Nose & Sinus
Sinusitis and Nasal Polyps
Where are my sinuses?
Your sinuses are cavities in the bones that surround your nose. There are 4 main pairs of sinuses, these are called the:
- Frontal sinuses - these are located in the bones of your forehead, just above each eye.
- Maxillary sinuses – these are found in the cheeks.
- Ethmoid sinuses – these are located between your eyes, on either side of the bridge of your nose.
- Sphenoid sinuses – right at the back of the nose.
Your sinuses are lined with a pink “skin” called a mucous membrane and on top of this sits a thin layer of mucus. This mucus layer is moved by tiny hair cells called Ciliated Cells and keeps the sinuses clean, this process is called much-ciliary clearance. Most of the sinuses drain into the nose through a small gap in the bones known as the middle meatus. The ciliated cells then move the mucus to the back of the nose where it, and any debris contained in it is swallowed. Stomach acid then kills any germs in the mucus.
What do my sinuses do?
Our sinuses are believed to help moisten the air we breathe in, they lighten the bones of our skull and they may also improve the sound of our voices.
What problems can affect my Sinuses?
Acute sinusitis is a painful infection of the sinuses. It is most commonly caused by viruses identical to those that cause the common cold. Bacterial sinusitis is less common, but if untreated, can cause serious complications. Symptoms of acute sinusitis include a blocked nose, fever, pain in the sinus regions and discoloured nasal mucus.
Chronic sinusitis is a process of inflammation in the sinuses that lasts for 3 months or longer. Symptoms include a blocked nose, nasal discharge, a decreased sense of smell and tenderness around the sinuses.
Allergic rhinitis (hay fever) affects 1 in 5 Australians. It occurs when the tissues in your nose and sinuses overreact to allergens such as pollens, dust mites or animal dander. Allergic rhinitis can cause a runny or blocked nose, sneezing and itching.
What are nasal polyps?
Nasal polyposis is a type of chronic sinusitis. Nasal polyps are soft, painless, benign growths in the nasal passages and sinuses. They can cause a blocked nose, decreased sense of smell but only rarely do they cause recurrent infections.
How will my doctor diagnose what is wrong with my sinuses?
At My ENT Specialist, Dr McGuinness will take a detailed history and performa physical examination. During rhinoscopy, a small flexible tube with a camera on the end, is used to see the inside of the nose. This is helpful to see whether there is any infection, polyps or other causes for your symptoms. We will often organise a blood test to check for allergies. For more severe sinusitis a CT or MRI scans may be useful in order to see more clearly the amount of infection in the sinuses.
How are sinus problems treated?
After making a diagnosis of the type, severity and cause of your sinus problems, Dr McGuinness will advise on the best treatment. We generally recommend a “Pyramid” approach starting with simple treatments first and building up to more involved treatments only when required.
Simple treatments include nasal saline rinses, allergy avoidance and antihistamines. Sometimes a stronger nasal steroid rinse such as Pulmicort is used often in combination with an antibiotic. Cases that do not respond to medical treatment may require surgery.
Surgery is usually performed via the nostrils (Functional Endoscopic Sinus Surgery or FESS) and may involve removing nasal polyps, or opening the natural drainage pathways to improve sinus drainage and ventilation. It is often combined with surgery to improve the breathing – septoplasty and turbinoplasty. Any surgical sinus procedure does involve specific, yet minimal complication risks. These will be discussed with you in detail during your appointment at My ENT Specialist.
