"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 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