When my nose is blocked with congestion from allergies, a cold, or whatever, I always think there should be a surgical treatment similar to angioplasty for coronary arteries. After all, the nose is much more accessible than the heart. Surgeons out there, can you put a stent in my nose and solve this problem once and for all?
The medical literature reports that “functional endoscopic sinus surgery (FESS) has revolutionized the surgical management of chronic sinusitis” (2). This technique was introduced over two decades ago, and is currently performed at least 200,000 times per year in the U.S.
The indications include:
1. Chronic sinus infection that does not clear up with medication
2. Recurrent or complicated sinus infection
3. Nasal polyps or mucoceles
4. Chronic sinus headaches
5. Impaired sense of smell
6. Tumors of the nasal and sinus cavities
Allergies alone are not yet an indication for surgery, but they contribute to sinus infections. Sinus surgery is included in the Health Reference Series book on allergies (1). The major symptoms of chronic sinusitis are nasal obstruction, a feeling of facial pressure, runny nose and reduced sense of smell. Other symptoms include headache, toothache, bad breath, fatigue, dry cough, fever and earache.
A Brazilian study found general health improvements in 50 percent of patients who received sinus surgery, and 54.2 percent reported a considerable gain in quality of life. Their subjects had chronic sinusitis, with or without polyps. The success rate for the surgery is very high in terms of correcting the nasal problems. However, surgery has many risks that medication does not have.
Complications of sinus surgery include:
1. Post-operative bleeding,
2. Adverse reactions to the anesthesia,
3. Cerebrospinal fluid leaking into the sinuses,
4. Visual loss from bleeding into the intraorbital space,
5. Loss of sense of smell,
6. Voice changes,
7. Infection,
8. Nasal obstruction from scar bands,
9. Numbness.
The American Rhinologic Society provides a Web site with extensive information about sinus surgery and medical alternatives.
References:
1. Amy L. Sutton, ed., “Allergies Sourcebook”, third edition, Omnigraphics, 2007.
2. Huang BY et al, “Failed endoscopic sinus surgery: spectrum of CT findings in the frontal recess”, Radiographics. 2009 Jan-Feb; 29(1): 177-95.
3. Bunzen DL et al, “Efficacy of functional endoscopic sinus surgery for symptoms in chronic rhinosinusitis with or without polyposis”, Rev Bras Otorrhinolaringol. 2006; 72(2): 242-6.
4. American Rhinologic Society:
http://www.american-rhinologic.org/patientinfo.phtml
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.