Sinus & Allergy
The four sinus cavities, frontal, maxillary, ethmoid, and sphenoid are lined with soft tissue called mucous membrane and covered with cilia. The lining and cilia protect the body from dust, pollen, germs, and other foreign bodies in the air, and humidifies the air entering in through the nose. However, such high exposure to environmental irritants can overwhelm the body’s natural defenses and makes many people susceptible to sinus infection or bacteria-nearly 50 million Americans are affected by sinus disorders annually.
Symptoms of sinus disorders vary widely. Infection from colds or sinusitis can result in facial pain and pressure, discolored mucous discharge, or nasal obstruction. Most people can be treated with antibiotics, i.e. decongestants, antihistamines, and saline sprays, although surgery is an option if pharmaceuticals prove to be ineffective. Other factors such as a deviated septum may necessitate surgical treatment.
Sinusitis is a condition that refers to an inflammation of the lining within the paranasal sinuses. Sinusitis can be classified by location:
- maxillary, which causes pain or pressure in the cheek area;
- frontal, which causes pain or pressure above and behind the eyes;
- ethmoid, which causes pain or pressure between or behind the eyes; and
- sphenoid, which causes pain or pressure behind the eyes.
Sinusitis can also be classified by duration: acute lasts for four weeks or less, subacute lasts four to twelve weeks, chronic lasts more than twelve weeks, and recurrent, which consists of several acute attacks within a year.
Most acute cases of sinusitis are caused by an inflammation of the sinuses that eventually lead to a bacterial infection. With chronic sinusitis, the membranes of both the paranasal sinuses and the nose are thickened because they are constantly inflamed, possibly due to allergies, nasal polyps, or asthma.
Sinusitis can be treated through courses of antibiotics, decongestants, saline sprays, or in cases of severe chronic sinusitis, oral steroids. When pharmaceuticals fail, surgery may be an alternative. The goal of the surgery is to improve sinus drainage and reduce blockage. Thus, a surgeon will enlarge the opening of the sinuses, remove any polyps, and correct any defects that contribute to the nasal obstruction. While many people have fewer symptoms as a result of the surgery, many others experience a recurrence of their symptoms post-surgery.
Sinus and Nasal Surgery
Sinus and nasal surgery is performed to enlarge the openings that drain the sinuses, in order to effectively treat conditions such as nasal congestion, rhinitis, sinusitis, polyps and others. Patients may turn to surgery after other treatments such as medications, nasal sprays and humidifiers have been unsuccessful in relieving symptoms, or for chronic, recurring conditions.
The symptoms of sinus problems can vary widely depending on the type and severity of each patient’s condition, but often significantly affect a patient’s quality of life. Common symptoms include:
- Facial pain and pressure
- Mucous discharge
- Nasal obstruction
- Vision disturbances
There are several different types of sinus surgery, most of which can be performed through minimally invasive techniques that require no incisions and no hospital stay. Some of the most commonly performed procedures include functional endoscopic sinus surgery (FESS), image-guided surgery, the Caldwell Luc operation and Balloon Sinuplasty.
Most sinus and nasal surgeries are performed on an outpatient basis under general or local anesthesia. Patients may experience mild bruising, swelling and discomfort after surgery, but are usually able to recover quickly with no lasting side effects. Your doctor will decide which procedure is best for you after a thorough evaluation of your individual condition.
Balloon sinuplasty is an advanced surgical procedure used to treat sinusitis and other related problems through minimally invasive techniques. This involves inserting a thin endoscope into the nose without disrupting the surrounding bone and tissue. A small balloon is then gently inflated to widen blocked passageways and allow for proper drainage of sinus fluid. Patients can benefit from less bleeding and shorter recovery times with balloon sinuplasty.
Acclarent Balloon Sinuplasty
Endoscopic Sinus Surgery
Endoscopic sinus surgery involves inserting a thin, lighted tube with a camera on the end into the nose so that your doctor can visually examine the area. Tiny surgical instruments are then inserted to remove the obstructive tissues. Endoscopic sinus surgery does not require any incision, as the whole procedure is performed through the nostrils.
Functional endoscopic sinus surgery (FESS) is the most common type of surgery for chronic sinusitis performed today. FESS is performed using a small endoscope inserted through the nostril. This minimally invasive procedure has significantly improved the results of sinus surgery. Advantages of FESS include a shorter recovery time, reduced risk of infection, decreased postoperative pain, and less scarring.
Imaged-guided sinus and nasal surgery combines endoscopic techniques with a CT imaging scan for even more precise results. The CT scan is performed simultaneously during surgery to guide your surgeon to the targeted area within your sinuses where blockage or infection occurs. It can help create a computerized model of the skull.
During this procedure, blockages or obstructions within the sinuses are cleared using tiny surgical instruments. Patients can benefit from faster recovery times, less discomfort and more accurate correction of sinus problems with this advanced procedure.
The Caldwell-Luc procedure is ideal for clearing blockages within the maxillary sinus. It involves entering the sinuses through the mouth after an incision is made in the gums above the canine teeth. A small part of the maxillary bone is removed during this procedure in order to improve drainage within the sinuses.
Named after Dr. George Caldwell and Dr. Henry Luc, this procedure was more common before endoscopic techniques were developed. The Caldwell-Luc procedure is usually performed under general anesthesia and may cause swelling, bruising and numbness after surgery. There are no scars associated with this procedure, since incisions are made within the mouth.
Allergies are a common condition affecting more than one out of every 5 people. Allergies are an abnormal response of the immune system triggered by a typically harmless substance. This substance, such as pollen, mold or animal dander), is known as an allergen. When a person is exposed to an allergen, their bodies produce antibodies and release a variety of chemicals including histamine. Histamine is the main cause for most allergy symptoms. Most allergies are inherited. People with asthma are more likely to suffer from allergies. Since most allergens are found in the air, the reaction occurs in the eyes, nose and lungs. If the allergen is ingested, the reaction can occur in the mouth or stomach.
Most allergic reactions result in mild symptoms that include sneezing, runny nose, watery eyes, itching or rashes. Moderate or severe reactions, called anaphylaxis, are rare but can be life-threatening and cause abdominal pain, cramps, vomiting and dizziness. Bee stings, penicillin and peanuts can cause more serious reactions.
Allergies can be seasonal and only cause reactions during certain times of the year. This condition is known as allergic rhinitis or hay fever and is usually caused by pollen and other allergens that are in the air from March until November. These allergies can be affected by the weather.
Allergy treatments are usually prescribed in the form of over-the-counter or prescription medication. Antihistamines prevent the reaction caused by the release of histamine and reduce symptoms. Decongestants unblock nasal passages and improve breathing. Nasal sprays keep the nasal passages clean and moist and limit the reaction to allergens. But the most effective treatment in relieving allergy symptoms is simply to avoid the allergen. Wearing sunglasses while outside and washing your hands frequently can help to keep you free of contamination.
Your doctor can help you decide which form of treatment is best for you.