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Sinusitis

Sinuses are spaces like caves in our skull around our nose fill with air. They open to nasal passage with tiny orifices. They have many functions: They make the skull lighter, provides the resonance of voice, clean the nose with continuous mucous secretion, act like a cushion in haed traumas etc. If they cannot do their functions, they effect the quality of life very much.

Very important developments are achieved in the diagnosis and treatment of sinusitis with the development of endoscopic examiations. Treatment of sinusitis and nasal polyps are very well achieved now. Patient comfort is increased after the operation.


Functional endoscopic sinus surgery

Endoscopes are very popular in many branches of medicine recently. These can be described as hard or flexible cameras. We can see and manipulate many organs and pathologies with the help of them that normally are not possible.
Endoscopes open a new era in ear, nose, throat diagnosis and treatment.
“Endoscopic sinus surgey” is the name given to the operations done by the help of endoscopes in the nose. Advantage is that we can directly see the pathology and can treat with less trauma to the tissues. Besides results are more functional and better.
They bring new techniques to treat sinusitis, vacuum headaches, polyps, tumors. Healing after the operation becomes very quick.
You are getting an important operation even if there is no incision or swelling outside of your nose.
These informations are prepared to help you to have a successful and comfortable operation. Whatever these informations are, if you have any question please do not hesitate to ask your doctor.

Preparation for operation

What to bring with us?

Most patients return to home at the same day. Even low probability to stay at hospital bring your tooth brush and some other things you can need with you.
If you use contact lenses, using glasses will be more comfortable after the surgery.
Leave your valuable belongings at home.
Bring your personal drugs if you have.
Arrange your transport. Since you cannot drive car at least 24 hours after the operation, you may need someone to take you home.
Avoid aspirin. Do not use aspirin or like drugs causing bleeding at leats one week before and after the operation.

Operation day

Anesthesia: It is a branch of medicine that arranges patients to have operation without feeling any pain. Do not afraid of anesthesia. It is not fainting rather controlled sleeping and waking up by the anesthesiologist. During the surgery the specialist will beside you checking your respiration, heart beats, blood tension and other vital signs.
Necessary tests will be performed before surgery. Patients undergoing general ensethesia should have an empty stomach, therefore you should not eat or drink at least 6 hours before surgery. If stop smoking five days ago, you will be more comfortable after the operation.
Anesthesia will be according to your needs, heavy or light anesthesia means nothing.
Patients just after anesthesia are sleepy even they can answer your questions, do not worry.

After operation:

Patient stays at the rooom after the operation until doctors decide according to the situation of the patient. Patient is discharged at the same or the day after surgery.
Nasal pack: You most probably have a nasal tampon after the operation. Tampon changes according to the type of the operation. A gauze may be present under your nose just to suck the blood if comes from your nose. This is changed when filled with blood. Tampon in your nose will be taken out by your doctor when needed to be.
Pain: There may be a little pain after the operation therefore pain killers are used. Please take the analgesic that is adviced, do not use any analgesic like aspirin or aspirin containing.
If you want we inform your familiy after the operation even if they are not with you at the time of the operation.

Diet: There may be a little stomach upset after the operation. First 24 hours after the operation we advice you to eat light food mostly liquid. Do not eat spicy food to prevent sneezing. Also avoid very hot beverages.

First week after the operation

Avoid heavy physical activities. They may increase the blood pressure and cause bleeding.

Nasal care: Do not sneeze your nose first week. If mucous or blood accumulate in yoru nose, take them inside with a light breath and spit them out. You will see drainage of bloody mucous in your nose first week, do not afraid of it. If high amount of blood comes then contact to your doctor. Even sometimes scant amount of blood can come out of the nose in one month.
Do not insert anything in your nose. If dry blood blocks the entrance of your nose, you can take it with cottons immersed with oxygen smoothly.

Sneezing: If you have to sneeze do it as your mouth open, so you do not give any pressure to your nose.

Flight: Air is dry in the planes therefore you need to moisture your nose while flying. You may feel pressure in your face also therefore ask your doctor to take decongestant drugs.

Drying of lips: Your lips may dry because of mouth breathing. You can use lipsticks or vaseline to moisture them.

Discomfort after the operation: A little pain and pressure feeling occur rather than an intense pain. Swelling inside of the nose and secretions in the sinuses may cause pressure feeling. Raise your head while lying may ease the problem.

First control after the operation: Your follow up and controls are very important for your healing. These controls are mostly painless do not afraid of them.

First months after the operation

Physical activity: You can do aerobic after one week, try to not to get trauma to your nose first month. Do not swim first two weeks.
Healing period: Your tissues will be best after after six weeks. Sometimes you can feel blockage of nose, this is normal.
Do not forget, healing is a process not an event.


Nazal Polyp

What is polyp?

Polyp means sagging of the mucosa inside an hollow organ. Polyps can occur in all mucosal linings like digestive system, respiratory system etc. Nasal polyps are mucosal saggings into the sinuses and nasal passages changing in number and
bigness. It mostly starts as a damage of the mucosa.

What causes polyps?

Exact mechanism is not known but persistant irritation causing mucosal damage is suspected. Chronic infections, chronic irritaion of the nose, familial reasons can cause polyps. They occur in some astma and nearly all cystic fibrosis cases also.

What do they cause?

They obstruct the nasal passage and can cause mouth breathing, headache, snoring, sleep apnea, dry mouth and irritation, prolongation of rhinitis and sinusitis, smelling impairments, postnasal drainage and triggering asthma because of postnasal drip.

How are polyps treated?

When they form they do not disappear by themselves mostly. At the beginning they can be very small but gradually they become bigger and bigger. Tiny ones can be treated by drugs but bigger ones mostly need operation to be treated.
Nasal polyp operations are becoming more efficient with the developments of some technical facilities recently. Operations are mostly done from inside the nose with the help of endoscopes. These are more physiologic, less traumatic and more comfortable operations.

Do polyps recur?

We can divide patients with nasal polyps into two. One goup is in which there is not any associated disease with the polyp. Succes of functional endoscopic sinus surgery in these patinets are above 90%. But if the patients have asthma, cystic fibrosis, Samter’s syndrome polyps recur in time.


Operation in Sinusitis with Balloon Technique (Balloon Sinuplasty)
The sinuses are the spaces like caves, full of air, within our cranium around our noses. These spaces are opened into the nose through a thin channel. In medical language we call ”sinusitis” to the blockage of these channels and pyogenesis of sinuses. There are also various forms of sinusitis such as acute, subacute, chronic, frequently repeating. The treatment of each one changes according to its type and factor.
In sinusitis cases caused by the congestion of the sinus channel/ostium anatomically, a technique developed recently. In this technique the balloons -placed into the sinuses' mouths- are blown up and the sinuses' mouths are widened with minimal tisse damage. It took 4-5 years since this technique’s first usage and the sinuses had been stayed open at 95 % of patients. For the time being, maxillary (under cheek), frontal (forehead) and sphenoid (the hindmost of nose in cranium) sinuses could be opened by this technique. It could be used in addition to the classical endoscopic technique in patients who have ethmoidal sinusitis and polyps as well.

My persistent symptoms 31 May, 2013 - 12:14

I am writing to you from St. John's, Newfoundland (Canada). I have a sinus problem started in Nov 2008 upon working for more than a month in a gas plant. I did not have sinus problems prior to this date.

At that time, I may have been exposed to airborne asbestos and other irritants. In the place where I lived at that time, the Winter is so harsh. Temperature during Winter is normally at least 25 Cecilius below zero.

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