What is Sinusitis?
Acute bacterial sinusitis is an infection of the sinus cavities caused by bacteria. It usually is preceded by a cold, allergy attack, or irritation by environmental pollutants. Unlike a cold, or allergy, bacterial sinusitis requires a physician’s diagnosis and treatment with an antibiotic to cure the infection and prevent future complications.
Normally, mucus collecting in the sinuses drains into the nasal passages. When you have a cold or allergy attack, your sinuses become inflamed and are unable to drain. This can lead to congestion and infection. Your doctor will diagnose acute sinusitis if you have up to 4 weeks of purulent nasal drainage accompanied by nasal obstruction, facial pain-pressure-fullness, or both. The sinus infection is likely bacterial if it persists for 10 days or longer, or if the symptoms worsen after an initial improvement.
What are the common symptoms of sinusitis?
Common symptoms include:
- Facial pain, pressure, congestion or fullness
- Difficulty breathing through the nose
- Discharge of yellow or green mucus from the nose
- Teeth pain
- Loss of the sense of smell or taste
- Sore throat
- Bad breath
When does acute sinusitis become chronic?
When you have frequent sinusitis, or the infection lasts three months or more, it could be chronic sinusitis. Symptoms of chronic sinusitis may be less severe than those of acute; however, untreated chronic sinusitis can cause damage to the sinuses that sometimes requires surgery to repair.
What treatments are available?
An oral or nasal spray or drop decongestant may be recommended to relieve congestion, although you should avoid prolonged use of non-prescriptive nasal sprays or drops. Inhaling steam or using saline nasal sprays or drops can help relieve sinus discomfort.
Antibiotic therapy- Therapy for bacterial sinusitis should include an appropriate antibiotic. If you have three or more symptoms of sinusitis, be sure to see your doctor for diagnosis.
Intensive antibiotic therapy- If your doctor thinks you have chronic sinusitis, intensive antibiotic therapy may be prescribed. Surgery is sometimes necessary to remove physical obstructions that may contribute to sinusitis.
Balloon Sinuplasty: This in-office minimally invasive procedure utilizes a small, flexible, sinus balloon catheter that is placed into the nose to reach the sinuses. The sinus balloon catheter is gradually inflated to gently restructure the previously blocked nasal passage, maintaining the integrity of the sinus lining and restoring normal sinus drainage and function. There is minimal bleeding, and many patients have been able to return to normal activities within 24 hours. Clinical research has indicated that the Balloon Sinuplasty™ system is a safe and effective tool in dilating blocked sinuses. Depending on your sinus disease, you may or may not be a candidate for balloon sinuplasty.
Sinus surgery- Surgery should be considered only if medical treatment fails or if there is a nasal obstruction that cannot be corrected with medications. The type of surgery is chosen to best suit the patient and the disease:
- Functional endoscopic sinus surgery (FESS) is recommended for certain types of sinus disease. With the endoscope, the surgeon can look directly into the nose, while at the same time, removing diseased tissue and polyps and clearing the narrow channels between the sinuses. All endoscopes and instruments are passed through the nostrils without the need for external incisions.
- Image guided surgery: The sinuses are physically close to the brain, the eye, and major arteries. The growing use of a new technology, image guided endoscopic surgery, is alleviating that concern. This type of surgery may be recommended for severe forms of chronic sinusitis, in cases when previous sinus surgery has altered anatomical landmarks, or where a patient’s sinus anatomy is very unusual, making typical surgery difficult. Image guidance is a near-three-dimensional mapping system that combines computed tomography (CT) scans and real-time information about the exact position of surgical instruments using infrared signals. In this way, surgeons can navigate their surgical instruments through complex sinus passages and provide surgical relief more precisely.
Risks of surgery
The risks of surgery include the risk of anesthesia, bleeding, infection, injury to the eye, and leakage of fluid from around the brain.