What is Sinusitis?

12-02-2020 | ENT & DENTAL CENTRE

Sinusitis is an inflammation of the lining of one or more of your sinuses usually caused by a bacterial infection.  The nasal membranes become swollen and can cause a blockage of the openings between the sinuses and the nose.  This blockage usually causes a build up of mucus or muco-pus in the sinuses.  This gives a feeling of pressure or congestion or even pain.

What factors contribute to the development of sinusitis?
Many factors contribute to the development of sinusitis.  They include colds, allergies, nasal polyps, a deviated septum, bronchial asthma, smoking, air pollution, and low humidity.  Any of these may irritate the sinuses, causing blockage that results in poor mucus drainage.  In children, other factors like adenoids, tonsillitis may also play an important role.

Infections can be bacterial, viral, or fungal.  Because the mucus membranes of the nose extend into and line the sinuses, a bacterial infection in the nose can easily spread to the sinuses.  In some cases, dental disease can also spread to the sinuses, causing sinusitis.

What are the symptoms of sinusitis?
Headaches and pressure around your eyes and nose are usually the first and most severe symptoms of sinusitis. Also, you will probably have a runny nose with yellow-green discharge, congestion, and postnasal drip.  You may even have a fever as a result of an infection.  In children, the typical symptoms may not be present and nasal obstruction, chronic cough, foul smelling breath and behavioral changes are additional symptoms that may indicate the presence of sinusitis.

What is the treatment of sinusitis?
The treatment of sinusitis may involve several approaches:

Antibiotic therapy to cure the infection responsible for the fever, pain, and blockage
Topical nasal sprays and/or oral decongestants to reduce the swelling and promote drainage of the sinuses
Pain medication as needed
Surgical treatment may be necessary in those cases of recurrent sinusitis and chronic sinusitis not responding to medical treatment.

What is the modern surgical treatment for sinusitis and is it safe?
FESS has been the gold standard of treatment for sinusitis that does not respond to medication. It is a safe and effective procedure. However, in the last 7 years, a novel and minimally invasive procedure called Balloon Sinuplasty has shown excellent results in the treatment of chronic sinusitis. In this procedure, a thin balloon catheter is introduced into the sinus opening and the balloon is inflated. Then the catheter and balloon are withdrawn. The success rate is over 95%. And so far in the world over 2,00,000 sinuplasties have been done with no serious complications. This is because there is no cutting of bone or tissue in this procedure. It can also be done under local anaesthesia.

How is the operation done?
The aim of the operation is to open or enlarge all the sinus openings which are blocked.  This lets air into the sinuses and allows the secretions from the sinuses to come out into the nose. Once this is done, the infected sinuses usually come back to normal within a few weeks.

The operation is done using special endoscopes and there are no cuts on the face.

Can sinusitis develop again after the surgery?
After the surgery, the patient will still catch the common cold just as any normal person, and the cold will last for the usual 5-7 days.  However, the patient will not suffer from the symptoms like headaches etc. and will improve quickly with medication.

In a few cases of polyps, the polyps may grow again after the surgery but can usually be controlled by medication and regular visits to the surgeon for endoscopic cleaning.