Paranasal sinuses are paired structures which are lined with mucosa and in health are filled with air. The different sinuses are depicted in the adjacent diagrams.
Inflammation of the paranasal sinuses is referred to as sinusitis. When symptoms last for less than four weeks the condition is referred to as being acute, sub-acute when symptoms last between four and eight weeks, or chronic when symptoms are ongoing.
• Facial pain
• Nasal congestion or obstruction
• Purulent nasal discharge
• Post-nasal drip
• Diminished taste and smell
Most cases of sinusitis will settle spontaneously. However, medical management with antibiotics and short-term use of nasal decongestants may be necessary. Where there is an underlying anatomical predisposition to sinusitis, for example obstruction of a sinus drainage passageway, surgery may be indicated. In modern rhinological practice this will normally be endoscopic sinus surgery, or balloon sinuplasty
Proper assessment of the individual patient is required to enable formulation of the most appropriate treatment plan. It is important to remember that there may be a number of factors which are causing sinusitis, for example allergic rhinitis, hypothyroidism and septal deviation. The CT scan shows a patient who was unfortunately suffering with recurrent acute sinusitis which was due to the presence of a cell obstructing the frontal recess.
The video shows the use of a microdebrider, a surgical instrument, to remove the cell and open the frontal sinus: