What is sinusitis, and how does it develop? Sinuses are air-filled cavities located within the facial bones surrounding the nose, which are connected to the nasal passages. Sinusitis, the most common disease affecting the sinuses, is an inflammatory condition of these cavities. It often occurs when the openings of the sinuses become blocked following an upper respiratory tract infection. In the early (acute) stages, symptoms may include nasal congestion, facial and head pain, and nasal discharge without a high fever. Diagnosis can typically be made through physical examination with cameras, and computerized sinus tomography is not always necessary during this early stage. Acute sinusitis is treated with antibiotics and nasal sprays.
What is chronic sinusitis, and what can cause it? In some cases, sinusitis may persist (chronic) despite medication treatment. Conditions such as deviated septum (cartilage-bone curvature within the nose), hypertrophic nasal conchae, and the presence of polyps (abnormal tissues that should not be there) can make individuals more susceptible to chronic sinusitis. Additionally, respiratory allergies can contribute to the development of this condition. In some cases, infections or dental treatments involving upper teeth can also lead to sinusitis.
What are the symptoms of chronic sinusitis? In cases of chronic sinusitis, patients often complain of persistent symptoms such as unrelenting facial pain, headache, thick nasal discharge, nasal congestion, and postnasal drip. Other symptoms may include bad breath and coughing.
How is sinusitis diagnosed? The diagnosis of sinusitis is made through a detailed examination of the nose and sinuses using cameras. During this examination, conditions like deviated septum, hypertrophic nasal conchae, and polyps are evaluated. To support the diagnosis, especially in cases where the disease is thought to have become chronic, and to plan for surgery if needed, a computerized tomography (CT) scan of the sinuses is often requested. In specific cases where sinusitis has spread beyond the sinuses, magnetic resonance imaging (MRI) may be necessary.
How is chronic sinusitis treated with surgery? For patients who do not respond to medication and have received a diagnosis of chronic sinusitis through a sinus CT scan, “endoscopic sinus surgery” is typically recommended. These surgeries are performed under general anesthesia, and they are conducted through the nose without any external incisions, using cameras. The primary goal of the surgery is to remove the inflammation filling the sinuses, if present, as well as any polyps, open the sinus openings, and improve the sinus ventilation. During the same procedure, if necessary, correction of deviated septum, reduction of nasal conchae, and even aesthetic nose surgery can be performed.
How are sinuses opened with balloon sinuplasty? In endoscopic sinus surgery, balloon devices, known as “balloon sinuplasty,” are often used to more easily open the sinus openings. It’s essential to note that balloon sinuplasty is not an alternative to endoscopic sinus surgery; instead, balloons are auxiliary tools used during sinus surgery to facilitate the opening of sinus openings.
Why are navigation systems used during surgery? During endoscopic sinus surgery, navigation technology can be used to prevent damage to neighboring organs such as the eyes and brain. This technology is particularly helpful in cases where patients have previously undergone surgery that altered their anatomy and for patients with polyps.
What should be considered after sinus surgery? There is typically no pain after sinus surgery. Dissolvable packing material is sometimes placed inside the nose postoperatively, so there is no need for removal. Nasal irrigation with saline and the use of nasal sprays are employed to maintain nasal hygiene. Moisturizing drops may also be used to reduce the formation of crusts within the nose and sinuses. Patients are usually seen for nasal cleaning appointments once a week for 3-4 weeks after sinus surgery.