Chronic Sinusitis: An Overview of Sinus Surgery

          Chronic sinusitis, sinus pain, facial pain, nasal polyps, nasal congestion, mycetoma, allergic fungal sinusitis, nasal tumors, and nasal injuries are complex conditions treated by otolaryngologists (or ENT) physicians and their staff such as Doctor Neeta Kohli-Dang in Huntsville, Alabama.  Please visit  Huntsville ENT or call (256) 882-0165 for more information or to schedule an appointment.

          “John” suffered from recurrent sinus infections for years. We discussed surgery on a few occasions, and eventually decided to proceed.  Surgery confirmed severe disease and the sinuses were carefully and thoroughly cleaned.  After months of regular follow-up and more treatment, John joyously announced that he had regained his sense of smell.  Imagine our delight when he started bringing in absolutely delicious homemade cakes to the office.  Their quality would have put a seasoned baker to shame.  As well, his family was thrilled to have Dad in the kitchen again making delicious food with wonderful aromas.   Alas, what about our low calorie and cholesterol diet? FAT CHANCE – cakes like these don’t walk into your office every day.  John and I have since become good friends and I wish him continued good health and success.

         SINUS disease is rampant in the United States affecting millions of children and adults.  It is estimated that approximately 150 per 100,000 people in the general population are affected by chronic sinusitis.  The incidence appears to be increasing every year with the disease becoming more common in patients with AIDS, common variable immune deficiency, diabetes, polyps, and severe allergies.  There are about 20 million physician visits in the United States each year for chronic sinus issues.


         We usually have eight fully developed sinuses with bilateral frontal, sphenoid, maxillary, and ethmoid cavities.  Acute symptoms may include dull mid-facial pain, frontal headaches, thick discolored postnasal drainage, nasal congestion, sore throat, poor sense of smell, bad breath, dental pain, and fatigue.  A variety of organisms can be responsible for sinus disease.  These may include viral, bacterial (Staphylococcus aureus, Hemophilus Influenza, Moraxella catarrhalis, Strep pneumoniae, Pseudomonas aeruginosa, anaerobic bacteria), and fungi (Aspergillus, Alternaria).  Initial treatment includes appropriate antibiotics, steroids, cortisone nasal sprays, decongestants, and saline nasal rinses.  However, in patients with recurrent sinusitis an underlying etiology needs to be determined. This may include environmental allergies, structural changes (as evident on CAT scan), polyps, immunodeficiency, ciliary dysfunction, bony spurs, and chronic mold exposure.  CAT scan of the sinuses is considered the gold standard to evaluate individual sinus cavities in more detail and assess ostiomeatal units as well as transitional spaces.

          Further options include surgical intervention with endoscopic sinus surgery.  No longer do we use external excisions or extensive nasal packing.  There is no facial bruising or swelling, and patients can often return to work within a few days.  Balloon sinuplasty is a new technique that is becoming increasingly popular and very helpful in selected individuals.  This procedure can also be performed in our office utilizing state-of-the-art equipment including a stereotactic computerized navigational CAT scan that allows access to diseased and obstructed sinuses in a safe and effective manner.  Balloon sinuplasty is especially helpful in older patients who may prefer to undergo the procedure under local anesthesia rather than receiving a general anesthetic at the hospital.  Untreated chronic sinusitis can sometimes lead to serious complications with extension of disease into the orbit and intracranial cavity.  Fortunately, these cases are very rare.  Patients with asthma often note significant reduction in the severity of their disease when chronic sinusitis is appropriately treated.

BalloonSinuplasty-img          We strive to provide compassion along with exemplary medical and surgical care.  Should you or your family wish further evaluation, please feel free to contact our office so that we may recommend a tailored plan of management to suit your ear, nose, and throat concerns.


Contributing by my collaborating physician, Dr. Neeta Kohli-Dang , M.D.  F.R.C.S (C)

Call to schedule at appointment with Dr. Dang and Kari today: 256-882-0165.

Dr. Neeta Kohli-Dang is a board-certified otolaryngologist and a Fellow of the RoDr Dang red dressyal College of Physicians and Surgeons.  She has been practicing in Huntsville for about 20 years with regional and international patients.  She was selected to participate in a national multi-centric study involving chronic sinusitis and balloon sinuplasty with subsequent publication regarding its efficacy.



                      This article was written for and published by Inside Medicine.

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