Sinus Treatment Options: Surgical & Non-Surgical

Overview

The nose is the organ that enables smelling and forms a main passage for the transportation of air in and out of the lungs. It warms, cleans and moistens the air before it enters the lungs. The nose is surrounded by bones that contain hollow spaces known as paranasal sinuses. The sinuses are lined with a mucous membrane that traps incoming dirt particles and directs them to the nasal cavity through a small sinus opening (ostia). Certain health conditions like colds or allergies can easily block these small openings due to swelling of the mucous membrane. 

This blockage leads to sinus inflammation and infection, which need non-surgical or surgical sinus treatment options for recovery.

What are Sinuses?

The sinuses are hollow cavities located in the skull, specifically situated behind the forehead, nasal bones, cheeks and eyes. These spaces are filled with air. However, the term is most commonly linked with the paranasal sinuses that are located near the nose and connect to the nasal cavity. They possess mucus and tiny hairs that warm and humidify the inhaled air before it reaches the lungs. 

There are four groups of paranasal sinuses depending on the respective bone it is associated with. These are maxillary (cheekbones), ethmoid (besides the upper nose), frontal (the lower forehead) and sphenoid sinuses (behind the nose). They help to diminish the weight of the facial bones and skull while maintaining bone strength and shape.

Alternative Name of Sinuses?

Sinuses are also known as Sinusitis.

Importance of Sinus Treatment

The sinuses trap particles, protect the skull and affect voice quality. Sinus infections cause symptoms like stuffy nose, facial pain, headache and fever. Timely treatment is crucial to prevent complications from sinus inflammation. If left untreated, sinusitis can lead to more severe health issues and prolonged discomfort. Thus, it is crucial to seek medical attention and receive appropriate treatment to alleviate symptoms and enhance overall health.

Non-Surgical Sinus Treatment Options

Acute sinusitis that lasts for less than four weeks can be easily treated by non-surgical sinus-treatment options.

Nasal Irrigation

Nasal irrigation is a safe and easy home-based method of rinsing the sinuses. It helps to clear the mucus (snot) that can clog the nasal cavities and also flushes out pathogens, allergens or other debris. Nasal sprays or solutions are easily available in a pharmacy or a drug store and can be administered with ease.

Medications

Medicines like corticosteroids (oral or injected) are often used to relieve inflammation from severe sinusitis, especially when there is the formation of nasal polyps (non-cancerous growth on the lining of the nasal passage). Long-term use of corticosteroids may lead to significant side effects; therefore, they are reserved for treating severe symptoms.

Allergy Management

Allergies can cause sinusitis by blocking sinus drainage channels, resulting in fluid build-up from swelling. To treat sinus infections in such cases, doctors may recommend allergy medications such as nasal corticosteroids or antihistamines.

Home Remedies

A sinus treatment can be easily done with numerous home remedies, such as:

• Increasing warm fluid intake and running a humidifier or vaporizer: Hot fluids and humidification can help thin mucus and promote sinus drainage, providing significant relief.

• Using steam: Steam helps to relieve nasal blockage and congestion by loosening mucus.

• Warm and cold press: Rotating warm and cold compress on the sinuses helps to loosen mucus very effectively.

• Honey: Honey's antibacterial properties make it a potential remedy for relieving sinus congestion caused by bacterial infections.

Surgical Sinus Treatment Options

Sinus surgery is recommended for cases of chronic sinusitis or when non-surgical treatments are ineffective in curing sinus problems. It involves the removal of polyps, bone, or infected tissues that cannot be treated through non-surgical methods.

Endoscopic Sinus Surgery

Sinus surgery using a nasal endoscope is the most common procedure performed for chronic sinusitis. It involves the use of a specialised endoscope with a camera and light source to guide the surgery. During the procedure, small surgical instruments are used to remove obstructing tissue or polyps from the nasal passage. The surgery usually takes approximately two hours and does not require an overnight hospital stay.

Balloon Sinuplasty

Balloon sinuplasty is a minimally invasive surgical procedure used to treat sinusitis. During the procedure, an endoscope and catheter are used to guide a small balloon into the sinuses. The balloon is then inflated, which expands the sinus passageway and helps to drain trapped mucus, providing relief from sinus symptoms.

Functional Endoscopic Sinus Surgery

Functional Endoscopic Sinus Surgery (FESS) is a common procedure where doctors use endoscopes to guide the surgery and widen the nasal and sinus passages. By removing bone or infected tissues, FESS helps to restore normal sinus function and allows trapped mucus to drain effectively.

Septoplasty

Septoplasty is a surgical procedure that straightens the deviated septum, the bone and cartilage dividing the nostrils. It is performed to improve drainage and reduce the risk of sinus infections. During the procedure, the nasal septum is repositioned, allowing for better airflow and decreasing the likelihood of sinusitis.

Sinus Surgery Risks or Complications

Sinus surgeries generally have a low risk of complications, but there are some associated factors to consider, including:

• Bleeding and infection

• Injury to the eye and its surrounding areas

• Leakage of cerebrospinal fluid.

• Loss of sense of smell (anosmia)

• Loss of vision

• Empty nose syndrome, where the nose become stuffy and clogged even after successful surgery

• Numbness in the front teeth

• Septal perforation (associated with septoplasty)

Choosing Between Surgical and Non-Surgical Treatment

Doctors usually prefer treating patients with medications or non-surgical methods for acute sinusitis. However, those who poorly respond to medications and suffer from chronic sinusitis are primarily treated with surgical methods.

Factors to Consider

Factors to keep in mind before undergoing sinus treatment are:

• Medication options: It is recommended to explore medication options for sinus treatment as they typically have minimal side effects. Medications can effectively treat sinus infections, except for oral corticosteroids, which may have side effects if used for an extended period.

• Home remedies: Home-based remedies can play a significant role in maintaining and improving sinus health. Simple remedies using readily available products can be effective in managing sinus symptoms.

• Surgical intervention: Surgery should be considered as a last resort when other treatments have failed, particularly in cases of chronic or subacute sinusitis. However, it is important to note that surgeries carry potential risks and complications, although they are relatively rare.

Doctors recommend surgical or non-surgical treatment of sinuses by reviewing patients’ medical history and the current situation of the sinuses.

Pros and Cons of Each Option

Non-Surgical Treatments: Sinus infections can often be effectively treated with antibiotics and home-based remedies, typically resolving within a few weeks. These medications are readily accessible at pharmacies, allowing patients to receive treatment without the need for hospital or nursing home visits. However, it's important to note that not all sinus infections can be successfully managed with these methods alone.

Surgical Treatments: Persistent sinus pain can significantly impact one's quality of life if left untreated. In such cases, doctors may recommend a minimally invasive surgical procedure that typically takes a few hours to complete and effectively addresses sinus infections. It's important to note, however, that these surgeries carry the risk of potential side effects, such as unusual bleeding and numbness, which require further medical attention.

Conclusion

Sinuses are equipped with mucus and tiny hairs that aid in the drainage of the nasal passage, ensuring a clean and protected nose from bacteria and allergens. However, sinus infections can impede this drainage, leading to breathing difficulties, cheek pain, tenderness, and elevated body temperature. Therefore, it is crucial to employ effective sinus treatments, both surgical and non-surgical, to maintain sinus health. While home-based remedies and medications are usually the initial options, in severe cases, various minimally invasive surgical procedures are available to remove tissue or polyps, restoring nasal passage and facilitating prompt recovery.

Frequently Asked Questions (FAQs)

1. Can Sinusitis Go Away on Its Own?

Sinusitis is the swelling of the sinuses, which usually clears up on its own within 2 to 3 weeks.

2. How Long Does Sinusitis Last?

An acute sinus infection lasts anywhere from ten days up to eight weeks. However, chronic infection may drag on for one to two months at times.  

3. Is Sinus Surgery Painful?

Healthcare providers use general or local anaesthesia while doing the sinus surgery. Thus, people don't feel any pain but might have mild to moderate pain for a week post-surgery. 

4. How long is The Recovery Period for Sinus Surgery?

The recovery time after sinus surgery typically varies from one to three weeks, which is contingent upon the complexity of the procedure.

5. Can Sinusitis be Prevented?

To prevent sinusitis, one can take the following steps:

1. Minimise exposure to upper respiratory infections.

2. Avoid close contact with individuals who are at a higher risk of infections.

3. Practice good hand hygiene by washing your hands regularly with soap and water, particularly before meals.

6. How Do I Know If I Need Sinus surgery?

Surgical treatment for sinusitis may be necessary if persistent pain is experienced despite medication, the presence of benign growths or polyps is detected or if there is a persistent fever indicating an infection.

7. What are The Risks Associated with Sinus Surgery?

The risks associated with surgery are:

• Heavy bleeding

• Teary eyes

• Leakage of cerebral spinal fluid

• Numbness

• Losing vision

• Empty nose syndrome

8. Can Sinusitis Lead to Complications?

Serious complications of chronic sinusitis are rare but may include vision problems. At times, sinus infection spreads to the eye socket, which causes reduced vision or possibly blindness that can be permanent.