What is Chronic Sinusitis?
It all starts with a congested nose due to a viral cold or allergy. Not much to do about the virus, it should resolve within 10 to 14 days. Chicken soup is a good idea for a cold. Antihistamines, decongestants, and nasal steroid sprays for allergy control don’t even seem to be enough. But, you just don’t seem to improve even after a couple of weeks.
Facial pressure and pain (particularly when you bend over to tie your shoes), fatigue, persistent discolored nasal mucous, cough, and even wheezing are signs that the congestion has progressed to something more: sinusitis. Now we call in the big guns – antibiotics and even oral steroids like prednisone. Most of the time that infection gets better. But, sometimes all the medicines you have taken can’t get you better.
You may end up in your friendly neighborhood ENT office. But not to worry, there is a way out. Your Otolaryngologist (medicalese for ENT) will likely take a look around, even to the point of putting a scope in your nose to see where the problem resides. And if you are both convinced that you have run out of rational medical options you have to begin to consider surgery. Yes, it comes to that sometimes.
Before you can have any type of procedure the precise nature and location of your infection needs to be found. CT scans are our best bet for this. It is an X-ray, which means radiation exposure. We know and take that into account. But don’t worry, a screening CT is fast, painless (no needles I promise), and has minimal X-rays involved. Without this critical piece of information, a sinus surgeon would just be operating blind – and you don’t want that I promise.
So, now know you know what is going on and you can make decisions based on information. Sinus surgery is surgery (duh) but it is usually VERY effective at relieving those unremitting, chronic sinus infections.
The prevalence of concha bullosa and nasal septal deviation and
their relationship to maxillary sinusitis by volumetric tomography.
Smith KD, Edwards PC, Saini TS, Norton NS - Int J Dent (2010)
Mark T. Brown, MD, FACS