Sinus is an air cavity located around the nasal cavity. There are a total of 4 pairs. The sinus drains through the nasal cavity opening according to the natural mechanism. However, if the drainage opening becomes blocked and the sinus cannot be fully drained, sinusitis occurs, which eventually affects the respiratory system and the sense of smell. The effective treatment for sinusitis that also helps reduce recurrence nowadays is sinus surgery through an endoscope, called Innovative Full House FESS.
Understanding Why Sinusitis Occurs?
As mentioned above, there are 4 pairs of sinuses around the nasal cavity: the cheek sinus (Maxillary sinus), the sinus near the eyes (Ethmoid sinus), the forehead sinus (Frontal sinus), and the sinus at the back of the brain base (Sphenoid sinus). The main causes of sinusitis are usually as follows:
- The patient’s sinus drainage opening is blocked, preventing normal elimination of pathogens.
- The nasal cavity cilia cells do not function well, making it impossible to drain pathogens and pus from the sinus cavity.
When sinusitis occurs, patients experience nasal congestion, thick mucus in the nose or dripping down the throat, resulting in reduced sense of smell and facial pain. This inflammation is called acute sinusitis, which is not chronic. If patients receive proper treatment, they will recover normally. However, since the sinuses are close to the eyes and brain, some patients may develop serious complications, such as pus from the sinus flowing into the eye, causing eye swelling, double vision, inability to move the eye, and eventual blindness. Pus from the sinus may also spread to the brain, causing disability and death later on.
Tried Everything to Treat Sinusitis, But It Doesn’t Heal?
Sinusitis is divided into 2 types: acute sinusitis and chronic sinusitis. In cases of chronic sinusitis, patients experience changes in nasal symptoms such as nasal congestion, runny nose with mucus that is white cloudy, yellow, or green. Some patients may also have bad breath. These abnormalities persist for at least 3 months. The treatments for sinusitis are as follows:
- Antibiotic medication
The traditional treatment for chronic sinusitis is that doctors prescribe antibiotics that kill the bacteria causing the disease. Doctors may collect pus for testing to identify the type of bacteria and which medication is effective. However, many patients still do not improve even after receiving effective antibiotics because chronic sinusitis is not a chronic infection but a chronic inflammation caused by the sinus mucosa itself. - Nasal spray
The use of steroid nasal sprays acts locally to reduce inflammation effectively. Newer sprays are safe and have no side effects on the body. However, research shows that nasal sprays cannot reach the sinus cavities. The latest research published in the Cochrane review journal found that topical steroids are effective only if the medication can reach the sinus cavities. - Sinus surgery
If patients do not improve after full medication treatment, surgery is necessary. Early surgeries focused on draining pus from the sinus cavities, but later surgeries aim to correct the blockage of the sinus drainage openings to restore normal drainage function.
Innovative Full House FESS Endoscopic Sinus Surgery
The International Forum of Allergy and Rhinology journal published research highlighting new knowledge and understanding about chronic sinusitis and a new surgical technique called Full House FESS.
Innovative Full House FESS endoscopic sinus surgery is an effective sinus treatment that reduces the chance of recurrence. The doctor performs surgery to widen the sinus cavities, connecting all 4 pairs of sinuses together, allowing the thick mucus and pus trapped inside the sinuses to be completely suctioned out, improving treatment outcomes as follows:
- Good access to the sinus mucosa, allowing direct inflammation reduction
- Reduces the chance of repeat surgery
- Increases airflow circulation in the sinuses
- Allows medication to be sprayed thoroughly inside the sinuses
- Effective nasal medication use without the need for oral drugs
With high-definition endoscopic technology (HDTV), this reduces surgical trauma and prevents nasal mucosa wounds. Combined with image-guided surgery using CT scans during the operation, similar to a navigation system for driving, it helps doctors avoid getting lost and reduces the risk of surgical complications. After surgery, patients no longer suffer from the discomfort of nasal packing or pain when removing the packing as in the past.
Real Experience Sharing After Sinus Treatment with ‘Innovative Full House FESS’ Technique
Once, a patient came to see the doctor with chronic sinusitis symptoms. The patient had nasal congestion on both sides, thick mucus dripping down the throat, and no sense of smell. The patient often worried about the danger to life and property if there was a gas leak. Additionally, the patient had asthma for over 10 years, which was uncontrolled and unresponsive to inhalers. The patient told the doctor that a doctor at another hospital recommended sinus surgery instead of nasal sprays. However, after the first sinus surgery using the conventional technique, the patient still had severe nasal congestion, thick mucus, and loss of smell. Scarring was found between the nasal septum and the sides of both nostrils, and new nasal polyps had developed.
Finally, the patient underwent a second sinus surgery at Phyathai 1 Hospital using the Innovative Full House FESS endoscopic sinus surgery. The doctor removed the scar tissue, widened the sinus cavities, and prevented scar recurrence by using soft silicone before rinsing the nose with saline mixed with medication. Today, this patient can breathe freely and smell normally. Asthma symptoms have also improved, reducing medication use. Currently, the patient still manages the sinuses mainly by nasal rinsing with medication, not oral drugs, so there is no concern about side effects from medication. This is the effectiveness of the Innovative Full House FESS endoscopic sinus surgery, the latest advancement in sinus treatment.
