Allergies are a common cause of inflamed sinuses and headaches as well as runny or itchy nose, sneezing, itchy or watery eyes, blocked or itchy ears, rashes and wheezing. Allergies are in essence an overreaction by the body’s immune system to one or more objects in the environment, called allergens. Common allergens include dust, pollen, animal dander, mould and certain foods. The body produces antibodies to these substances (called IgE antibodies). Nasal endoscopy, blood tests or skin “scratch” tests are often all that is needed to determine the presence and cause of an allergy. Then the physician and patient can work together to plan treatment and management of symptoms.
There have been some exciting developments in the field of allergy management, and nowadays, certain allergies can not just be controlled, but actually cured.
Functional Endoscopic Sinus Surgery (“FESS”)
Sinuses are cavities within the forehead and facial bones (around the eyes) Normally, they open into the nasal passages via small drainage pathways called “ostia”
Why is sinus surgery necessary?
In cases in which antibiotics, nasal drops, sprays and decongestants have failed to clear the problem, it is likely that the sinuses are physically obstructed and blocked. In this event, it may be advisable to undergo surgery to unblock these passages, in the hope of restoring normal function by improving mucus drainage, (i.e. “functional” endoscopic sinus surgery or “FESS”).
Why are endoscopes used?
These fibreoptic instruments allow us to carry out much more precise surgery which addresses the individual problem, particular to that patient. We know which sinuses are diseased by looking at the CT scan, and so we can operate on those that are diseased and leave alone those that are not.
What is the outlook after the surgery?
FESS is highly successful at improving the symptoms of sufferers of chronic sinusitis, but it may not offer a permanent, complete cure because the mucus drainage mechanism has already been badly damaged by the infection. Artificially-created pathways never work as well as natural ones, but are better than none at all. For this reason, even after successful surgery, the patient will be more prone to bouts of sinus trouble than the average person, but usually this will still be better than if they had never had their sinus operation. Most often, even if sinusitis recurs in somebody who has had FESS, it can be brought under control medically (rather than surgically) using various antibiotics, sprays/drops, decongestants or anti-inflammatory steroids. Thus overall, most patients who undergo FESS although not completely cured, are a lot better.
The sinuses are small, hollow chambers inside the nose, cheeks and forehead that reduce the weight of the facial bones, give the bones shape and support, assist in mucus drainage from the nose, and help the voice resonate. Healthy sinuses are filled with air. When their mucous membranes swell from allergies, the common cold, infection or another cause, the sinuses become blocked, the pressure inside them drops, and they can fill with fluid, which easily leads to bacterial infection (called sinusitis, or rhinosinusitis if the nasal tissues are also affected). Blocked, inflamed or infected sinuses can be very painful. Pain at the back of the head or in the area of the temples is not due to sinus problems.