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Although sinuses appear to be hollow spaces, they are actually a well-integrated system that connects to the nose through narrow channels. The sinus cavities are lined with specially designed microscopic cells called cilia. They help keep the channels open by allowing air into the cavities and promoting drainage of mucus into the nose. Healthy sinuses are free from bacteria, viruses, and allergens. Sinuses that become inflamed or infected soon become blocked and can make life miserable on a seasonal basis or chronically.

Where are my sinuses?

There are 4 paired sinus cavities in the face:

  • Frontal
  • Maxillary
  • Ethmoid
  • Sphenoid

Sinusitis is a term used to describe inflammation of the sinus linings. This condition is most often the result of repeated bacterial or viral infections, allergies, or anatomic problems such as blocked sinus openings, deviated nasal septum, and/or nasal polyps. The sinuses normally drain through small openings, called ostia, in the nose. Anything that obstructs that flow can cause a buildup of mucus, and sometimes pus, in the sinuses. These openings can be blocked simply by anatomical variations between individuals, or by inflammation caused by frequent infections and/or seasonal allergies.

How are Sinus problems diagnosed?

  1. Patient History: It is important to discuss each patient’s particular history of sinus and allergy problems in order to provide an appropriate diagnostic plan and create the most effective and customized treatment strategy. Since every individual is different, it is important to provide individualized options in order to achieve our goals of treatment.
  2. Nasal Endoscopy: A tiny camera is used to view the nasal passages and openings of the sinus cavities. This is painless, takes just a few minutes, and is very easily tolerated in the office. Nasal polyps, inflammatory processes, nasal/sinus anatomy, and allergy-related changes of the nasal linings can be seen during this examination.
  3. CT (CAT) Scan: This is the “gold standard” for imaging the sinus cavities. CT scans are quick, painless, and are routinely acquired for nearly all of our sinus and allergy patients. No intravenous (IV) contrast is needed, and the images are taken in digital format to review in the office.
  4. MRI: This is only utilized in rare cases of sinus abnormalities, such as congenital malformations and cancer progression. The test may require intravenous (IV) contrast, and takes 30-45 minutes to complete, and is not considered a standard method to diagnose sinus and nasal problems.

What are the most popular sinus treatments or procedures?

The goal of any sinus procedure is to clear blocked sinuses, restoring normal drainage and ventilation pathways, and preserving the natural nasal and sinus anatomy.

  • Medications – Antibiotics, nasal steroid sprays, nasal antihistamine sprays, and sometimes oral anti-inflammatory steroids are used to treat recurrent or chronic sinusitis.  Allergy testing and treatment is very important to help identify and treat the underlying problem that can cause sinusitis.
  • Allergy Testing and Treatment – Environmental (trees, grasses, weeds, pollen), animal, and food allergens are thoroughly tested in our office using a relatively painless technique that children and adult can easily tolerate.  Identifying the specific allergens that cause your symptoms, and treating them appropriately is important in creating a comprehensive treatment plan.  Allergy drops (sublingual) therapy is now available.  No needles or injections are needed for treatment.
  • Balloon Sinuplasty – This represents the newest and safest FDA approved procedure to treat chronic and recurrent sinusitis.  A tiny catheter that carries a small balloon is used to gently open the blocked sinus passages and restore natural sinus flow.  This is performed in the office, under endoscopic guidance, with the use of topical liquid anesthesia.  No nasal packing is required, and recovery time is as little as 12-24 hours.
  • Functional Endoscopic Sinus Surgery (FESS) – This procedure is the traditional sinus surgery technique and utilizes an endoscopic camera and specialized instruments to help open blocked sinus passages.  It is typically performed under general anesthesia in a surgery center or hospital and requires 2-5 days of recovery.  No nasal packing is required, so recovery is traditionally quick.
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