Chronic sinusitis is a long-term inflammation of the sinuses. The sinuses are moist air spaces behind the bones of the upper face between the eyes and behind the forehead, nose and cheeks. Normally, the sinuses drain through small openings into the inside of the nose. Anything that obstructs that flow can cause a buildup of mucus, and sometimes pus, in the sinuses. Drainage from the sinuses can be obstructed by structural abnormalities of the nose, infection, or tissue swelling caused by allergies. The buildup of mucus leads to increased sinus pressure and facial pain. In adults, chronic sinusitis most often is linked to nasal swelling caused by allergies, especially allergies to inhaled dust, mold, pollen, or the spores of fungi. These allergies trigger the release of histamine and other chemicals that cause the inner lining of the nose to swell and block sinus drainage.

Chronic Sinusitis Symptoms
These last three months or more and may include but not be limited to:
• Chronic fatigue
• Cough
• Facial pain around the eyes or in the forehead or cheeks
• Headache (in the front of the head or around the eyes)
• Nasal congestion
• Nasal drainage (yellow, yellow-green, thick)
• Pain in the roof of the mouth or teeth

Surgery can bring relief when all other courses of treatment have failed to improve breathing and cure your chronic sinusitis. It is especially effective when polyps are present or when a deviated septum prevents adequate passage of air through the nose.

Your doctor will not recommend surgery unless symptoms have been chronic or frequent over a period of time, and either have not responded to medication or are especially severe.

Types of Sinus Surgeries
There are several different types of sinus surgery that may be recommended. Endoscopic sinus surgery is rapidly becoming the surgery of choice for more and more doctors. This type of surgery utilizes a thin, lighted instrument called an endoscope. Unlike most traditional surgeries, it does not involve cutting through the skin, as it is performed entirely through the nostrils. Therefore, most people can go home the same day. Additionally, it leaves no visible scars and causes less pain and discomfort. Depending upon the extent of the surgery, a local anesthetic or general anesthetic may be used.

A sinus washout is a minor operation in which one of the maxillary sinuses, the pair closest to the cheekbones, is punctured with a small needle passed through the nose. The excess mucus is then washed out of the sinus. When the sinuses are clear, and any infection or pus has been washed out, the swelling will go down. The mucous membrane and cilia are then able to return to normal functioning.

Sinus washouts are rarely painful and are usually performed under a local anesthetic, which means the person is awake but cannot feel any pain in the area of the operation. However, the procedure can be uncomfortable, as the needle can create a crunching feeling, and the washing of the mucus can feel quite strange.

A general anesthetic, which puts the person completely to sleep, is preferred with children. Some adults may also feel more comfortable under general anesthesia.

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