Sinusitis is defined as acute if it lasts less than 4 weeks and chronic lasts for at least 3 months. Recurrent occurs 4 or more times per year. The sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. One in eight adults will be affected by sinusitis every year. In some patients, the sinus inflammation is so severe that polyps can grow and obstruct drainage.

Most cases are caused by viruses and should not be treated with antibiotics.  Patients with bacterial sinusitis get better faster with the appropriate use of antibiotics. For patients with frequent infections, we can treat with “culture directed antibiotics” by culturing the pus and determining exactly which antibiotic is most effective. Salt water nasal irrigations, nasal steroid sprays, and allergy medications are the main treatments for chronic sinusitis.

When medications fail, surgery can be very effective to treat recurrent and chronic sinusitis.  Using telescopes through the nostrils, endoscopic sinus surgery (ESS) widens the natural drainage pathways between the sinuses and the nose, allowing mucus out and air in.  Medications can also get into the sinuses better after surgery. This is usually performed on an outpatient basis.

Balloon sinus dilation is a newer treatment option that can be done in the office under local anesthesia. Instead of removing the diseased tissue that blocks the sinus, a balloon is used to dilate the sinus openings and make them larger. In the correct patient, this minimally invasive treatment can be very effective https://ent.stryker.com/conditions/sinusitis .

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