and specific symptoms the patient is currently experiencing.
The Diagnostic Process
Different methods can be used to diagnose sinusitis:
This is a standard way to determine whether there is a problem with the sinuses. During this test, a flexible tube with a light at the end known as an endoscope, provides the physician with a view inside the nasal cavity. The procedure is not painful and can be performed in our office.
In some instances, your doctor may want to see sinuses that cannot be examined through a nasal endoscopy. In this case, a CT scan performed in our office may be ordered to collect images of those areas. These tests may reveal inflammation deep inside the sinuses, or a physical obstruction like a polyp that may not be detected through other means.
People with chronic sinusitis may be advised to undergo allergy testing if an allergic reaction is suspected as a culprit in the inflammation. A blood or skin test can be performed, which takes a couple of hours to complete. You will be tested for a broad range of indoor and outdoor substances, which may provide insight into how to manage or treat your allergies to reduce your symptoms of chronic sinusitis.
Sinus tissue cultures are not frequently used as a way of diagnosing sinusitis, but they can be helpful if you are not responding well to treatment. This type of test can help to pinpoint the bacteria or fungi in the tissue that may be contributing to the symptoms.
There are a variety of ways that sinusitis can be treated, but the primary goal of any treatment is to encourage healthy drainage, reduce inflammation, and eliminate the underlying cause of the condition when possible.
Some of the treatments for sinusitis include:
- Nasal irrigation using a saline rinse to clean out allergen and pollutants
- Topical or systemic corticosteroids that treat inflammation and prevent it from returning
- Aspirin desensitization, if aspirin sensitivity is contributing to your nasal congestion
- Antibiotics, if an infection is present
- Sinus surgery in cases where the condition is not relieved through irrigation and/or medication
For acute sinusitis some different treatment options include:
- Decongestant nasal spray use for a recommended time period
- Antibiotics for cases of sinusitis that are caused by viruses or intranasal corticosteroids.
For chronic or recurring sinusitis treatment options include nasal surgery:
- Endoscopic Sinus Surgery – During this surgery, blockages will be cleared allowing air to circulate and mucus to drain normally. Your surgeon may open up blockages by straightening the septum to allow for more breathing space, removing polyps, opening the ethmoid sinuses, and/or clearing nasal passages.
- Frontal Sinus Stenting – This is a new and highly successful procedure that has been proven very effective for recurrent or persistent sinus infections and complicated sinus illnesses. This treatment option uses a surgically implanted stent to hold the airway open and allow for more efficient breathing. Research shows that stents left in place for 6 months greatly improve the long-term outcome.
Frontal Sinus Stents
If you’ve been suffering with chronic sinus conditions and conventional treatment options aren’t effective, surgical intervention may be necessary to find relief. The physicians and staff at Acadian ENT & Facial Plastic Surgery Center have extensive experience in diagnosing and treating a wide range of conditions, including surgical intervention for sinusitis.
Sinus surgery is a delicate procedure that removes irregular tissue from the nasal cavity, helping to reduce swelling, congestion, headaches, and other symptoms related to their condition. We successfully utilize sinus stents to maintain surgical openings, reinforcing the walls of the nasal cavity to keep the airway open and free of obstruction while healing after surgery. This technique has helped patients find long-term relief from their chronic sinusitis symptoms.
What are Frontal Sinus Stents?
There are two types of frontal sinus stents currently available; medicated and non-medicated. In general, frontal sinus stents are used after endoscopic sinus surgery to avoid restenosis, or narrowing of blood vessels. Stents help maintain drainage of the frontal sinuses and provide ventilation.
Medicated sinus stents, such as PROPEL™ allow for anti-inflammatory medications to be delivered to the sinus tissue as well as provide drainage and ventilation. PROPEL™ has been clinically proven to prevent obstruction of the frontal and ethmoid sinuses following surgery, resulting in improved post-operative outcomes and reducing the need for additional surgical procedures.
When Is A Frontal Sinus Stent Necessary?
Sinus stents are necessary any time the frontal sinus outflow tract must be kept open or unobstructed following surgery, to promote drainage and allow for proper healing.
How Can Frontal Sinus Stents Help With Sinus Surgery?
Frontal sinus stents reduce the need for procedures such as frontal sinus obliteration, where the sinuses are completely removed to prevent chronic infection, making them non-functional, and frontal sinus drill out procedures which allows the sinuses to be flushed by drilling through bone and inserting a catheter into the sinuses. Long-term use of frontal sinus stents may also reduce the rate of recurrent sinusitis and reduce the need for antibiotic therapy, since the stents will help to maintain long-term patency of the frontal sinus outflow tract, which is usually challenged by scar formation and stenosis following surgery.
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