Chronic Sinusitis is a condition that persists or reoccurs, with failed treatment to antibiotic and decongestant therapy.  Chronic sinusitis is often caused by long-standing allergies, obstruction in sinus passages due to inflammation or polyps, or prolonged exposure to irritants such as smoke, chemicals and or fumes.

Signs and Symptoms of Chronic Sinusitis include: (Lasting 12 weeks or more)

  • Facial pain/pressure
  • Facial congestion/ fullness
  • Nasal obstruction/ blockage
  • Thick nasal discharge
  • Discolored post-nasal drainage
  • Pus in the nasal cavity
  • Headache, bad breath, fatigue, fever*
  • *May also have these symptoms

How Does an Ear Nose and Throat Physician Treat Chronic Sinusitis?

The treatment of chronic sinusitis will begin with a thorough and detailed history of the patient's signs and symptoms. The physician will also look at previous attempts at treating chronic sinusitis and adjusting therapy as needed.  Along with the detailed history, the physician will then perform a detailed physical examination.

What Does the Physical Examination for Sinusitis Include?

The patient will receive a thorough ear nose and throat examination. During that examination the physician will investigate the facial features where redness and swelling may exist. This usually occurs in the cheekbone area, the maxillary sinus is located under this area on the face. Facial swelling and redness are usually worse in the morning; as the patient remains in an upright position, symptoms gradually improve. The physician may press on the sinuses accessing for tenderness. Additionally, the physician may tap the teeth to help identify an inflamed paranasal sinus.

What Other Diagnostic tools Will the Physician Order?

The physician may also order other diagnostic tests to aide in treatment of sinusitis. These tests include a CT scans of the sinuses, X-rays, mucous culture, nasal endoscopy and allergy testing.  These tools aid in the choice of treatments the physician will order after a diagnosis has been made.
What is  Nasal Endoscopy?
Nasal endoscopy is a fiber optic instrument used for a thorough visual examination of the nasal cavity and sinus drainage areas.  This allows the physician a reliable view of all accessible areas of the pathways that drain out of the sinuses. This also allows the physician to look for obstruction or any nasal polyps hidden during a routine physical examination. The physician will also be paying attention to any pus as well as any structural abnormalities that may cause recurrent sinusitis.

What Treatments Will the Physician Consider?

To treat nasal congestion the physician may prescribe nasal sprays, nose drops, or oral decongestants. Antihistamines may be recommended for the treatment of allergies. Antihistamines/decongestants are targeted at reducing inflammation and decreasing mucous production.  Antibiotics may be prescribed if a bacterial infection is present. Antibiotics are usually prescribed for 10-14 days. With treatment from antibiotics, symptoms usually subside although it is important to take the prescribed course of antibiotic in its entirety.  After the prescribed antibiotics are finished, treatment will consist of oral and intranasal decongestants to assist in alleviating symptoms.

How Helpful are Nasal Sprays or Non-Prescription Nose Drops?

Prolonged use of nonprescription drops or spays may help control symptoms.  Although it is important to know that extended use of non-prescription decongestant nasal sprays can aggravate symptoms, therefore making them worse. These sprays should not be used beyond their labeled uses.

Is There Anything I Can Do at Home to Help Relieve Sinus Pain?

Yes! Warm moist air such as, vaporizers or steam from a pan of boiled water (removed from heat) may alleviate sinus congestion. Humidifiers should be used only when a clean filter is in place. This prevents any spraying bacterial or fungal spores into the air. Warm compress are useful in relieving pain in the nose and sinus region. Saline nasal sprays are helpful in adding moisture in nasal passages and providing daily cleansing rinses.

When is Surgery an Option?

Your physician may consider surgery as an option for you if more conservative therapy has failed or if your CT results show blockage in your sinus passages due to inflammation. These canals in your sinus passages allow for your normal mucous in your sinuses to drain out of them, when these become blocked normal mucous movement is stopped, which can lead to infection.

What Does Sinus Surgery Achieve?

The surgery should enlarge the natural opening to the sinuses. Ear Nose and Throat specialists have found endoscopic surgery to be highly effective in restoring the patient's normal function to their sinuses. The procedure removes areas of obstruction in the sinus passage, leading to the normal flow of mucous in the sinuses. 

What is Balloon Sinuplasty Surgery?

Balloon Sinuplasty is a less invasive option for patients suffering from chronic sinusitis.  This technology is an endoscopic, catheter-based approach in which a small flexible balloon catheter is used to open blocked sinus passageways, which will restore normal sinus drainage. When the balloon is inflated, it restructures and widens the walls of the sinus passageway while maintaining the integrity of the sinus lining.  This less invasive procedure allows the physician to avoid any removal of tissue or bone in the nasal passage.  Balloon Sinuplasty is a fast an effective way to relieve chronic nasal obstruction due to enlarged inferior turbinates without the inconvenience associated with traditional approaches.
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