Sinuses

 

Acute sinusitis causes pain in the affected sinuses, and usually is accompanied by fever.  It is associated commonly with an upper respiratory infection or cold.  Acute sinusitis is treated with antibiotics for about ten days, and complications are rare.  Patients with diabetes, or other conditions that compromise the immune system, are at much greater risk from acute sinusitis and require more aggressive evaluation and treatment.

Chronic sinusitis is defined by symptoms of nasal congestion, facial pressure or pain, and post-nasal drainage lasting at least 12 weeks.  Other common symptoms include headache, general fatigue, and loss of sense of smell.  Chronic sinusitis may begin with a period of acute sinusitis that isn’t treated completely, and it can be associated with allergy or structural blockages to normal sinus drainage.  The most common obstruction to sinus drainage is a deviated nasal septum, but nasal polyps and congenital sinus abnormalities also may contribute to the problem.  The inflammation, which causes the symptoms associated with chronic sinusitis may be triggered by allergy, viral infection, bacterial infection or fungal colonization.

In our practice, we strive to make an accurate diagnosis and use aggressive medical treatment to address ongoing symptoms, and most importantly, the underlying causes of  chronic sinusitis.  Nasal and sinus endoscopy is performed easily in the office and allows a thorough, magnified examination inside the nose using just topical and or local anesthesia.  Cultures from sinus drainage noted during endoscopy are utilized to define the infection and follow your response to treatment.  In addition, our physicians work with allergists throughout the Delaware Valley for assessment and treatment of allergies.  We can provide patients with the newest methods of antibiotic treatment that improve responses and reduce the risks and discomforts typically associated with long-term treatment.  Medications may be provided by spray or by nebulizer.  This can reduce your chances of stomach upset and the complications of antibiotic resistance associated with repeated use of strong antibiotics taken by mouth.

Comprehensive evaluation and aggressive medical treatment provide effective relief for many patients, but surgery is indicated occasionally.  When surgery does become necessary, the newest techniques of endoscopic surgery are utilized.  In almost all cases, surgery is performed on an out patient basis and is done without external incisions.  Our physicians use technology for intraoperative navigation and microdebridement whenever necessary.  This equipment allows the surgeon to approach surgery in the sinuses more safely with a real time x-ray picture of your sinuses available during surgery, and to limit the amount of surgical trauma to the tissues.

Not all facial pain or headache is caused by sinusitis.  Many patients with facial pain syndromes are mistakenly treated for chronic sinusitis, and some patients may have both conditions.  In our practice, you will be evaluated for neurologic causes of your facial pain as well as more the more traditional causes such as sinusitis.  You may be treated with medication, local nerve blocks, and less commonly, with surgery.  Treatment for your facial pain is often coupled with treatment for sinusitis.