What is Sinusitis?
Affecting more than 40 million people a year, sinusitis is one of the most common medical conditions in the U.S. In terms of days missed at work and the cost of treatment, sinusitis is a significant public health issue.
But what exactly is sinusitis? Sinusitis is an inflammation of the tissue lining the paranasal sinuses. Paranasal sinuses are air-containing spaces in the facial skull that are located alongside of and drain into the nose. Because the tissue lining is responsible for clearing the healthy mucus they produce, when this lining becomes inflamed, the sinus mucus becomes thick, infected and difficult to clear. If the small openings from draining the sinuses into the nose are blocked (from a virus, allergy or nasal anatomy), further inflammation of the sinus tissue lining will occur from retained, infected sinus secretions.
The most common causes of sinusitis are viral upper respiratory infections (URI) and allergies, both of which cause tissue inflammation of the sinus lining and the sinus outflow tracts into the nose. Sinus and nasal anatomy may also predispose to the development of sinusitis. Enlarged turbinates, septal deviations, narrow sinus outflow tracts and polyps are physical barriers to normal sinus drainage.
Cold, Allergy, or Sinusitus?
Symptoms of sinusitis may include thick yellow-green discharge, facial pressure, low grade fever (99-100 degrees), and headache. “Cold” (viral URI) symptoms can be confused with the initial symptoms of sinusitis during the first week. Because the majority of acute sinusitis and viral URI episodes resolve on their own, over-the-counter medications, not antibiotics, are recommended for the first week of symptoms.
Effective over-the-counter medications include decongestants like Pseudoephedrine (Sudafed®), mucus-thinners like Guifenasin (Mucinex®), and saline sinus rinses. If symptoms last for more than 7-10 days despite the use of over-the-counter remedies, bacterial sinusitis is likely and antibiotic treatment may be needed.
Functional Endoscopic Sinus Surgery (FESS)
In the 1980’s a technique for performing sinus surgery was introduced in Europe. In contrast to the traditional methods for performing sinus surgery which sometimes required external incisions and painful sinus packing, the newer technique was completely intranasal and targeted only the areas of the sinus that were “functional” in its drainage.
Functional Endoscopic Sinus Surgery (FESS) is performed through the nose by using small telescopes called endoscopes to visualize critical sinus drainage areas and specialized instruments to enlarge them. During the mid-1990s, the use of “powered” instruments (microdebriders) replaced the small cutting instruments used to enlarge sinus openings in the early days of FESS.
The microdebrider has a small blade that rotates back and forth, similar to those used by orthopaedic surgeons to perform arthroscopic joint surgery. The oscillating blade of the microdebrider “shaves” off obstructive tissue and bone, with minimal effect to the surrounding tissue. The use of the microdebrider reduces operative time, reducing patient pain and recovery time after. Because blood loss is minimal with the microdebrider technique, sinus packing is almost never necessary. Our doctors have performed FESS since it’s introduction to the US in the early 1990s and have helped hundreds of patients suffering from sinusitis with this advanced technique.
To learn more about FESS visit: The Sinus Info Center
Balloon Sinuplasty™ / The FinESS™ Procedure
The newest development in the treatment of sinusitis is Balloon Dilation of the Sinuses. In this novel, minimally invasive technique, a balloon-tipped catheter is placed into the sinuses under endoscopic guidance. The balloon is then inflated in the region of the narrowed sinus drainage passages, enlarging them in the same way an angioplasty balloon opens up the arteries in the heart. The procedure takes just twenty minutes and because there is no tissue removal, post-operative pain and bleeding are uncommon, with most patients returning to normal activities within twenty-four hours.
Balloon Dilation of the Sinuses
Balloon Dilation of the Sinuses is ideal for those patients who have frequent sinus infections requiring antibiotics or those suffering from ongoing sinus pressure despite the use of medications. Our doctors are of the few physicians in Southern California performing this breakthrough procedure in sinus surgery.
For more information on balloon dilation of the sinuses, visit: Entellus Medical