What is sinusitis?
A sinus infection is an inflammation of the delicate membranes that line the sinuses. The sinuses are air-filled cavities within the bones around your nose and behind your cheeks that connect and drain through small channels into your nose. Sinusitis most commonly develops when inflammation from infections or allergies causes the sinus lining to swell and blocking the small channels that naturally drain the sinuses. This blockage causes the mucous and infectious secretions to become trapped in the nose and sinuses.
Sinusitis can cause a variety of uncomfortable symptoms that range in severity, including:
- Nasal congestion
- Discolored Nasal discharge - often green, yellow or thick
- Pain in the upper teeth
- Facial pain or pressure
- Reduced sense of smell (anosmia)
- Cough
- Headache
- Postnasal drip
Sinusitis is classified as either acute or chronic. Acute sinusitis lasts for up to four weeks, while chronic sinusitis can last for 12 weeks or longer.
What causes sinusitis?
Acute sinusitis is frequently caused by a recent viral or bacterial infection or swelling and inflammation related to nasal allergies. Chronic sinusitis is usually caused by a more prolonged inflammation of the sinus membranes and blockage of sinus drainage. Chronic sinus infections can often last more than 3 months. Chronic infection of the sinuses is often related to several factors which can include: prolonged infection, nasal allergies, fungal infections, a weakened immune system, anatomic narrowing or blockage of the nose and sinuses from a deviated septum, nasal polyps or swollen turbinates.
How is sinusitis treated?
If you have chronic or frequent sinus pain or pressure you’re definitely not alone. It is estimated that approximately one out of eight Americans suffer from sinusitis. Sinusitis can be treated in a variety of ways based on the severity and cause of the symptoms. Many cases of acute sinusitis are caused by a virus, like the common cold, and often resolve with conservative management within a week or two. Nasal saline sprays, acetaminophen or ibuprofen and over the counter decongestants and allergy medications are helpful for relief of symptoms including pain and pressure.
Acute sinusitis may also be caused by a bacterial infection. Treatment with a 7-10 day course of antibiotics is often helpful in making patients feel better faster. Chronic sinusitis is frequently related to underlying chronic inflammation and obstruction of sinus drainage. This blockage can be related to chronic infections, allergic swelling and anatomic obstruction from a deviated septum, nasal polyps, or natural congenital variations in sinus anatomy. Antibiotics can sometimes be helpful but successful treatment of chronic sinusitis usually requires proper identification and management of the underlying inflammation and blockage. CT scans of the sinuses, while unnecessary in most uncomplicated acute sinusitis are frequently helpful to diagnose the severity and cause of chronic sinus symptoms. Salt water nasal irrigations, steroid nasal sprays, and topical and systemic decongestants are helpful to reduce inflammation and promote drainage. Sometimes, short courses of oral decongestants and steroids are also used. Long term allergy management and environmental modifications can help to address underlying allergic problems.
Surgery can be a very effective therapy for chronic sinus problems that have not resolved with more conservative medical management. The most common type of surgery for the sinuses is functional endoscopic sinus surgery. This modern, minimally invasive technique uses a thin fiberoptic endoscope attached to a high definition video monitor to navigate safely and clearly inside the nose and sinuses to pinpoint regions of blockage and infection. Specialized small surgical instruments are used to widen the natural drainage pathways between the nose and sinuses improving the ability of the sinuses to drain.
Balloon sinuplasty is the newest available treatment option. During this procedure, a small, flexible balloon catheter is gently inserted into narrow sinus passageways under endoscopic camera guidance. The balloon is then inflated to gently open and widen the natural sinus pathways and restore normal sinus drainage. This procedure can be performed in the office under local anesthesia or in the operating room in conjunction with endoscopic sinus surgery.
Dr. Lloyd Loft offers a comprehensive range of minimally invasive office and hospital-based surgical treatments for sinusitis including:
- Endoscopic sinus surgery
- Computer-assisted image-guided sinus surgery
- Septoplasty (deviated septum repair)
- Turbinate reduction surgery
- Balloon sinuplasty
- PROPEL@ sinus stent — for nasal polyps or chronic sinusitis
Dr. Loft performs these minimally invasive procedures in his office or the operating rooms of Lenox Hill Hospital, and the Manhattan Eye, Ear, and Throat Hospital, where he is an attending surgeon.
Call Lloyd Loft, MD, FACS, or make an appointment online today for expert diagnosis and treatment for sinusitis and the many conditions that can cause sinus inflammation.
