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How is chronic sinusitis treated?

Sinusitis is the inflammation of the sinuses. Infections can cause it, but also anatomical conditions, such as deviation of the nasal septum.

If the infection does not resolve, it can become chronic. How should one intervene in this case?

Sinusitis: The symptoms

Sinus inflammation symptoms include headache, difficulty breathing, discomfort, lacrimation, decreased sense of smell, and catarrhal discharge.

Inflammation could be triggered by viral, bacterial, and rarely fungal infections. In some cases, the cause may be anatomical, such as a deviation of the nasal septum, hypertrophy of the turbinates, and other anatomical variations. 

If the infection does not resolve in the short term, it might become chronic. To prevent this from happening, there are several solutions.

Generally, people try to prefer drug therapy, which can resolve even the most persistent inflammation. However, if this treatment is ineffective, the specialist and the patient may opt for surgical therapy.

Chronic sinusitis and surgery

Surgery to treat sinus inflammation is minimally invasive endoscopic surgery. This type of surgery uses endoscopic optics with micro-video cameras and specific instruments inserted into the nostrils. 

In this way, not only does the patient experience less pain in the postoperative period, but they also heal more quickly, and the chances of a successful surgery increase. 

In addition, with this technique, the patient can sometimes be discharged even on the same day of surgery. In other cases, however, an overnight hospitalization is required. 

The surgical procedures are polypectomy with microdebrider, ethmoidectomy, maxillary antrostomy, sphenoidotomy, frontal sinusotomy, and septoplasty combined with turbinoplasty. 

The different procedures are differently combined according to each patient in a customized and modulable intervention:

  • Ethmoidectomy – clears the sinuses located between the eyes and the bridge of the nose;
  • Maxillary antrostomy – used to free the drainage of the sinuses located behind the cheekbones;
  • Sphenoidotomy – that is the opening of the most posterior paranasal sinus of the nose;
  • Frontal sinusotomy – serves to restore drainage of the sinuses located superiorly, behind the forehead;
  • Septoplasty combined with turbinoplasty – in case of breathing difficulties caused by a crooked nasal septum and enlarged turbinates or to create a better view for performing the other previously described procedures.
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