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Endoscopic Sinus Surgery

About The Sinuses

Thursday, March 22, 2012 - 12:21

Contributing Author: Guy Slowik FRCS

The sinuses are spaces filled with air in some of the bones of the skull. Air passes in and out of these spaces, and mucus drains through them and out of the nose. They also reduce the weight of the skull and give our voices a nicer sound.

There are four main pairs of sinus openings, sometimes called sinus cavities, in the face:

  • Maxillary - in the cheekbones
  • Ethmoid - between the eye sockets
  • Frontal - in the forehead and above the eyebrows
  • Sphenoid - deep in the head at the back of the nose

Each of these pairs of sinus openings has a channel that leads to the nose. These channels are quite narrow, and when the lining of the channels becomes swollen, blockage results. This lining is called the mucous membrane. This same mucous membrane forms the inner lining of the nose.

The mucous membrane in the nose and sinuses is our personal air conditioner. It warms, moistens, and cleans the air. The mucous membrane creates a clear, wet, slightly sticky mucus that gathers any dust, smoke, bacteria, or virus particles that may have been in the air. Tiny hairs along the membrane called cilia act as tiny oars, moving the mucus along much like a conveyor belt through the sinuses and out the nose.

When the mucus containing the unwanted particles reaches the nose and throat, the body prompts us to swallow, spit, sneeze, or cough it out of the body. When a cold or allergy prevents the cilia from moving the mucus through, the nose becomes blocked.

The mucous membrane is also one of the body's front-line defense systems. It releases chemicals that help to destroy bacteria and viruses before they can attack.

If a virus, bacteria, allergen or other irritant is strong enough to prevent the mucous membrane and cilia from doing their job, blockages can occur in any of the pairs of sinus openings.

Endoscopic sinus surgery can correct chronic or severe blockages in one or more of the maxillary, ethmoid, frontal, or sphenoid sinuses.

What Causes Sinusitis?

The potential causes of sinusitis include:

  • Virus
  • Bacteria
  • Fungus
  • Allergies
  • Asthma
  • Poor air quality
  • Extremes of temperature and humidity
  • Dehydration
  • Excessive nose blowing
  • Foreign objects placed in the nose
  • Stress
  • Diseased teeth
  • Hormonal imbalances
  • Medication side effects
  • Low immune system
  • Deviated septum
  • Small sinus openings
  • Polyps
  • Tumors

Most cases of sinusitis can be easily treated by a family doctor. However, in those cases where the sufferer has chronic sinusitis or repeated attacks of acute sinusitis that have not responded to medication, endoscopic sinus surgery may be the answer. This is especially true in the case of nasal obstructions such as polyps.

There are two types of sinusitis:

  • Acute sinusitis means that the symptoms of the condition are temporary, usually lasting no more than 30 days. However, the symptoms of acute sinusitis are more severe and painful than the symptoms of chronic sinusitis.
  • Chronic sinusitis means that the symptoms of sinusitis occur frequently or for long periods of time. The symptoms are usually more annoying than painful. However, those with chronic sinusitis are more likely to have recurring attacks of acute sinusitis, which can be quite painful.

What Are The Symptoms Of Sinusitis?

Symptoms of sinusitis vary from person to person. The most common symptoms are:

  • Stuffy or runny nose
  • Clear, thin discharge from the nose (as in chronic sinusitis), or thick yellow or green discharge from the nose, sometimes tinged with blood (as in acute sinusitis)
  • Sneezing and/or coughing
  • Pain over the bridge of the nose
  • Headache that is worse in the morning, when bending forward, or when riding an elevator
  • Post-nasal drip from the nose into the throat
  • Frequent throat clearing
  • Itchy eyes and/or nose
  • Impaired sense of smell and/or taste
  • Bad breath
  • Fever and chills
  • Pain in the roof of the mouth or teeth
  • Face and eye pain

Less common symptoms, which may or may not be accompanied by a stuffy nose, are:

  • Earache, feeling of fullness in the ear, swelling, and tenderness behind the ear, and/or ear popping due to mucus in the eustachian tube of the ear
  • Sore throat and hoarse voice caused by infected post-nasal drip
  • Swelling of the eye area due to spread of infection from the sinuses to the eye
  • Severe headache with vomiting, a very rare symptom, indicates the possibility of meningitis or the spread of infection into the brain.

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