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Sinusitis Treatments Go High-Tech

Coughing, fatigue, headaches, post-nasal drip and intense pressure throughout the face. For millions of Americans, these aren't just the side effects of a short bout with the flu, but what they experience every day living with sinusitis. Technological advancements in the diagnosis and treatment of sinusitis have one otolaryngologist very optimistic about the future for patients with sinusitis.

"Sinusitis is the most commonly reported chronic disease in the United States, and it can be very debilitating," says Raj Sindwani, M.D., a SLUCare otolaryngologist and assistant professor of otolaryngology at Saint Louis University School of Medicine. "The quality of life in patients with chronic sinusitis can be worse than in those with emphysema, congestive heart failure, or back pain, not to mention the direct costs of treating patients who suffer from sinus infections."

Sinus infection treatments are evolving as researchers learn more about the disease. Sindwani wants to help patients breathe a little easier by teaching them about modern treatments for sinusitis. As the head of the SLUCare Comprehensive Sinus Clinic, which brings together allergists, otolaryngologists and radiologists, he says patients no longer need to go through antiquated or painful procedures.

Technology and Sinusitis Treatments
According to Sindwani, the first step in treating sinusitis is performing a painless sinonasal endoscopy to check patients' sinuses for sites of blockage, polyps and infection. During sinonasal endoscopy a tiny telescope is guided up into the nasal passage and sinuses in order to help doctors spot blockage and infection. This advanced technology allows the examination to be done without anesthesia and doctors like Sindwani can take an even closer look at the actual drainage pathways of the sinuses than ever before.

"Before sinonasal endoscopy, our ability to look directly into someone's nose and sinuses was very limited," he says. "When a scope is not available, a light source or ear speculum is used to look into the nasal cavity. Only a very limited view of the front part of the nose is obtained this way."

Sinonasal endoscopy is an advanced way for medical professionals to rule out any problems that may be contributing to the patient's sinus symptoms; Sindwani cites nasal polyps, cysts, scar tissue from previous surgeries and crooked septums as common culprits.

If an infection is detected, the endoscope can also be used to sample some of the pus present within the nose and sinuses, which can then be cultured in the lab and help doctors choose the most effective antibiotic for any given infection.

Digital Sinus Surgery
If surgery is needed, doctors can use the same endoscopes used in diagnosing the problem to perform minimally invasive sinus surgery. This particular kind of surgery is the most advanced of its kind, says Sindwani, and has ushered in an entirely new way of thinking among doctors who treat sinusitis.

"At the SLUCare Comprehensive Sinus Clinic, our surgeons also use a state-of-the-art surgical navigation system, which allows them to more safely make their way through the tiny sinus passageways, ensuring that all of the sinuses are adequately opened," Sindwani says. "With the help of a computer, the patient's CT (computed tomography) scan is used as a roadmap in the operating room, and special instruments are used that are tracked as the surgeon enters each of the patient's sinuses."

The procedure leaves the patient with no cuts on the nose or face and allows the surgeon to get a magnified view of the sinuses during surgery with image-guided technology only adding a few minutes to the procedure. Sindwani recommends image-guided surgery for patients who have had previous sinus surgery or those with abnormal anatomy or extensive sinus disease.

Sindwani says he is optimistic about the future for sinusitis sufferers. “Sinusitis is not just a stuffy or runny nose; it oftentimes is a very serious medical condition,” Sindwani says. “But as long as we continue to be open to breakthrough technologies and procedures, we can make life a lot better for patients.”

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