How is Sinusitis Treated?
Sinusitis is generally first treated with antibiotics, decongestants and/or anti-inflammatory drugs. If medication is not effective, or if there is a blockage, surgery is generally recommended. Your ENT specialist will prescribe medications (antibiotics, decongestants, nasal steroid sprays, antihistamines) and procedures (flushing) for treating acute sinusitis.

Surgical Treatment
The most common corrective surgery approach for treatment of acute or chronic sinus inflammation is endocscopic sinus surgery or navigated sinus surgery, or a combination of both. Both techniques are much less invasive than older conventional surgical methods. Nevertheless, the extent of sinus disease varies from person to person. Surgery may therefore be a relatively minimal procedure or an extensive and prolonged operation.

Even with a long regimen of antibiotics, chronic sinusitis symptoms can be difficult to treat. In general, however, treating chronic sinusitis, such as with antibiotics and decongestants, is similar to treating acute sinusitis. When antibiotic treatment fails and infections are recurrent and/or non-responsive to the medication, allergy testing, desensitization, and/or surgery may be recommended as the most effective means for treating chronic sinusitis. When this occurs, surgery to enlarge the openings that drain the sinuses is an option. Research studies suggest that the vast majority of people who undergo surgery have fewer symptoms and better quality of life.A trained surgeon can now treat sinusitis with minimal discomfort, a brief convalescence, and few complications.

Functional Endoscopic Sinus Surgery (FESS)
Developed in the 1950s, the nasal endoscope has revolutionized sinusitis surgery. In the past, the surgical strategy was to remove all sinus mucosa from the major sinuses. The use of an endoscope is linked to the theory that the best way to obtain normal healthy sinuses is to open the natural pathways to the sinuses. Once an improved drainage system is achieved, the diseased sinus mucosa has an opportunity to return to normal. FESS involves the insertion of the endoscope, a very thin fiber-optic tube, into the nose for a direct visual examination of the openings into the sinuses. With state of the art micro-telescopes and instruments, abnormal and obstructive tissues are then removed. In the majority of cases, the surgical procedure is performed entirely through the nostrils, leaving no external scars. There is little swelling and only mild discomfort. The advantage of the procedure is that the surgery is less extensive, there is often less removal of normal tissues, and can frequently be performed on an outpatient basis.

Image-Guided Surgery
The sinuses are physically close to the brain, the eye, and major arteries, always areas of concern when a fiber optic tube is inserted into the sinus region. The growing use of a new technology, image-guided endoscopic surgery, is alleviating that concern. This type of surgery may be recommended for severe forms of chronic sinusitis, in cases when previous sinus surgery has altered anatomical landmarks, or where a patient's sinus anatomy is very unusual, making typical surgery difficult. Image-guidance is a near-three-dimensional mapping system that combines computed tomography (CT) scans and real-time information about the exact position of surgical instruments using infrared signals. In this way, surgeons can navigate their surgical instruments through complex sinus passages and provide surgical relief more precisely.