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.
