Sinusitis

Updated 28 August 2017

Do you need surgery to stop your sinus infections?

When you've just about had enough of battling your sinus infections, it may be time to consider going under the knife.

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Once again, you wake up unable to breathe and your head feels like it's going to explode.

You've exhausted most options trying to manage a condition which is slowly wearing you down. Nothing seems to alleviate the buildup and pressure in a never-ending series of sinus infections. 

A last resort

Dr Azgher Karjieker, a Cape Town ear, nose and throat (ENT) specialist, told Health24 that surgery to alleviate sinus problems may be considered when all other options have been exhausted. And doctors use a telescope, knife and chisel for these surgical procedures. It might sound invasive, but it's generally not dangerous procedure. 

"Surgery is a last resort when the best medical treatment has failed or when the mechanical obstruction of the nose does not allow nasal sprays to enter the nose. The best medical treatment includes antibiotics, oral steroids and nasal sprays," says Dr Karjieker.

"Once you and your specialist have tried all other options to improve your sinus functionality, and all have failed, a CT scan of the sinuses will be able to show the extent of abnormalities and infection.

"From the scan, we will be able to determine the surgery required. Sinuses are gaps within the facial bones which produce mucus all the time, which is meant to exit the sinus cavities via tiny drainage holes.

"If these drainage holes are blocked, the mucus builds up under pressure and worsens if infected. It's these blocked drainage holes which could be surgically widened, if necessary. This would restore normal function to the sinuses," says Dr Karjieker.

Severe abnormalities

Generally, the procedure isn't too invasive and the procedure is performed via the nostrils using telescopes and various other instruments such as an endoscope, along with special, delicate endoscopic instruments.

Things could however become more serious, should your specialist discover severe abnormalities which could become life-threatening at a later stage in life – such as a deviated septum.

"Most sinus sufferers have a deviated nasal septum," Dr Karjieker adds. This, combined with swollen nasal lining, due to allergies, blocks the sinus drainage holes. This means septoplasty usually forms part of the sinus surgery procedure."

People may be born with a deviated septum, but it could also be the result of injury to the nose.

The procedure doesn't really entail a great amount of cutting, but it could be slightly uncomfortable. Your nose won't be entirely reconstructed, but your nasal passages will end up being straight, which allows for proper airflow.

Lifestyle changes

If you're not quite ready for surgery, you can try certain techniques and changes to your lifestyle (coupled with medication to manage buildup):

  • Flush the nasal passages with a neti pot.
  • Drink more water to thin the mucus.
  • Inhale steam with a few drops of eucalyptus or menthol crystals.
  • Sleep with your head higher to aid with mucus drainage.
  • Try to make your house as allergy-proof as possible (e.g. remove carpets).

"People need to stop smoking, drink fewer caffeinated drinks and more water. Weight could be a factor as well, so one should consider a weight loss programme," says Dr Karjieker.

He adds that if you need a glass of water on your bedside table at night, you should consider seeing an ENT, because waking up during the night with a dry mouth and throat (chronic mouth-breathing) is abnormal. Struggling to breathe through your nose while sleeping and exercising is also an indication that something's not right.

Image supplied by iStock

 

Ask the Expert

Sinusitis Expert

Dr Gary Kroukamp MBCHB, FCORL(SA) is an ENT Specialist, practising from rooms at Kingsbury Hospital in Claremont, Cape Town. He also has a teaching sessional appointment as an ENT Consultant at the Tygerberg Hospital. He is a member of the ENT Society of South Africa and the South African Cochlear Implantation Group. His interests in the ENT field include sinusitis and sinus surgery, nasal allergy and ENT conditions in children.

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