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As a general rule, sinusitis can be treated with medications in the majority of patients, as instructed by the specialist. These medications may include the use of antibiotics to treat any active infection, allergy medicines (if this is a suspected cause), nasal steroid sprays, decongestants, or pain relievers. Most patients with sinusitis respond well to these medications. In cases where the response to treatment is not adequate, or when the infection recurs repeatedly, or when complications arise or are imminent, surgery may be considered.
A Patient's Guide to Endoscopic Sinus Surgery
When patients do not respond well to medications, sinus surgery may be recommended. Currently, the most common surgical technique uses fiber optic lenses which are inserted through the nostrils, without the need for any facial incisions. This technique provides excellent visibility within the nasal cavity and sinuses due to modern lenses that allow angular vision within the nose. This type of surgery is known as Functional Endoscopic Sinus Surgery (FESS).
The aim of FESS is to open the natural drainage pathways of the sinuses, thus restoring their function and health. The goal of the surgery is to carefully remove the thin, delicate bone and mucous membranes that block the drainage pathways of the sinuses. The term .endoscopic. refers to the use of small fiber optic telescopes that allow the surgery to be performed through the nostrils, without the need for any skin incisions. Endoscopic sinus surgery is generally performed on an outpatient basis, meaning that hospitalization is usually not required. Although the vast majority (85-90%) of patients report feeling significantly better after surgery, it is important to realize that surgery alone should not be considered a cure for sinusitis and some patients may need to use long-term maintenance medications to optimize symptom control.
If the surgical candidate has had previous nasal surgeries, has nasal polyps, or if the internal nasal structures have been altered in any way, it may be necessary to use a surgical navigation system for surgery. This is known as Computer Image-guided Surgery. This form of surgery uses a special computer in the operating room which reconstructs three-dimensionally the patient's anatomy using data from the pre-operative CT scan. This reconstruction then helps the surgeon identify key structures in the nose and .navigate. intra-operatively.