What is sinusitis and how is it treated?

Sinuses are air-filled pockets close to the nasal cavity. The sinuses produce mucus. This fluid cleans bacteria and other particles from the air you breathe.

Sinusitis is an infection of the lining of the sinuses near the nose. These infections often occur after a cold or as a result of allergies. There are 4 types of sinusitis:

Acute Sinusitis: Symptoms last less than 4 weeks and improve with the right care.

Subacute Sinusitis: This type of infection is not cured by treatment at first. Symptoms last 4 to 8 weeks.

Chronic Sinusitis: Chronic infection happens with repeated or inadequately treated acute infections. These symptoms last 8 weeks or longer.

Recurrent Sinusitis: If you have an attack of acute sinusitis 3 or more times a year, this is called recurrent sinusitis.

Conditions Causing Sinusitis

Sinus infection can occur after a cold. A cold inflames the nasal passages. This can prevent the sinuses from opening and lead to infection. Allergies can also cause the nasal tissue to swell and produce more mucus, which can lead to sinusitis.

Other conditions that can lead to sinusitis include

Abnormalities in the structure of the nose
Enlarged adenoid
Diving and swimming
Tooth infections
Nose injury
Foreign bodies stuck in the nose
Passive smoking

If the drainage of mucus is blocked, bacteria can start to grow. This leads to a sinus infection or sinusitis. The most common viruses and bacteria that cause sinusitis also cause the flu or some types of pneumonia.

Symptoms of Sinusitis

The symptoms of sinusitis may vary depending on your age. The most common symptoms of sinusitis in some age groups are as follows:

In young children;

Runny nose that lasts longer than 7-10 days. The discharge is usually dark green or yellow, but can also be clear.
Cough at night
Occasional daytime cough
Swelling around the eyes

Older children and adults;

Runny nose or cold symptoms lasting longer than 7 to 10 days
Complaints of dripping from the nose into the throat
Head and throat pains
Facial pain
Difficult breathing
Cough
Fire
Swelling around the eyes

Symptoms of sinusitis may look like other conditions or health problems. An examination by an ENT doctor is necessary for diagnosis.

Sinusitis Treatment

The following methods can be applied in the treatment of sinusitis:

A saline nasal spray that you spray into your nose several times a day to rinse the nasal cavity.
Nasal corticosteroids. These nasal sprays help prevent and treat inflammation.
These medicines are available as tablets and nasal sprays. You only use nasal decongestants for a few days.
Allergy medicines. If your sinusitis is due to allergies, using allergy medicines can help reduce allergy symptoms.
Some painkillers such as acetaminophen, ibuprofen or aspirin.
Sinusitis surgery if medication does not help.

What is Sinusitis Surgery and What Are Its Types?

Sinus infections can leave you feeling exhausted and tired. For people diagnosed with chronic sinusitis for whom prescription medications do not provide relief, sinusitis surgery may be a solution.

Sinusitis surgery opens up natural drainage passageways to provide adequate ventilation and drainage. It also allows a biopsy to be performed to assess the presence of bacteria or tumors in the sinuses.

In our private clinic, we perform various sinus surgeries that are not available elsewhere. ENT specialist Op. Dr. Kemal Demir is also an expert in repairing a failed previous sinus surgery.

What conditions are treated with sinus surgery?

Sinus surgery can be performed to treat many conditions, including

Chronic sinusitis (sinus infection or allergies)
Deviated nasal septum
Nasal polyps
Tumors and cancer of the nasal cavity and paranasal
Sinus cavity
Enlarged adenoid
Enlarged turbinates (nasal flesh)
Sleep apnea

What are the Types of Sinusitis Surgeries?

There are various types of nasal and sinus surgery applied in sinusitis surgery:

Functional endoscopic sinus surgery (FESS): FESS inserts an endoscope equipped with a camera and light into the nose and guides it into the sinuses. This allows the inside of the sinuses to be clearly seen and the necessary interventions to address problems there are performed with surgical instruments passing through the endoscope. This minimally invasive procedure can be used to remove polyps, tumors or other blockages in the nose that impede airflow and sinus drainage.

Septoplasty: This procedure is used to treat problems with the septum, the thin wall of bone and cartilage that divides the nose into two chambers. Normally, the septum is straight. However, sometimes it bends or curves. This is known as a deviated septum. Septoplasty is a surgical procedure to correct a deviated septum to improve breathing and reduce sinus infections and/or nosebleeds. It can be performed using an endoscope or openly through an incision.

Turbinate surgery: The turbinates are thin bones in the nose. They are covered with mucous membrane. When air is inhaled and passes through the nose, the turbinates filter, warm and moisturize the air. Allergies, sinus infections and upper respiratory infections can cause the mucous membrane of the turbinates to become inflamed and enlarged. Enlarged turbinates can block airflow and make breathing difficult. To treat enlarged turbinates, these turbinates or parts of them can be removed. Laser or radiofrequency ablation may be used for this purpose. Depending on the specific procedure used, the surgery may require a small incision or may be performed using an endoscope.

Sinusitis surgery with balloon: Also known as sinus ostial dilatation or balloon ostial dilatation, this minimally invasive procedure is used to treat chronic sinusitis. A thin, flexible tube called a catheter is inserted into the nose and guided into the sinuses. At the end of the catheter is a deflated balloon. When the balloon is placed in the blocked part of the sinuses, the surgeon inflates it, deflates it and then reinflates it. This stretches and opens the affected part of the sinus, which improves drainage and airflow. After the procedure, the balloon and catheter are removed.

Postoperative Process

Sinus surgery recovery is multifaceted. Detailed instructions are given for your care after sinusitis surgery. Instructions may vary from patient to patient, but most people need nasal irrigation, oral antibiotics, oral steroids and pain medication. We usually request a follow-up appointment for one week after surgery.

Some bloody discharge may be seen for about two weeks after the procedure. You should not blow your nose for at least two weeks.

What are the Risks of Sinusitis Surgery?

Bleeding: Although the risk of bleeding in sinus surgery is very low, in rare cases significant bleeding may occur requiring the procedure to be terminated. Postoperative bleeding may require the placement of a nasal plug. Blood transfusion is rarely necessary.

Postoperative Infection: As with any surgical procedure, sinusitis surgery carries a risk of infection. If an infection develops after surgery, antibiotic treatment is administered.

Recurrent Sinus Infections: Although endoscopic sinus surgery offers significant benefits, surgery is not a cure for sinusitis. It may be necessary to continue taking sinus medications after surgery. The main goal of surgery is to reduce the frequency and intensity of symptoms. In some cases, additional surgery may be required.

Other Risks: Some people experience tearing of the eyes due to sinus surgery or sinus inflammation. You may feel numbness or discomfort in the upper front teeth for a while. Swelling, bruising or temporary numbness of the lips, as well as swelling or bruising around the eyes may occur. It is also common to have slight changes in your voice.

Op. Dr. Kemal Demir's Approach to Sinus Surgery

ENT specialist Op. Dr. Kemal Demir is an expert in performing various sinus surgeries and revision sinus surgery if a previous sinus surgery has failed. In addition, he uses the latest image guidance technologies and postoperative treatments.