Do I Need Sinus Surgery?

Sinuses are hollow, air-filled cavities found throughout our bodies. For the purposes of this blog, however, we’ll discuss only the cavities located within the skull, which are connected to the nasal passage through the ostium, a hole in the bone.

Humans have four pairs of sinuses usually viewed as a single unit called the "paranasal sinuses." They’re lined with mucus-secreting cells, epithelial cells, and cells that are part of the immune system. They’re also lined with cilia, hair-like appendages that help sweep mucus, trapped particles, and invading pathogens through the nasal passages and out into the nose.

The sinuses perform a number of functions. They decrease the weight of the skull, lightening the load on the spine. They also humidify and warm the air we breathe in, insulate the surrounding structures (eyes, nerves), increase the resonance of our voice, and act as buffers against facial trauma.

Sinuses that become blocked or otherwise obstructed produce a number of troublesome symptoms. At Oasis Ear, Nose, and Throat, Dr. James Osborne, Dr. Bryan Smedley, and their expert team specialize in the treatment of sinus problems. That includes both conservative measures as well as a variety of minimally invasive surgeries. Here’s what they want you to know about if and when you need sinus surgery.

Sinus conditions

One of the more common  or “routine” conditions ENT doctors see, with about 30 million adults affected, is sinusitis, an inflammation of the paranasal sinuses. The inflammation can be due to allergies from environmental pollen or toxins, chemical irritation, the growth of nasal polyps, or a viral or bacterial infection.

If the problem is short-lived, it’s considered to be acute. One of the most common causes for acute sinusitis is the common cold, which is a viral infection. The infection goes away on its own within about 7-10 days. If the tissues remain swollen and inflamed for at least three months, despite treatment, it’s considered to be chronic.

Chronic sinusitis comes with a number of symptoms, including:

• Difficulty breathing through your nose
• Inflamed nasal tissues
• Thick, colored discharge
• Post-nasal drip
• Pain, tenderness, and/or swelling around eyes, nose, cheeks, and/or forehead
• Decreased sense of smell and taste

You may also experience a sore throat, ear pain, an ache in the upper jaw and teeth, bad breath, and fatigue from fighting the infection.

The symptoms can be exacerbated by nasal polyps, which can grow in the nasal passages or sinuses, blocking breathing. They can also be affected by a deviated nasal septum, a bend in the cartilage that divides the two nostrils. If the inflammation prevents the cilia from clearing mucus, or if it blocks the ostium, it can progress into a bacterial infection.

Sinus treatments

At Oasis Ear, Nose, and Throat, we try to use conservative treatments before recommending a surgical solution, though we specialize in minimally invasive procedures. Medications we may recommend (OTC) or prescribe include:

• Antibiotics (only for bacterial infections)
• Decongestants and mucolytics such as guaifenesin that break down mucus (for viral infections)
• Nasal saline sprays or rinses
• Nasal decongestant sprays
• Nasal steroid sprays or oral steroids
• Antihistamines (for allergy-related inflammation)

If your infections are recurrent or persistent, though, we may opt  for sinus surgery. The goal of the different procedures is to enlarge the openings between the inside of your nose and the sinuses. That allows air to get in easily and drainage to flow out. We can also remove infected sinus tissue, bone, or nasal polyps during a surgical procedure.

There are two main types of sinus surgery:

1. Functional endoscopic sinus surgery (FESS)

We perform this minimally invasive procedure on an outpatient basis. Your surgeon inserts an endoscope (a thin fiber optic cable connected to a monitor) into the nostril, which allows him to see the inside of the nose and the openings of the sinuses. If he sees infected tissue or polyps blocking the passages, he then inserts very thin instruments next to the scope to remove the blockage.

Surgeons often use an image-guided system for this procedure, as it allows them to better view the entire nasal/sinus anatomy and remove as little tissue as possible. And because of the added precision, overall safety improves as well.

2. Balloon sinus dilation

Also a minimally invasive, outpatient option, balloon sinus dilation uses small balloons placed at various points along the sinuses. The surgeon inflates them to hold open the passageway, allowing him greater visibility and access.

The best way to find out if you need sinus surgery or not is to come in for a consultation with one of our surgeons. Call our office at 623-234-4640 to schedule the consultation, or book online with us today.