Sinusitis can affect everyone, regardless of age. Acute sinusitis can be cured within an average of a week with the correct diagnosis and treatment. However, if it becomes chronic, surgical treatment comes to the agenda.

"Rhinosinusitis", commonly known as sinusitis, is a common disease in the community. The confusion in its definition stems from the separate treatment of the nose and sinuses. However, as the nose and sinuses are whole, the diseases seen here do not separate from each other. Sinusitis is always accompanied by nasal infection.

Beware of the Pain in the Face!

Different causes are playing a role in the emergence of the disease. In some cases, an external microbe, anatomical stenosis, allergic constitution or laryngeal reflux can cause rhinosinusitis. Significant symptoms are listed as pain, nasal congestion, nasal and nasal discharge, cough, breath odor, and sputum in the head, especially in the face, on the sides of the head, and at the top. Stating that sinusitis is divided into two, Yeditepe University Hospitals Ear, Nose, and Throat Diseases, Head and Neck Surgery Specialist adds: "Sinusitis is divided into two groups as acute and chronic. If the disease resolves within four weeks, it is considered acute sinusitis, and if it lasts longer than 12 weeks, it is considered chronic sinusitis. Between 4-12 weeks, it is called subacute sinusitis. There are effective drugs used in the treatment of acute sinusitis. If the correct diagnosis is made, the correct treatment is started, and the patient adapts to the treatment, recovery is achieved within an average of a week. In some cases, treatment time may be longer. If no results are obtained, this indicates that the disease is chronic, in which case surgical treatment is on the agenda."

Can Be Present in the Brain and the Eyes

Chronic sinusitis can also lead to other disorders. For example, it can go down the respiratory tract, down to the lungs, and turn into pneumonia. Many patients who consult chest disease specialists and are diagnosed with pneumonia may have underlying sinusitis. Chronic sinusitis plays a key role in this. Sometimes it can lead to complications in the brain, such as meningitis or brain abscess. If it splashes into the eye, it can lead to abscesses, blindness, and even death in specific cases. Although the thought of a person losing their life due to sinusitis is surprising, our specialist says that such situations have been encountered in the recent past, but today, such cases are very rare thanks to both the diagnosis and the development of treatment methods, and about the risky groups: "Sinusitis occurs more easily if the patient has some diseases such as cystic fibrosis, immotile cilia syndrome, allergy, nasal polyp, laryngeal reflux, or some anatomical problems. Such ailments make treatment difficult as well as sometimes impossible."

Imaging Is Performed When Necessary

The patient, who presented to the physician with symptoms such as headache, respiratory tract infections, and nasal discharge, was first examined with the help of an endoscope. Computerized tomography is also used when necessary. However, underlining that not every sinusitis patient undergoes computed tomography (CT) so that the patient does not receive unnecessary radiation, our ENT specialist says, "CT is requested if there is no improvement in the patient, if surgical treatment is considered, or if a spread or complication is suspected in the patient's brain, eye or another organ, despite appropriate and adequate treatment."

Surgery is the Only Choice for Adults

Bacteria play a key role in the emergence of the disease. Therefore, it is sufficient to use drugs against these microorganisms in the treatment of acute sinusitis. Our specialist, who pointed out that additional drugs for allergies or reflux, if any, as well as antibiotics, should be included in the treatment, adds: "In chronic sinusitis, our main treatment principles are functional endoscopic sinus surgery and balloon sinuplasty. With this method, which has been applied for about 20-30 years, close to 100 percent of successful results are achieved. However, this does not mean that every patient with chronic sinusitis necessarily needs surgery. The criterion here is the impact of the disease on one's life! First of all, it is necessary to answer questions such as how much the disease forces the person, what effect it has on their social life and business life, how often they need to go to the doctor, and how much drug they should use. In childhood, endoscopic sinus surgery can be performed as needed from the age of 8-10. However, it is of great importance that the surgeon who will perform the surgery on children is very careful. Because children's anatomically bone structures are delicate, small, and thin! Since the bone wall is thin, it is more common in children to spread sinusitis to the eye, but surgery is not always necessary. Surgery stands out only in cases that progress and lead to orbital abscess and vision loss. In adults, surgery is the only option. Although it can be used in every patient, this drug should be discontinued one week before surgery in those who use blood thinners." The main goal of endoscopic sinus surgery is to save patients from complaints such as headache, nasal discharge, halitosis, and cough caused by sinusitis, and to protect patients from much worse conditions by spreading the disease to the eye or brain. However, having sinusitis surgery does not mean that you will never have sinusitis again. Because everyone who continues their social life is likely to get germs from someone with an upper respiratory infection. So even if the person undergoing surgery has an acute upper respiratory tract infection or acute sinusitis, it never becomes chronic and progresses to prolonged and risky conditions."

Balloon Treatment For Sinusitis

One of the current methods used in sinus surgery for the treatment of chronic sinusitis is balloon sinuplasty! Although this procedure, which was applied in Turkey one year after it was started to be used in the USA about 15 years ago, is a surgical method, it allows entering all sinuses on the face without the need for any surgical instruments or incisions, to open the mouths of the sinuses and clean the inside, to ventilate the sinuses and to heal chronic sinusitis. Ear, Nose and Throat, and Head and Neck Surgery Specialist stated that high cost is an important factor in the prevalence/not exceeding of balloon sinuplasty and said, "In this method, which is as effective as endoscopic sinus surgery, all sinuses can be opened easily with balloons and the results are as successful as other surgical methods. We have not used tampons in balloon sinuplasty surgeries such as rhinoplasty, septum deviation, and endoscopic sinus surgery for the last seven to eight years. In this way, the patient's return to daily life after surgery is much faster and treatment duration is shortened."

This content was prepared by Yeditepe University Hospitals Medical Editorial Board.

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