Why do we have sinuses?

  • Rosenberg Scope

    Humidifies air
  • Purifies air
  • Warms air
  • Makes head lighter
  • Crumple zone 

 

Septum of NoseLateral Wall of Nose

 

How We Breath

How sinuses workWhat effects how we breath? 

  • Nasal Cycle
  • Temperature
  • Exercise
  • Head Position
  • Menstrual Cycle
  • Pregnancy
  • Allergy
  • Infection
  • Medication

How sinuses work?

Mucociliary FlowMucociliary Flow

1-2 liters of mucus a day!

Increases with:

  • Air Pollution
  • Smoke
  • Infection
  • Allergies

Post nasal drip

Works best:

  • Warm
  • Moist
  • Oxygen-rich
  • Alkaline

Works worst:

  • Dry
  • Smoke
  • Foreign Body
  • Swelling
  • Contact

What can go wrong?What can go wrong?

  • Anatomy
  • Allergy
  • Infection
  • Neoplasm

Anatomy

  • Deviated Septum
  • Concha Bullosa
  • Haller Cells

Acute/Subacute Rhinosinusitis

Acute/Subacute Rhinosinusitis Acute/Subacute Rhinosinusitis

Chronic Rhinosinusitis (CRS)

Chronic Rhinosinusitis

Fungus Ball

Fungus Ball

Fungus Ball Fungus Ball

Nasal Polyps

Nasal Polyps Nasal Polyps

Treatment of sinus problems

Goals

  • Restore drainage of sinuses
  • Restore aeration to the sinuses
  • Re-establish normal airflow dynamics
  • Remove diseased tissue

Treatment options

  • Environmental control
  • Immunotherapy (allergy shots)
  • Medicines
  • Surgery
  • Combination

Sinus medications

  • Saline
  • Antihistamines
  • Decongestants
  • Steroids
  • Leukotriene antagonists
  • Antibiotics

Inferior Turbinate Reduction

Coblation: Opens the narrowest part of the nose

  • Office Procedure
  • Local Anesthesia

Inferior Turbinate Reduction Inferior Turbinate Reduction

Septoplasty

  • SeptoplastyRequires general anesthetic
  • Performed through a small incision inside the nose
  • Remove only what is necessary
  • Outpatient surgery

Functional Endoscopic Sinus Surgery (FESS)

  • Minimally Invasive
  • Outpatient Procedure
  • Establishes natural drainage of sinuses

Sinus Surgery

  • Requires a general anesthetic
  • Outpatient surgery
  • Length of surgery 30 min - 2 hours (average 1hr)
  • Image Guidance

Surgical Technique

  • Open sinuses in a systematic, graduated approach
  • Performed through the nose with endoscopes (NO INCISIONS)
  • Remove only what is required to restore function
  • Reduce turbinates; Septoplasty

Balloon Sinuplasty

  • Ultra-Minimally Invasive
  • Office Procedure
  • Local Anesthesia
  • Establishes natural drainage of sinuses

Balloon Sinuplasty Balloon Dilation Final Result