The sinuses are air-filled spaces in the bones of your skull. You have eight in total. Two above the eyes (frontal sinuses), two between the eyes (ethmoid sinuses), two below the eyes (maxillary sinuses) and two behind the eyes (sphenoid sinuses). They make your head lighter so that you are not walking with a heavy block of bone on your neck. They also give resonance to your voice. The sinuses are also lined with cells that produce mucus which travels into the nose and down the throat.

The sinuses help to warm and humidify the air you breathe in. It also produces mucus that traps dusts and particles in the air preventing it from going into your lungs. As mentioned before, it lightens the skull and gives your voice resonance. It also acts as an air cushion barrier to protect the brain from injury.

Rhinosinusitis (sinusitis) is inflammation of the lining of the nose and sinuses.

Sinusitis can be acute or chronic. Acute sinusitis will last for 4 weeks or less but typically resolve within 10 days. It is most commonly caused by a virus. Acute sinusitis can also be caused by bacteria. Sinusitis symptoms include colored nasal discharge (e.g. yellow or green), nasal congestion, facial pain or pressure, fever, headache, post-nasal drip, stuffiness, bad breath, fever, headache, tiredness or toothache. Acute sinusitis can resolve on its own but often needs medications to relieve the symptoms.

It is not normal to keep getting recurrent acute sinusitis multiple times a year. When you have 4 or more acute sinusitis episodes in a year it is called recurrent acute sinusitis. You are at risk for this if you have allergies, a deviated nasal septum, or a structural abnormality affecting your sinuses. These structural problems will not resolve with medical therapy and may require procedures done by a sinus specialist.

Chronic sinusitis is when your symptoms last for three (3) months or longer. Chronic sinusitis occurs when there is a long-standing inflammation of the lining of the sinuses caused by bacteria that never cleared, fungus, or an abnormal excessive ongoing inflammatory response; this may result in the formation of polyps. Polyps are growths of the lining of the sinuses that block and obstruct the sinuses and the nose, often resulting in stuffiness, poor smell, nasal discharge and post-nasal drip.

There are many causes of Sinusitis. Common among them is a blockage to the opening of the sinuses.

Some of the causes include:

Viruses

Bacteria

Fungus

Allergies

Enlarged turbinates or deviated (bent) nasal septum

Inflammatory airway diseases e.g. Aspirin exacerbated respiratory disease (Sampter’s triad)

Reflux disease

Tooth decay

Air pollution

Smoking

Intranasal drug use

Pregnancy or birth control use

Congenital conditions e.g. Kartagener Syndrome

Tumors

Scar tissue from prior surgery or trauma to the nose

Autoimmune conditions e.g. Sarcoidosis

Immune deficiency

The diagnosis is made based on symptoms, examinations, findings, or scans of the sinuses.

Your sinus doctor will ask if you have

Nasal congestion

Pain or pressure of the face

Nasal discharge

Decreased sense of smell

Additional symptoms include:

Post-nasal drip

Cough

Adult-onset asthma

Bad breath

Fatigue

The examination of the nose is performed with an endoscope. This is a tiny camera inserted into the nose in-office for a magnified examination of the nose and sinuses. Your sinus specialist may also request a CT scan, which is a special and detailed x-ray of the sinuses and nose.

Viral sinusitis, which is the most common form of sinusitis, can be resolved on its own. Medications such as antihistamines, decongestants, nasal sprays, and rinses help resolve sinusitis symptoms. Viruses will not respond to antibiotics as they are used to treat bacteria. So, your doctor may decline to prescribe antibiotics if they think a virus caused it.

Antibiotics are prescribed when you have acute bacterial sinusitis. This is usually given from 7 up to 14 days depending on the severity of the infection, local resistance trends, other medications being used and other medical conditions.

In addition, your doctor may prescribe painkillers, intranasal steroid sprays, decongestions, antihistamines or saline rinses.

Chronic sinusitis is a more complicated issue because of the variety of causes. Initially, people are put on medical therapy (medicines). Surgery is an essential and effective tool to treat chronic sinusitis for those who don’t respond effectively to medicines.

Sinus surgery has evolved to be a technologically advanced procedure done with an endoscope through the nostrils without cuts or bruises to the face. Its main goal is to use minimally invasive tools to remove the blockage to the sinuses returning them to normal function. The sinuses may also serve as a pathway to the eyes and brain for special procedures that involve those organs. Our techniques also allow you to go home on the same day with minimal pain and quick resumption of your daily lives.