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.|
When Acute Becomes Chronic Sinusitis
Therapy for bacterial sinusitis should include an appropriate antibiotic. If you have three or more symptoms of sinusitis (see chart), be sure to see your doctor for diagnosis. In addition to an antibiotic, an oral or nasal spray or drop decongestant may be recommended to relieve congestion, although you should avoid prolonged use of nonprescription nasal sprays or drops. Inhaling steam or using saline nasal sprays or drops can help relieve sinus discomfort.
Antibiotic resistance means that some infection-causing bacteria are immune to the effects of certain antibiotics prescribed by your doctor. Antibiotic resistance is making even common infections, such as sinusitis, challenging to treat. You can help prevent antibiotic resistance. If the doctor prescribes an antibiotic, it is important that you take all of the medication just as your doctor instructs, even if your symptoms are gone before the medicine runs out.
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.
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. Surgery can be performed under the upper lip, behind the eyebrow, next to the nose or scalp, or inside the nose itself.
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. The decision whether to use local or general anesthesia will be made between you and your doctor, depending on your individual circumstances.
Endoscopic sinus surgery
Why It Is Done
Endoscopic surgery may be needed when medication treatment has failed to improve or cure chronic sinusitis. It is the preferred method of surgery for most cases of chronic sinusitis that require surgery.
Endoscopic surgery improves symptoms in about 85% of people.
However, surgery does not always completely eliminate sinusitis. Up to 20% may need a second operation.1
Surgery is most successful when used along with medication and home treatment to prevent future sinus infections. A second surgery and future sinus infections may be avoided if antibiotics are taken to prevent reinfection.
As with any surgery, there are always some risks involved. However, endoscopic sinus surgery is very safe when performed by an experienced surgeon who has special training with endoscopic surgical techniques.
Minor complications (such as scar tissue attaching to nearby tissue, or bruising and swelling around the eyes) occur in a small number of people who have the surgery. Major complications (such as heavy bleeding) occur in fewer than 1% of cases.2 Most complications of endoscopic sinus surgery can be managed or prevented.
Sinus surgery may involve the use of scalpels, lasers, or small rotating burrs that scrape away tissue. No one method is necessarily any better or safer than another; techniques vary depending on the surgeon’s experience and preferences. The rotating burr is becoming the preferred device for sinus surgery.
In endoscopic sinus surgery, an endoscope is inserted into the nose, providing the doctor with an inside view of the sinuses.
Recovery also may involve:
- > Packing the nose with gauze to absorb bloody drainage.
> Taking antibiotics.
> Using a nasal spray containing a steroid for 6 months or longer to reduce inflammation.
> Using saltwater washes (saline nasal lavage or irrigation) to keep the nasal passages moist.
> Avoiding activities such as blowing the nose, exercising strenuously, and bending forward for a few days.
> Using a humidifier to keep room air moist, especially in the bedroom.