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An otolaryngologist—head and neck surgeon will, for the most part, advocate surgery when antibiotics and other medical treatments fail to alleviate chronic sinusitis or multiple episodes of acute sinus infection.
Antibiotics are generally effective for most cases of acute sinusitis resulting in severe facial pain and pressure. Twenty years ago, otolaryngologist —head and neck surgeons would perform surgery on the individual sinuses that had become infected, leading to the use of procedures such as the Caldwell-Luc operation.
The endoscopic procedure usually lasts from one to three hours and is performed using general or local anesthesia. In addition to fevers, an infection in sinus will cause headaches and thick fluid from the nose.
When you have decided that it is bacterial infection, the treatment is amoxicillin 500mg three times daily for 7 days. Before considering surgery, the otolaryngologist will typically prescribe four to six weeks of antibiotics plus sprays, decongestants, and possibly antihistamines and steroids.
Other treatments for lingering symptoms include sinus irrigation, which requires the placement of an instrument in the maxillary sinus to flush out that cavity with salt water. In the past, operations on the sinuses were conducted externally through incisions on the face. Since then, the development of endoscopic sinus surgery (ESS) ushered in a new philosophy allowing the surgeon to target the ostiomeatal complex (OMC), an area in the anterior ethmoid sinus region.


Generally, the patient goes home after surgery unless other medical conditions complicate recovery. Attribution to the American Academy of Otolaryngology—Head and Neck Surgery is required.
First, you should ask yourself if the patient has a bacterial infection requiring antibiotics. Incisions were made under the upper lip through the gum (the Caldwell-Luc operation) or an external ethmoidectomy, a removal of the sinuses between the eyes through an incision in the face. Obstruction in the OMC can lead to subsequent infection of the maxillary, frontal, and sphenoid sinuses. A severe infection of the frontal (forehead) or sphenoid sinus (behind the eyes) can be very serious. However, most surgical procedures for the sinuses are now carried out using endoscopic sinus surgery. Accordingly, endoscopic sinus surgery, a procedure through the nose, removes thickened and diseased tissue that blocks the OMC.
Dry blood, mucus, and crusting in the nose may occur, presenting symptoms of a severe cold or sinus infection.
If oral or intravenous antibiotics are not effective, surgical drainage of the sinus may be undertaken.


Nasal irrigation or salt-water sprays and antibiotic lubricants as recommended by the surgeon to facilitate normal sinus activity. The sphenoid sinus can be accessed surgically through the nose or through an incision under the eyebrow. Endoscopic surgery can also be utilized for removal of polyps and to straighten the septum thus restoring a normal flow from the sinuses.
Proper post-operative care is essential to prevent scar formation and allow normal healing. Unlike other sinus surgical procedures, endoscopic sinus surgery has minimal and usually temporary effect on the patient's appearance.
The surgeon performing the procedure will generally perform all required follow-up procedures. Patients who depend on their voice for their livelihood should be warned that endoscopic sinus surgery may have an effect on their resonance. Additionally, some patients may have underlying nasal mucosal problems that remain after surgery.




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09.08.2014 admin



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