Sinus problems are common, causing discomfort that can disrupt daily life, affecting breathing, sleep, and overall well-being. Ear, Nose, and Throat (ENT) doctors, also known as otolaryngologists, specialize in diagnosing and treating conditions of the ears, nose, throat, and related head and neck structures. They address a wide range of sinus conditions, from common infections to complex anatomical issues.
Why Sinuses Need Attention
The sinuses are air-filled cavities located within the bones of the face around the nose, including the forehead, cheeks, and between the eyes. Their healthy function involves producing mucus, which helps to humidify inhaled air and trap foreign particles, and then draining this mucus into the nasal cavity through small openings. When these natural drainage pathways become obstructed or inflamed, a variety of symptoms can arise.
Common conditions leading to sinus congestion and discomfort include acute and chronic sinusitis. Acute sinusitis is a short-term infection, often viral, causing inflammation of the sinus lining and symptoms like facial pain, pressure, nasal congestion, and discolored discharge. Chronic sinusitis involves inflammation lasting 12 weeks or longer, often caused by bacterial infections, nasal polyps, or structural abnormalities.
Allergies can also trigger sinus inflammation. Nasal polyps, which are non-cancerous growths, and a deviated septum, where the wall separating the nasal passages is off-center, can physically block sinus openings and impair drainage. These conditions cause symptoms such as facial pressure, pain, nasal obstruction, reduced smell and taste, and a feeling of fullness.
How ENTs Address Sinus Congestion
ENT specialists use medical management and procedures to alleviate congested sinuses. Medical treatments aim to reduce inflammation and promote natural drainage. These include antibiotics for bacterial infections, oral corticosteroids for severe inflammation, nasal steroid sprays, antihistamines for allergies, and saline rinses to clear mucus.
When medical treatments are insufficient, ENTs may consider minimally invasive procedures. Balloon Sinuplasty involves inserting a small balloon catheter into the sinus opening and gently inflating it to widen the passage, restoring natural drainage without removing tissue. This approach reshapes the sinus anatomy to improve airflow and mucus clearance.
For persistent or severe blockages, surgical interventions like Functional Endoscopic Sinus Surgery (FESS) are performed. During FESS, an endoscope is inserted through the nostrils to visualize the sinus passages. The surgeon uses specialized instruments to remove obstructions such as diseased tissue, polyps, or bone that impede drainage and airflow. This procedure directly clears the pathways, allowing the sinuses to function more effectively.
What to Expect from Sinus Procedures
Before a sinus procedure, patients typically undergo a thorough diagnostic process. This often includes an initial consultation, a nasal endoscopy to directly view the nasal and sinus passages, and a CT scan to provide detailed images of the sinus anatomy and identify the extent of inflammation or blockages. The ENT specialist will discuss treatment options, explaining the benefits and risks of each, to determine the most suitable approach.
During the procedure, most sinus surgeries, including FESS, are performed under general anesthesia, ensuring the patient is unconscious and feels no pain. Some procedures, like Balloon Sinuplasty, may be done with local anesthesia and sedation. These are typically outpatient procedures, meaning patients can return home the same day.
Following the procedure, patients can expect a recovery period with common symptoms. Mild to moderate pain, nasal congestion, and bloody discharge are normal during the first few days to a week. Post-operative care usually includes frequent saline nasal rinses to keep passages clear and aid healing. Patients are advised to avoid forceful nose blowing for one to two weeks, and to refrain from strenuous activities or heavy lifting. While initial recovery may take a few weeks, full healing can take several months.
Knowing When to See an ENT
Knowing when to consult an ENT for sinus issues is important for effective management. If symptoms persist for more than 10 to 12 days without improvement, despite home remedies or over-the-counter medications, an ENT visit is advisable. Recurrent acute sinus infections, occurring multiple times within a year, also warrant specialized evaluation.
Other indicators for seeking an ENT’s expertise include severe facial pain or pressure that impacts daily life. A persistent loss of smell or taste, chronic congestion that makes breathing difficult, or symptoms accompanied by fever, changes in vision, or facial swelling are reasons for prompt consultation. These symptoms suggest an underlying issue that may require a specialist’s diagnosis and targeted treatment.