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New Treatments Provide More Options for Patients with Chronic Sinus Problems

Chronic sinusitis is a growing problem in this country with up to 16 percent of the population diagnosed with the condition each year.

"While some of the most severe cases may require surgical treatment, many cases can be treated effectively with aggressive and long-term medical management, says Samuel Pate, MD, ear, nose and throat specialist at Nebraska Medicine. "The emphasis is on aggressive."

Samuel Pate, MD
Samuel Pate, MD

A person is considered to have chronic sinusitis when symptoms persist for more than 12 weeks, notes Dr. Pate. If a patient continues to have symptoms after 12 weeks, more aggressive medical management needs to be taken.

Dr. Pate recommends the following therapy for these patients: regular sinus irrigation, a nasal steroid spray, nasal antihistamine spray, oral antihistamines, when appropriate, evaluation for allergies and a two-to-three week course of antibiotics.

If the sinus infection clears up, continue this regimen based on the patient's symptoms and add or delete medications as needed until you have fine-tuned the medical plan to fit your patient's needs, he advises.

Should the infection fail to clear up after aggressive treatment therapy, Dr. Pate recommends that the patient have a CT scan and endoscopy and is evaluated by an ENT specialist, who can determine whether the patient is a surgical candidate.

Many patients, however, may be able to bypass traditional surgery to open up their sinuses, in favor of a less invasive procedure that is becoming the new standard of care called balloon sinuplasty.

"Balloon sinuplasty has been shown to be just as effective as traditional surgery with faster recovery time and fewer follow-up visits," says Dr. Pate, who has been performing the procedure for more than four years.

The procedure is performed in the office with local anesthesia and takes less than a couple hours to complete. Balloon sinuplasty involves inserting s a narrow tube with a small balloon on the end of it into the sinus cavity. Then the balloon is inflated, opening up the closed sinuses and providing a larger space for the sinuses to drain. Unlike traditional surgery, no tissue is removed, which can sometimes lead to scarring and the need to repeat the procedure later. With sinuplasty, most patients never need to have the procedure done again.

Candidates for the procedure typically include those who experience repeated episodes of sinusitis over a year and do not get relief with other sinus therapies. This includes individuals with seasonal allergies, asthma, chronic bronchitis, inflammatory airway conditions or anatomical problems. Those that might not qualify for the procedure include those with severe polyps, fungal disease, severe or advanced sinus disease that requires more aggressive therapy.

Several other procedures available to those who have recurring nasal congestion. One of these is referred to as the Celon® method, which involves using selective thermotherapy that is used to reduce the size of the inner nasal area called the nasal turbinates. When the nasal turbinates are enlarged, it becomes difficult to breathe through the nose. The Celon procedure can be done in the clinic and takes about 10 to 15 minutes. Patients feel a difference after just a few days of receiving the treatment, notes Dr. Pate.

Another in-office procedure that is commonly used to treat patients with chronic nasal problems is nasal cautery. This involves treating the affected sinus area with a chemical solution over a period of time and it is highly effective as a supplement to medical therapy or for patients who are not surgical candidates.

To learn more about sinus pain therapy or to make a referral with Dr. Pate call, 877-647-7497.