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Health care information for sinusitis sufferers |
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Health care information for sinusitis sufferers |
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Medical
Treatment
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Treatment OptionsSurgical Treatment OptionsAdenoidectomy | Endoscopic Sinus Surgery | Ethmoidectomy |Extended Endscopic Frontal Sinus Surgery | Frontal Sinusotomy | FESS (Functional Endoscopic Sinus Surgery) | Maxillary Sinusotomy | Open Frontal Sinus Surgery | Polypectomy | Reduction Removal of Inferior Turbinate | Reduction Removal of Middle Turbinate | Septoplasty | Sphenoidotomy | Tumor Removal In the vast majority of cases, acute sinusitis improves with medical therapy. But if acute sinusitis is persistent over several months, surgery to unblock the sinuses may be the best medical strategy. The exact procedure varies with the sinus (or sinuses) involved, but in general, the object is to flush out infectious material if it is present and ensure that passages are unblocked and draining freely. Most (but not all) of the time, this kind of sinus surgery is a minor procedure and requires only local anesthesia. Two more serious forms of acute sinus infection can occur in the frontal sinuses of the forehead or the sphenoid sinuses behind the eyes. Infection in these sinuses should be closely monitored, ideally by an otolaryngologist (ENT specialist), because the risk for spread of infection is higher. If antibiotics are not effective, more extensive surgery may be required, including surgical drainage of the sinus and removal of diseased tissue. Depending on the type of infection and the patient's individual sinus anatomy, the surgeon may use an endoscope inserted through the nose, operate through a small external incision, or combine techniques. Surgery is usually necessary if the infection has already spread outside the sinus to the eye socket area (orbit) or around the brain (intracranial). Although a more invasive surgery is sometimes required, the majority of these operations can be performed endoscopically under general anesthesia as an outpatient procedure – as long as there is no evidence that infection has spread outside the sinus. With endoscopic surgery, mild painkillers are usually enough to make the patient comfortable afterwards. Surgery for chronic, recurring sinusitis is much more common than surgery to relieve acute sinusitis that has not responded to medical treatment. Before considering surgery, your otolaryngologist probably will prescribe a number of medications over a period of several weeks or months. These medications typically include topical nasal steroid sprays and antibiotics, and may also include antihistamines, oral steroids, and possibly decongestants and nasal irrigations. After you have used your prescribed medicines for a period, your doctor may order a CT scan and an office diagnostic nasal examination (endoscopy) to evaluate the extent and severity of any disease that remains. In most cases, surgery is only considered when problems persist or recur repeatedly despite appropriate medical treatment. It is important to note that certain lifestyle risks – especially continued smoking and ongoing allergy exposure – increase the risk of persistent sinusitis, as well as the failure rate if surgery is performed. Effective, long-term results following your surgery are largely dependent upon making lifestyle changes that will help your condition. Antibiotics are typically most effective for acute sinusitis or when a person with chronic symptoms becomes worse and develops an infection. When symptoms worsen but there is no bacterial infection, a short course of oral steroids can help reduce inflammation and ease discomfort. Not everyone, however, is a candidate for steroid therapy. Your physician is the best judge of your tolerance level. Be sure to give your doctor a complete medical history, including any medications you are taking currently, and whether you have problems like glaucoma, high blood pressure, gastritis, osteoporosis, or a previous history of tuberculosis. In summary, sinus surgery is usually reserved for chronic sinus conditions. Nowadays, surgical procedures are likely to be less invasive than in the past. The most widely used method is endoscopic surgery. A list of surgical procedures is shown below.
Adenoidectomy
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