Chronic Sinusitis and Surgical Treatment

Symptoms of chronic sinusitis vary from person to person but are generally long-lasting.
Most common symptoms
• Continuous nasal congestion
• Fullness or pain in the face, teeth, and around the eyes
• Headache
• Dark colored nasal discharge or postnasal drip
• Decreased or loss of the sense of smell
• Bad breath
• Fatigue and easy tiring

Chronic sinusitis usually arises from a combination of multiple factors.
Common causes
• Recurrent or poorly treated sinusitis infections
• Nasal polyps
• Allergic rhinitis
• Nasal bone curvature (septal deviation)
• Adenoid enlargement
• Smoking and air pollution
These factors cause the sinus openings to become blocked and secretions inside the sinuses cannot be emptied.

Diagnosis begins with the patient’s complaints and an ear, nose, and throat examination.
Diagnostic methods used
• Nasal endoscopy: Detailed evaluation of the inside of the nose and sinus openings is performed
• Computed tomography (CT): Ideal for evaluating the anatomical structure of the sinuses and the extent of inflammation
• Allergy tests
• Nasal culture when necessary
CT is the gold standard for surgical planning.

Treatment is planned according to the severity and cause of the disease and the patient’s previous treatments.
Medical (drug) treatment
• Nasal sprays containing cortisone or saline
• Antibiotics (when necessary, long-term)
• Allergy treatments
• Nasal wash solutions
Many patients find relief with drug treatment. However, if complaints continue despite the medication, surgical options come into play.
Surgical Treatment Options for Chronic Sinusitis

Functional Endoscopic Sinus Surgery (FESS)
FESS is the most frequently used surgical method in the treatment of chronic sinusitis. With the help of an endoscopic camera and micro
surgical instruments, the sinus openings are opened and inflamed tissues and polyps, if any, are cleaned.
Advantages:
• Minimal invasive method (no facial incision scar, etc.)
• Less bleeding
• Faster healing process
Who is it suitable for? Patients who do not respond to drug treatment and have blocked sinus passages.

Balloon Sinus Dilation
In this method, the sinus openings are widened with the help of a balloon. Sinus drainage is provided without removing tissue. It is a method developed especially for the frontal sinus.
Advantages:
• Short procedure time
• Low risk of complications
• Quick return to daily life
Who is it suitable for? Patients with mild and moderate sinus obstruction.

Septoplasty
If the cause of chronic sinusitis is nasal bone curvature, the nasal airway is corrected with septoplasty. It can be performed together with sinus surgery if necessary.

• There may be nasal congestion and mild pain in the early days
• Nasal wash treatments accelerate healing
• Most patients return to normal life within 1–2 weeks

Surgical treatment provides long-term relief in most patients. However, sinusitis may recur if allergies, smoking, and environmental factors continue. For this reason, regular follow-up and lifestyle changes are important

Risks are quite low when performed by experienced surgeons. Possible risks:
• Bleeding
• Infection
• Rarely problems with the eye area or vision
• Rarely skull base problems and cerebrospinal fluid leakage problems