Chronic Sinusitis

Chronic sinusitis is generally defined as inflammation of the sinuses and nasal passages lasting more than three months (acute sinusitis, usually caused by viruses or bacteria, usually clears more quickly sometimes with antibiotic treatment). This inflammation in the sinuses may be linked with several different factors, including the body’s immune response to multiple triggers, such as allergens, bacteria, fungi or other toxins. Chronic sinusitis can also result from infection or a blockage, caused by a physical defect (such as a deviated septum or nasal polyps).

Sinusitis diagram

Treating Chronic Sinusitis

Treatment for chronic sinusitis is based on a thorough patient history and complete examination, including nasal endoscopy, to determine the best care plan. Medical therapy is the first step in treating chronic sinusitis, with the goals of reducing sinus inflammation, promoting drainage and eliminating infections that may be present. Medical treatments can include antibiotics, nasal and sinus rinses, topical nasal steroids, immunotherapy, antihistamines and decongestants. Other research suggests that some patients with chronic sinusitis may benefit from control of gastroesophageal reflux disease (GERD), though the exact relationship between GERD and sinusitis isn’t completely understood.

Endoscopic Sinus Surgery

When chronic sinusitis resists medical treatment and medications, sinus surgery may be an option. Surgery may also be indicated when a physical abnormality is the cause of symptoms, such as a deviated septum or nasal polyps.

How is endoscopic sinus surgery performed?

Advanced sinus surgery at Virginia Mason Medical Center, in Seattle, Washington, is performed with a miniature high definition camera and small endoscope, assisted by a high definition video monitor. Our ear, nose and throat specialists have additional intensive training in Rhinology (nose and sinus surgery). Their expertise allows for the highest level of precision nasal surgery. In addition to superior visualization with the endoscope, they use Computer aided Image Guidance, via detailed CT scans, to create a virtual GPS system inside the sinuses during surgery.

Most surgeries are done on an outpatient basis, allowing patients to go home the same day. If you have questions or would like more information about endoscopic sinus surgery, call our team at (206) 223-6374.

Does endoscopic sinus surgery usually work?

Yes. However the careful selection of patients remains the best predictor of who will benefit from sinus surgery. When overlapping symptoms are caused by another disease state, such as migraine headaches, sinus surgery may do little to improve those symptoms.

It is important to remember endoscopic sinus surgery does not cure chronic sinusitis. Rather it works to reduce inflammatory triggers by opening the sinuses, removing obstructions and washing out the sinuses. This makes future medical therapy more effective, which often continues after sinus surgery to help prevent recurrence of severe inflammation and symptoms.

If you have questions or would like more information about endoscopic sinus surgery, call our team at (206) 223-6374.