Current Nasal Endoscopic Treatment for Sinus Problems:
The symptoms of allergy of the ears, nose, throat, and sinuses are caused by swelling of the membranes which line these cavities. Allergy can be seasonal (for example, only occurring in the spring or fall) or perennial (symptoms occur year round).
- Balloon Sinuplasty
- Allergy Desensitization
- Sinus infections that last 3 or more months and recur after multiple antibiotic therapy.
Symptoms of headaches, facial pain, loss of smell, post nasal drip, nasal congestion and inability to breath through the nose are the most common symptoms that many sinus sufferers describe.
The mechanism of these symptoms are simple. The sinuses are located in the face and are air containing chambers under, between and above the eyes (see figure). These chambers are lined with a mucous membrane which produces one to two pints per day of mucous. Each sinus has it’s own opening into the nose. There are four pairs of sinuses, starting from above the eyes proceeding downward:
- Frontal Sinuses
- Ethmoid Sinuses
- Maxillary Sinuses
- Sphenoid Sinuses
The mucous is swept forward toward the opening (ostium) entering the nose and evacuated down the throat. Air contaminants, whether they be allergens, viruses or bacteria, cause inflammation in the lining of the sinuses, followed by swelling. The swelling then blocks the opening of the sinuses. The mucous cannot be evacuated and therefore becomes thick and infected. The infection causes more inflammation and therefore more obstruction. When these openings are obstructed, individuals experience difficulty breathing, facial pain around the sinuses behind and below the eyes, and chronic sinus infections. Allergies, colds, and septal deviations are potential causes of sinus obstruction, but the result is the same, retained secretions become infected with bacteria and sinusitis develops.
Successful treatment requires both elimination of infection with appropriate antibiotics and removal of the source of obstruction.
In many cases this can be accomplished with medication alone. Expectorants, decongestants, antihistamines, cortisone and antibiotics, and sinus irigation, can often completely clear a sinus infection. However, persistent or recurrent sinusitis (blockage of the sinuses) can require surgical treatment.
Recent developments, fiberoptics, rigid telescope technology, video, hard drive digital memory storage, and developments of the KTP and Contact YAG Lasers have led to advances in nasal endoscopic sinus surgery. With specially designed sinus telescopes, ear, nose and throat surgeons can diagnose and surgically treat sinus problems that, in the past, were not easily identified by conventional examination techniques.
Before considering sinus surgery, a nasal endoscopic evaluation should be performed. This evaluation may also include a CT scan (computerized tomography) because it can reveal significant disease processes that standard x-rays often miss. A CT scan is a three dimensional road map for the surgeon’s telescope so that the surgeon will know the exact location of the obstruction. Once the doctor has evaluated test results and has determined that surgery would be the best medical procedure for the patient, a detailed description of the surgical procedure with a review of the CT scan results should be provided to educate the patient.
Today, sinus and nasal diseases are eing treated more effectively than ever before. New state of the art techniques have greatly improved the safety and reliability of the procedure, reduced the cost, and shortened the recovery time of endoscopic sinus surgery. The procedure is often performed as an out-patient with general anesthetic or local anesthetic with twilight sleep depending on the individual patient. After surgery, patients experience only a minimal discomfort, stuffy nose, and slight bleeding which does not require nasal packing.
Because of advancements in the ability to test allergies by means of a blood test, endoscopic sinus surgery, and the development of HEPA air filtration, control of the recurrence of sinus symptoms has markedly been improved.
It has been found that patients with severe surgical Allergic Rhinosinusitis who require HEPA air filtration (high efficiency particulate air filtration which filters particles down to a minimum of 0.3 microns) and who receive appropriate allergy desensitization have an 87% chance to remain relatively symptom free and not require future surgical intervention.
Air quality is more important than investigators ever believed. Air quality is the key in maintaining control of allergic sinus disease. Your local news provides information when the air quality is at dangerously high level.
Good medical therapy, both pre and post operatively, are key factors in maintaining sinus health in both children and adults.