Facial Plastic & Reconstructive Surgery
Facial Plastic & Reconstructive Surgery
Otolaryngology-Head & Neck Surgery
 

What are the sinuses?

 

Paranasal sinuses are air-filled pockets located in the head. There are four pairs of sinuses:

·        Maxillary sinuses

·        Frontal sinuses

·        Ethmoid sinuses

·        Sphenoid sinuses

How do healthy sinuses work?

 

When you breathe in air, mucus in the sinuses humidifies the air and collects bacteria and pollutants.

Tiny hairs lining the sinuses move the mucus (with pollutants) out of the sinus, into your throat.

You then swallow the mucus, and your stomach acid destroys the bacteria and pollutants.

Colds, allergies, environmental irritants or other conditions can slow or block natural drainage, and irritate the sinus lining.  This, in turn, can lead to swelling, additional blockage, and sinusitis.

Sinusitis Treatment: Dr. Wenzel's Approach to Medical Therapy

At Western Carolina ENT Specialists we follow the established clinical guidelines for treating sinusitis. Our first line treatment is medical therapy—which may include a range of medications designed to address your particular illness and symptoms.

 

Depending on your needs, Dr. Wenzel may recommend:

Nasal steroids for treatment of sinusitis

Nasal steroid sprays can decrease the swelling in the mucous membrane lining of the sinuses, which can help temporarily relieve symptoms. Some of our patients are reluctant to take medications containing steroids. Steroids can have side effects when taken over a longer period of time. You can find out more about steroid sprays in the package insert, or discuss possible side effects during your visit with Dr. Wenzel

Antibiotics and sinusitis

If sinus inflammation has led to the development of a bacterial infection, we may prescribe antibiotics to deal with symptoms related to that infection.  The antibiotic may be chosen based on a culture done in the office.

Decongestants and other medical management options

Decongestant nose drops or nasal sprays aim to soothe the mucous membranes and reduce swelling. This may make it easier to breathe through your nose.  Oral decongestants may help reduce swelling to promote drainage.  Nasal saline rinses or sprays help decrease the thickness of mucus and promote drainage and cleansing of the nasal cavity and sinuses.  Other nasal spray medications like antihistamine sprays may also help reduce swelling from allergies and rhinitis.  Each of these therapies will be recommended bases on your particular history and exam findings.

When Medical Therapy Fails—Advanced Treatment Options at Western Carolina ENT Specialists

We see many patients who suffer from chronic or recurrent acute sinusitis for whom medical therapy fails or only provides temporary relief. For these patients, we have developed expertise in more advanced surgical treatment options, including:

Office balloon sinus dilation 

Endoscopic sinus surgery

Your insurance companies may have guidelines that need to be followed when recommending these options in order receive coverage and these guidelines will be reviewed at our practice and preauthorization obtained where necessary. 

Sinusitis Treatment Options:

In-Office Sinus Dilation has been successfully performed in our office for over 4 years with excellent results.

 

Office sinus dilation is a minimally invasive option that can be performed by Dr. Wenzel right here, in our offices. The goal of office sinus dilation is to reshape anatomy to expand sinus pathways and restore drainage. Here's how it works:

 

The procedure utilizes small balloons placed in key places in the nose and sinus, which are then dilated to expand the sinus pathways. It may be an effective, lasting option for some patients whose symptoms do not resolve with medication.

The benefits of office sinus dilation include:

Delivers instant, lasting relief (1.2)

Convenient, comfortable office procedure (3)

Quick recovery—most patients return to normal activity in 24 hours (4)

May reduce healthcare costs

Discuss office sinus dilation with Dr. Christopher Wenzel today! (828) 627-1234

Dr. Christopher Wenzel is a trained and experienced user of office sinus dilation technologies. Make an appointment at our [location] office today to determine if balloon sinus dilation is right for you.

Article references:

 

1. Stankiewicz J, Truitt T, Atkins J, Winegar B, Cink P, Raviv J, Henderson D, Tami T. Two-year results: transantral balloon dilation of the ethmoid infundibulum. Int Forum Allergy Rhinol. 2012 May; 2(3): 199-206.

2. Stankiewicz J, Tami T, Truitt T, Atkins J, Liepert D, Winger B. Transantral, endoscopically guided balloon dilatation of the ostiomeatal complex for chronic rhinosinusitis under local anesthesia. Am J of Rhinology. 2009 May-June; 321-327.

3. Gould, J. In-office balloon dilation: Procedure techniques and outcomes using a malleable multi-sinus dilation tool. ENT Journal. Vendome Healthcare Media, 19 Dec 2012.

4. Stankiewicz J, Truitt T, Atkins J, Winegar B, Cink P, Raviv J, Henderson D, Tami T. Two-year results: transantral balloon dilation of the ethmoid infundibulum. Int Forum Allergy Rhinol. 2012 May; 2(3): 199-206.

Sinusitis Treatment: Endoscopic Sinus Surgery in the operating room

For some, medical therapy will not provide lasting relief from the symptoms of chronic or recurrent sinusitis. And balloon sinus dilation may not be an option.

In these instances, our doctors may suggest endoscopic sinus surgery, or ESS. The goal of ESS, like balloon sinus dilation, is to expand the sinus drainage pathways to help restore drainage and heal the sinus mucosa.

How endoscopic sinus surgery works

A doctor uses an endoscope, inserted through your nostrils, to view the passageways and sinus openings, and a series of micro-cutting instruments to remove obstructive or abnormal tissue. This tissue removal expands the openings to the sinuses and the pathways through which sinuses drain, helping clear sinuses and promote healing.

Clinical benefits of endoscopic sinus surgery

In multiple studies, patients who receive functional endoscopic sinus surgery show a statistically significant improvement in symptoms and quality of life following surgery.1

There are a number of approaches to ESS. Should you be a candidate for ESS, our doctors at [Practice Name] will discuss the option they recommend for you, as well as the risks associated with ESS.

Recovery from endoscopic sinus surgery

Recovery times for ESS vary, based on the extent of the procedure. Many people return to normal activities within one to two weeks following surgery.2

References

1Impact of functional endoscopic sinus surgery on symptoms and quality of life in chronic rhino sinusitis. Damm M, Quante G, Jungehuelsing M, Stennart E. Laryngoscope. 2002 Feb: 112(2): 310-5

2Pain treatment and recovery after endoscopic sinus surgery. Kemppainen TP, Tuomilehto H, Kokki H, Seppa J, Nuutinen J. Laryngoscope. 2009 May-June: 321-327

References:

 

1.   Stankiewicz J, Truitt T, Atkins J, Winegar B, Cink P, Raviv J, Henderson D, Tami T. Two-year results: transantral balloon dilation of the ethmoid infundibulum. Int Forum Allergy Rhinol. 2012 May; 2(3): 199-206.

2.   Kemppainen TP, Tuomilehto H, Kokki H, Seppä J, Nuutinen J. Pain Treatment and recovery after endoscopic sinus surgery. Laryngoscope. 2007 Aug; 117(8): 1434-1438.