Dr. Robert Guida's Sinus Surgery Central © 2015
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For cosmetic procedures, please
Yes, it is very common, completely safe, and often recommended, if needed, to perform these procedures at the same time. Often, a broken nose or a deviated nasal septum is the actual
cause of nasal obstruction that then causes chronic sinusitis. It makes complete sense to fix these problems at the same time.
In addition, doing cosmetic surgery while performing sinus surgery is safe and common. The patient will need to wear a splint on the nose for 5-6 days afterwards and bruising around the eyes for 7 – 10 days is likely. Again, there is rarely a need for nasal packing after these operations and there is little discomfort, except for a stuffy nose for about a week. In Dr. Guida’s experience from performing hundreds of these operations, he has found that combining functional nasal surgery and sinus surgery with cosmetic nasal surgery does not significantly change or prolong the discomfort, stuffiness, or swelling during the healing process.
Can sinus surgery be done at the same time as fixing a broken nose, having a "nose job" or fixing a breathing problem?
Several revolutionary advances have occurred in recent years that have improved the results of sinus surgery dramatically. Endoscopes connected to a TV monitor provide accurate and magnified views of the inside of the nose and sinuses, making surgery accurate and safe. CT scans are computerized x-rays giving detailed pictures of the nose and sinus anatomy allowing for accurate diagnosis and a “road map” during surgery. Powered nasal endoscopy is another major advance in this surgery. Using the nasal endoscope, the powered device gently shaves or debrides away the diseased, obstructive tissue under direct vision, while leaving normal tissue intact. Most significantly, new image-guided technology allows the CT scan to be used as a real time “road map” during the procedure, allowing for very specific accuracy during the operation. Improved anesthetic medications and techniques allow for a speedy recovery with less drowsiness or nausea. Most often, Dr. Guida does not “pack the nose” after surgery making the recovery is much more comfortable.
What's new in the surgical treatment of sinusitis?
· Thick drainage from the nose – The infected mucous is thicker, secreted in large amounts, is often yellow, and can be foul smelling.
· Headache and sinus pain – Blockage of the sinuses during an infection causes pus and mucous to become trapped in the cavities, pressure cannot be equalized, and this can cause severe facial pain, headache, toothache, and general malaise. This becomes much worse during a descent in a plane or sudden change in barometric pressure from climate changes. It is also worse when lying down, which can disrupt sleep.
· Loss of sense of smell and taste – The nerve for smell and taste is high in the nose. Due to swelling during an infection, air cannot reach the nerve endings making it difficult to smell and taste. This is almost always temporary.
· Recurrent infections – As sinusitis worsens, there is less and less of a response from antibiotic therapy. Patients may find they are on antibiotics every several weeks through out the year. This is when the condition becomes chronic. The pain, congestion, stuffiness, and drainage seem to never go away.
· Chronic fatigue – Facial pain and nasal congestion interferes with sleep and patients with recurrent sinusitis feel “out of it”, unmotivated to exercise, and tired all the time. This improves when the sinus condition is corrected.
Blocked sinus passages occur from a number of causes of obstruction. Most commonly, the sinus passages temporarily block up due to swelling from a common cold or allergies such as hay fever. Certain anatomic situations cause distinct blockage, such as a deviated nasal septum, a broken nose, nasal polyps, or enlarged turbinates (tissues in the nose that filter the air). The nasal septum is a partition made of cartilage and bone that separates the right and left sides of the nose. It is commonly deviated or bent due to heredity or a broken nose, causing blocked breathing and sinusitis.
The sinuses are air pockets that are located within the bones of the skull and face, which are connected and drain through the nose. There are 8 sinus cavities in the skull, that are of varying sizes. The walls of the sinus cavities are lined with a layer of tissue that constantly maintains a flow of fluid and mucous to moisten the air that we breathe and clean the nose. This flow of mucous is ongoing, cleansing the nose and throat of bacteria, viruses, and inhaled pollutants. These 8 sinus cavities drain through tiny holes into the nose. When these drainage passages become blocked, the sinuses do not drain properly, and the mucous gets blocked in the cavity. The cleansing effect is stopped and the fluid trapped in the sinus cavities fosters growth of bacteria and viruses, causing a sinus infection.
Dr. Guida appeared on Jane Wilkens Michael's iHeartRadio show, Better Than Before, to discuss everything you've ever wanted to know about your sinuses! Listen in at the link below, for some great tips, facts and updates about the disease that affects 1/3 of Americans!
Even though the condition is relatively common, it is under diagnosed or incorrectly diagnosed, probably due to lack of adequate knowledge of the disease and its treatment. Many people feel sinus infections are just “another head cold” and self-medicate with over the counter sprays and tablets, which are ineffective long term. Many people live with this condition until the symptoms are so bad, they finally seek medical help from a specialist.
Why is sinusitis so difficult to diagnose and treat?
Sinusitis and asthma are closely related. A sinus infection can bring on an asthma attack and chronic cough due to a persistent “post nasal drip”, which is drainage from the sinus and nasal cavities down the back of the throat. Often patients have a decrease in the number of asthma attacks if sinusitis is properly treated.