Why do we have sinuses?
-
Humidifies air
- Purifies air
- Warms air
- Makes head lighter
- Crumple zone
How We Breath
What effects how we breath?
- Nasal Cycle
- Temperature
- Exercise
- Head Position
- Menstrual Cycle
- Pregnancy
- Allergy
- Infection
- Medication
How sinuses work?
Mucociliary 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?
- Anatomy
- Allergy
- Infection
- Neoplasm
Anatomy
- Deviated Septum
- Concha Bullosa
- Haller Cells
Acute/Subacute Rhinosinusitis
Chronic Rhinosinusitis (CRS)
Fungus Ball
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
Septoplasty
Requires 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
