Acute sinusitis is an inflammation or swelling of the tissue lining the sinuses. Sinuses normally are filled with air but can become blocked and filled with fluid, which leads to infection. Conditions that cause sinus blockage include the common cold, allergic rhinitis (swelling of the lining of the nose), nasal polyps (small growths in the lining of the nose) or deviated septum (a shift in the nasal cavity). Allergies also can cause swelling and poor drainage of the sinuses.
Common treatments include antibiotics, oral/topical decongestants, prescription and nonprescription drops/sprays and antihistamine.
Sinus surgery may be necessary if medicine is not effective in opening sinuses or nasal polyps are present. Turbinate reduction, which involves bones in the nasal passages, may be performed to permanently shrink the swollen membranes of the nose.
Chronic infection and inflammation of the sinuses can lead to chronic sinusitis, a condition in which patients experience a variety of persistent symptoms which include nasal congestion, nasal obstruction, facial pain and pressure, loss of taste and smell, tooth pain and lethargy. Although physicians do not understand all the causes of chronic sinusitis, frequent colds, inhalant allergies, nasal polyps or tumors, deviated septum, nasal trauma and granulomatous diseases are some of possible causes of chronic sinusitis.
Minimally invasive endoscopic sinus surgery, and other techniques such as balloon sinuplasty, may be used to open the sinuses and improve the drainage patterns. Patients typically experience fewer sinus infections, less severe sinus infections and improve much faster with medical treatment after surgery.
Cerebrospinal Fluid (CSF) Leaks (Encephaloceles)
Cerebrospinal fluid leaks, or encephaloceles, may occur as a result of trauma, obesity, high intracranial pressure or other unknown causes. Patients usually experience clear drainage from one nostril, which may be worsened with bending, exercise and straining. Cerebrospinal fluid leaks may cause serious complications such as meningitis (inflammation of the brain membranes) or pneumocephalus (air in the brain).
Traditionally, leaks were repaired using large skull incisions, making bone flaps, retracting the brain, finding the leak and repairing it. Surgeons at The George Washington University Hospital now use newer, minimally invasive endoscopic techniques that allow them to find and repair these leaks through the patient's nose, thereby avoiding skull incisions. Patients often experience fewer complications, decreased pain, and leave the hospital more quickly with the use of these techniques.
Nosebleeds are a common medical problem and go away without treatment in most cases. If they do require medical attention, nosebleeds are usually controlled with simple packing or cauterization. In severe cases, bleeding may be the result of damage to the sphenopalatine artery, a blood vessel at the back of the nose. In those cases, surgeons at GW Hospital can often stop the bleeding by inserting an endoscope, a long-lighted rod, through the nose to identify the bleeding artery, and cauterize or clip the artery to produce immediate results. Following the surgery, discomfort is usually minimal and may include some nasal congestion. Patients can often return home the same or next day.
Nasal and Sinus Tumors
Several types of benign and malignant tumors may occur in the nose and sinus cavities. These lesions can often spread to the brain and base of the skull. These tumors have traditionally been removed with a variety of facial or skull incisions. Advances in minimally invasive endoscopic techniques now allow GW Hospital surgeons to remove these tumors more safely and completely without any facial incisions. Surgeons can remove these tumors through the patient's nose, a natural opening, and avoid facial or skull incisions. Patients typically experience fewer complications, decreased pain and leave the hospital sooner with the use of these techniques.