When Treatment Fails
So, when U.R. (initials used for patient privacy) had endured these symptoms, along with stopped up ears and throat irritation, 3-4 times a year for several years, his primary care doctor referred him to an otolaryngologist for further evaluation. “This is a typical progression of chronic sinusitis,” said Daron J. Smith, MD, board-certified otolaryngologist and partner at CornerStone Ear, Nose &Throat, PA, who assessed and treated the patient’s persistent condition.
While the patient had been treated with topical nasal steroid sprays, several antihistamines, steroid injections, and numerous antibiotics, he reported that his symptoms “aggravated by weather and temperature changes” were only partially and temporarily alleviated. A nasal exam with endoscopy revealed the cause of the patient’s complaints of nasal congestion, indicating 80% nasal obstruction. On Dr. Smith’s recommendation, the patient left his appointment with prescriptions for an antibiotic and a steroid dose pack to reduce the nasal swelling, an appointment with an allergist and for a CT scan of his sinuses.
Both the allergist and the CT scan confirmed Dr. Smith’s suspected diagnosis of chronic sinusitis, with the CT scan showing severe pansinusitis, involving all of the paranasal sinuses, but mostly affecting the maxillary sinuses. On follow-up, the patient reported that he felt the same as he did prior to treatment, with no improvement in his symptoms.
Based on these findings and that the patient would be a good candidate for a successful outcome, Dr. Smith advised proceeding with sinus surgery, septoplasty and turbinate reduction. He explained the minimally invasive techniques used with these procedures, including the no-sinus-packing approach, and Mr. R agreed to proceed. After undergoing the 90-minute procedure, he went home the same day to begin his recovery, which he describes as “great” and returned to work in just one week.
Important Post-op Follow-up
“I am breathing so much better already” the patient reported one week later at his first post-operative appointment, one of an estimated three visits following surgery during which the sinuses are cleaned and debris is removed from the surgical area. “These post-operative debridements” explains Dr. Smith, “are critical to proper healing and lead to much less likely recurrence of sinus disease following surgery.”
At his final post-op visit just one month after surgery, Mr. R presented with an excellent post-operative result with his sinus cavities appearing open, clear and healthy. As adjunct treatment and to maintain these successful surgical results, Dr. Smith recommended that the patient continue the use of nasal steroid spray and an over the counter antihistamine regularly, with instruction for adjustment as his allergic symptoms fluctuate. He will also follow-up regularly one to two times each year.
Seek Specialist Care when Symptoms Persist
Other symptoms of chronic sinusitis can include, pain, tenderness and swelling around the eyes, cheeks, nose or forehead, a reduced sense of smell and taste, ear pain, upper jaw and tooth pain, cough, fatigue and others. A patient could also have several bouts of acute sinusitis that can develop into chronic sinusitis. Patients should seek medical care for these symptoms and be referred to a specialist in otolaryngology when the symptoms persist and become chronic. Any of the four board-certified otolaryngologists at CornerStone Ear, Nose & Throat, PA, welcome and treat patients of all ages with conditions affecting the ears, nose, throat, head and neck.
Six months after his surgery, Mr. R says, “I still feel great!” He adds that he’s thankful for Dr. Smith’s care and is very pleased with the results of his sinus surgery, emphasizing that he tells his co-workers with sinus problems to call CornerStone Ear, Nose & Throat.