Does sinusitis require surgery?

Written by Deng Bang Yu
Otolaryngology
Updated on September 13, 2024
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Sinusitis refers to inflammation of the sinus, clinically mainly bacterial inflammation, as well as fungal inflammation. Whether sinusitis requires surgery depends on the specific condition of the patient. Endoscopic examination of the nose and sinus CT scans can be carried out to assess the condition of the sinus lesions. If there is a lot of sinus secretion and the sinus cavity is congested, and there is polypoid changes in the overall nasal passage, surgical treatment may be considered. For the vast majority of sinusitis patients, the current viewpoint is that treatment is mainly through medication, and only a small part needs surgical treatment after assessment. Therefore, sinusitis does not necessarily require surgery. Start with medication treatment; if the effect is not good, or there are other concurrent issues, consider surgical treatment after assessment.

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Written by Li Rui
Otolaryngology
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Common symptoms of sinusitis

The symptoms of sinusitis can vary widely, primarily related to the extent of the inflammation and the patient's own immune resistance. It is possible to have no obvious clinical manifestations, mainly in those with good resistance and very mild inflammation. The patient may not experience any significant symptoms, and sinusitis might only be discovered through a sinus CT or a head CT. If the inflammatory response is more noticeable, symptoms may include nasal congestion, purulent nasal discharge, headache, dizziness, and a reduction or loss of smell. Some patients might also experience numbness and a feeling of pressure in the face. Diagnosis typically involves a sinus CT or nasopharyngeal examination, as well as direct visual observation of the nasal cavity and an overall assessment of the patient's condition, followed by targeted treatment.

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How to treat sinusitis

The treatment of sinusitis is mainly divided into two categories. The first category is conservative treatment, and the second is surgical treatment. Conservative treatment is primarily used for acute sinusitis or for chronic sinusitis when the inflammatory response is not particularly severe. Overall, most patients can effectively control inflammation, improve their condition, and relieve symptoms with conservative treatments such as oral medications, nasal sprays, and saline nasal irrigation. However, some patients have a more severe inflammatory response and do not respond well to conservative treatment, or they might have fungal sinusitis. In these cases, surgery is generally considered necessary, mainly involving minimally invasive endoscopic sinus surgery, which has proven to be quite effective and causes minimal damage.

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Can you smoke with sinusitis?

Patients with sinusitis are advised not to smoke, as cigarettes have a relatively strong irritation and may affect the treatment of sinusitis, as well as increase the degree of inflammatory response. Some patients may also suffer from acute upper respiratory tract infections. Therefore, patients with sinusitis should visit an ENT specialist as soon as they experience symptoms, undergo a nasal endoscopy and sinus CT scan to assess the severity of the condition. Most patients can consider conservative treatment. Common treatments include nasal spray medications, oral medications, and rinsing the nasal cavity with saline. Regular follow-ups during the treatment process are needed to observe the treatment effects.

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Written by Zhang Jun
Otolaryngology
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What medicine is good for sinusitis?

Sinusitis is mainly caused by acute inflammatory infections, such as Staphylococcus aureus or Streptococcus pyogenes. When a patient's immunity and resistance are low, these bacteria can invade the sinuses through the sinus openings, leading to congestion, swelling, proliferation, and exudation of the sinus mucosa. Patients will experience persistent nasal congestion and discharge of yellow purulent secretions from the nasal cavity. Additionally, patients may also experience fever, facial swelling and pain, headaches, dry mouth, coughing, and other related symptoms. Upon examination, bilateral nasal turbinate mucosal congestion and swelling can be found, and yellow secretions may be seen adhering in the middle nasal meatus or common nasal passage. In terms of treatment, as it is a bacterial infection, patients firstly need symptomatic anti-inflammatory treatment. Oral cephalosporin antibiotics are effective. Moreover, using saline to rinse the nasal cavity also provides very good results. If necessary, patients may require endoscopic sinus surgery for recovery. (Please use medication under the guidance of a professional physician.)

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How should sinusitis be treated?

Sinusitis is caused by acute inflammatory infections, mainly hemolytic streptococcus or Staphylococcus aureus. Pathogens enter the sinuses through the sinus openings due to the patient catching a cold or having a flu, leading to congestion, swelling, hyperplasia, and exudation in the sinus mucosa. Symptoms include persistent nasal congestion, discharge of yellow secretions from the nasal cavity accompanied by a foul smell, and severe cases may also experience facial swelling, pain, and headaches. In terms of treatment, during the acute phase, patients need to first undergo symptomatic anti-inflammatory treatment, taking oral antibiotics such as cephalosporins, which are very effective. Additionally, physiological saline is used for nasal and sinus irrigation. If conservative treatment is ineffective, patients may require endoscopic sinus surgery and sinus mucosa clearance for recovery. (The use of medications should be under the guidance of a professional doctor.)