Normally our sinuses the empty space behind our cheeks, forehead and eyes act as an insulator and a humidifier. They help make our heads lighter, give resonance to our voices and, in case of a blow to the head, may even provide some helpful padding.
But to the sufferer of sinusitis, these useful little cavities can be a source of agony and exhaustion.
In addition to congestion, coughing and a runny nose, sufferers may lose the sense of smell, have painful pressure in the face and ears, feel pain in their teeth and even experience bad breath.
But many sufferers tend to endure these symptoms rather than seek treatment, according to the Asthma and Allergy Foundation of America, which found in one survey that about half of sinusitis sufferers misdiagnosed their condition and 36 percent failed to contact a physician.
They feel its nothing life-threatening, so let me just deal with it. Ill carry my meds and my tissues. But theyre not productive, said Angel Waldron, a spokeswoman for the foundation. Theyre showing up for work and showing up for school, but so much of their day is battling [symptoms]. Theyre just not productive.
In fact, the Centers for Disease Control and Prevention estimated in its last National Health Interview Survey that close to 30 million adults in the U.S. had been diagnosed with sinusitis, or about 13 percent of Americans over 18.
Simply defined, sinusitis is an inflammation of the sinuses. Allergy and asthma sufferers are typically more prone to sinusitis, but it can also be triggered by a cold, bacterial infection or structural problems.
In most cases, sinusitis goes away in about two weeks with simple treatments like decongestants, hot packs, salt water rinses and dehumidifiers, according to the American Academy of Allergy Asthma and Immunology. Prolonged sinusitis can typically be treated with antibiotics or steroids. And allergy and asthma sufferers may be prescribed other treatments that help prevent sinus inflammation.
But for some, sinusitis may become chronic, with the cavities persistently inflamed and blocked. Chronic sinusitis is typically defined as lasting more than three months.
In such cases, surgery can be an option. And thanks to advances in technology, doctors can now operate with far greater care, precision and ease, said Dr. Rolando M. Molina, a board-certified otolaryngologist and a partner in South Florida ENT Associates.
In the old days, we didnt have cameras and fancy equipment to safely and adequately take out the disease. Wed just make openings and holes, hoping the disease would drain out, Molina said. Now we have CAT scans and we actually know where the disease is hiding and where it is stuck.
Using the CAT scan, doctors can determine whether a patient is a candidate for surgery. Then, with the help of GPS, they can literally plot out a course in millimeters, creating a road map of the sinuses and using endoscopy, performing surgery as minimally as possible, he said.
The imagery lets us accurately go after the sinuses that are blocked and leave alone the ones that arent blocked, he said.
Once the inflammation is removed, Molina, who performs the surgery at Baptist Hospital, said doctors typically come up with a plan to better maintain the sinuses.
Doctors have gotten so good at the surgery, that in many cases it can be performed as an outpatient procedure. One such advancement that has dramatically improved results is the use of balloons, a technique similar to what cardiologists use in heart surgery.
Where before you had to open the chest and take the clogged artery and put in a new vein, when angioplasty came along, you took the same clogged artery and you could remove the stuff clogging the artery, he said. So we take the same balloon technique and were able to find the area narrowed or blocked and with a balloon, dilate those sinuses and irrigate them.
Molina pointed out that while the CAT scan and GPS greatly assist doctors, once they are in surgery they may encounter other issues.
Its a surgical road map for the planning stages. But when youre actually in the operating room and looking in the cameras, we may encounter areas not obvious on the CAT scan and have to tailor it, he said. We may find blockage because of a polyp or small tumor. The CAT scan may show inflammation, but not the details.
Still, the advancements have dramatically changed how surgery is performed and patients respond.
Surgery nowadays is not your grandfathers surgery, he said.
Nowadays, its very high tech using imagery and balloons that allow us to operate with the greatest care and least discomfort.