Sinusitis: Symptoms and Treatment with Endoscopic Sinus Surgery

 

 

 

     Sinusitis is an inflammation and infection of the mucous membranes lining the nasal cavity and sinuses—air-filled spaces located in the facial area, alongside the nose, cheeks, and base of the skull. It commonly occurs following a cold and is frequently found in individuals suffering from upper respiratory infections, those with insufficient rest, or individuals with underlying health conditions such as allergic rhinitis or asthma.

 

Symptoms of Sinusitis

• Nasal congestion with thick, yellow or green nasal discharge
• Pain in the sinus areas or facial regions and difficulty breathing through the nose
• Headache and thick mucus draining down the throat
• In severe cases, high fever, swollen and inflamed eyes, sinus pain, headache, and facial pain may occur

 

Differences Between Acute and Chronic Sinusitis

• If symptoms persist for less than 4 weeks, it is referred to as acute sinusitis.
• If symptoms last longer than 12 weeks, it is considered chronic sinusitis.

 

 

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In addition to the above symptoms, patients may experience a distortion in their sense of smell—either reduced sensitivity or an unpleasant odor emanating from the nasal cavity.

 

 

Diagnosis of Sinusitis

     Diagnosis typically begins with a review of the patient's medical history and a general physical examination. Nasal endoscopy is often performed to observe the sinus cavities directly. In some cases—especially in patients with a history of facial trauma—CT scanning may be recommended if the physician suspects complications such as nasal polyps.

 

 

 

 

 

 

Treatment of Sinusitis

There are generally two approaches to treating sinusitis, depending on the severity of the condition:

 

1.  Medication

     This includes antibiotics, nasal decongestants, antihistamines, saline nasal irrigation, and nasal sprays. Treatment usually spans 5–10 days. For chronic sinusitis, surgical intervention may be considered.

 

2.  Surgical Treatment

     If medications are ineffective, or in cases such as fungal infections in the sinuses, endoscopic sinus surgery may be necessary. This method offers high precision, leaves no external scars, and carries a low risk of complications. Post-operative recovery typically requires around two days. However, patients should avoid heavy lifting or straining for one month, refrain from flying for one week, and avoid swimming for two months to prevent nasal bleeding.

 

 

 

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In cases of severe sinusitis, surgery may be essential. A consultation with a physician is recommended to develop the most suitable treatment plan.

 

 

Medical Considerations for Sinus Surgery

Physicians may recommend surgery in the following scenarios:

 

1.  Necessary Cases

     When the infection spreads to the eyes or brain, or if there is suspicion of a tumor or fungal sinusitis.

 

2.  Recommended Cases

     In patients with chronic sinusitis, recurrent acute sinusitis, or nasal polyps that do not respond to 1–3 months of medical treatment. In such cases, surgery may offer more benefits than continued medical management.

 

Note : Physicians must carefully assess each patient to minimize surgical risks.

 

Surgical Risks and Complications

Given the proximity of the sinuses and nasal cavity to vital structures such as the eyes, brain, optic nerves, and major arteries supplying the brain, sinus surgery involves certain risks. Potential complications include:

 

• Bleeding in or around the eyes, which may temporarily impair vision
• Tear duct obstruction due to trauma, which can cause continuous tearing; this typically improves within one week after surgery
• Cerebrospinal fluid (CSF) leakage into the nasal cavity, resulting from trauma or injury to the nasal roof

 

 

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These complications are rare. Modern surgical procedures now employ advanced technology such as surgical navigation systems (Navigators), which enhance precision and significantly reduce risks.

 

 

 

 

Endoscopic Sinus Surgery

     Today, Functional Endoscopic Sinus Surgery (FESS) and Full House Endoscopic Sinus Surgery (ESS) are considered the most effective approaches, especially in cases involving pus in all sinuses, nasal polyps, or nasal tumors. These techniques are safer and more comprehensive than traditional surgical methods.

 

Surgical Procedure Steps

• The surgeon enlarges the sinus openings using an endoscope for visualization
• Once the area is visible, accumulated thick mucus and pus are suctioned out
• This improves airflow within the sinuses and allows medications such as nasal sprays to work more effectively and directly

 

Why Choose Ramkhamhaeng Hospital for Sinus Surgery?

     The Endoscopic Ear, Nose, and Throat Surgery Center at Ramkhamhaeng Hospital is equipped with high-performance medical technologies and offers advanced treatments under the care of expert physicians. The hospital is committed to restoring health and guiding patients forward with renewed vitality.