2-Chronic sinusitis

Nasal sinuses are air compartments that are found in the skull and they are distributed around the eye.

Frontal sinus is above the eye, ethmoidal sinuses are adjacent to the eye and maxillary sinus is below the eye while sphenoid sinus is behind the eye.

Nasal sinuses continuously secretes mucous and is drained from through their natural openings to the nasal cavity then back to the throat all the way to the stomach to ensure cleanness of the nasal cavity.

The functions of the nasal sinuses are still unclear but assumptions that they are present to secrete mucous to clean the nose or for protect the eye or they act as a sound box for the resonance of one’s voice.

Chronic sinusitis is more common in adults than that in children and there is no discrimination between males and females.

Chronic sinusitis id due to prolonged obstruction of the sinus opening which results in entrapment of mucous inside which leads to chronic inflammation and even formation of polyps though failure of medication like antibiotics and nasal drops to drain this trapped mucous.

As a complication of chronic sinusitis is extension of the infection to the eye or the brain which leads to proptosis, decreases the visual acuity as well as severe headache and lack of concentration.

Other symptoms of chronic sinusitis are nasal obstruction, anterior nasal discharge, chocking due to posterior nasal discharge together with chronic headache and in severe cases snoring, loss of smell and muffled voice.

Diagnosis of chronic sinusitis is by using the nasal endoscopy to detect the site of pus and polyps as well as computed tomography that detect the affected sinuses and whether there is extension to the eye or the brain.

In the old days, surgery was done through facial incisions either above the eye brow or beside the eye or sub labial to access the affected sinus and this leads to facial disfigurement and prolonged convalescence period.

Recent advances promoted the use of nasal endoscopy for the removal of nasal polyps using   the shaver, suction of the pus from inside the sinus and widening of the sinus ostium which guarantee not recurring the disease once more.

It is worth mentioning that endoscopic sinus surgery became a one day surgery and it can be done under local or general anesthesia through that nasal opening sparing and incisions in the face using the endoscope to be our eye and the shaver to be our hand.