Nose and sinuses
Heavy head, facial pressure, no sense of smell
Sinusitis treatment in KPHB, Hyderabad
Most sinus problems settle on the right medical treatment. Surgery is for the ones that have not.
Does this sound like you?
- A heavy head, pressure over the cheeks or between the eyes
- Thick discharge, post-nasal drip, a blocked nose
- Loss of smell
- Infections that keep coming back through the year
- Symptoms that have lasted more than twelve weeks
Sinusitis treatment at Sinocare ENT Hospital, KPHB Colony, Kukatpally, starts with a thin camera (an endoscope), not a prescription. The sinuses are air spaces in the bones of the face. Each one drains through a narrow opening into the nose. Sinusitis is what happens when those openings block and the sinus behind them fills. Most bouts follow a cold and settle in a couple of weeks. Sinusitis that goes on for months (chronic sinusitis) is a different condition. It means weeks and months of blockage, discharge, pressure and a dulled sense of smell. It is the one that brings people here. Most of it settles on proper medical treatment. Surgery is for the ones that have not.
What it looks like inside
What it usually is
A sudden (acute) bout is an infection in a sinus that has blocked because of a cold. It is usually a virus at first, and occasionally bacteria. Sinusitis that goes on for months is different. The lining stays inflamed and keeps the openings swollen shut. Allergy makes it more likely, and so does a bent wall between the nostrils (the septum) narrowing the drainage area. So do asthma and aspirin sensitivity. In some people the inflamed lining grows into soft growths (polyps). They are grape-like swellings that block the nose and take the sense of smell with them.
Many “sinus headaches” are migraine, and do not improve with sinus treatment. The examination and the pattern of symptoms usually tell the two apart. It is better to know before treatment than after.
What happens at the first visit
A thin camera (a nasal endoscope) is passed along the nose at the hospital in KPHB, for about a minute. It shows the drainage areas and any polyps directly. The history and the camera may point to sinusitis that has gone on for months. Then a CT of the sinuses is arranged. It shows which sinuses are involved. It is the diagnosis and, if it ever comes to it, the surgeon’s map. Allergy and asthma are asked about, because they change the plan.
How sinusitis is treated, and what is tried first
Full medical treatment means:
- A steroid nasal spray, daily, aimed correctly, for weeks rather than days.
- Saline irrigation, a rinse of the whole nose with a bottle or pot, once or twice a day. It does more than most people expect, and it is the part people skip.
- The right antibiotic course for a bacterial bout. Occasionally a short course of steroid tablets is added where polyps are present.
- Allergy treatment where allergy is driving it.
Given a proper run, this settles most sinusitis that has gone on for months, and shrinks many polyps.
When to come in sooner
- Sinus pain with a high fever, or swelling and redness around the eye
- A severe headache with a sinus infection, or a stiff neck
- Symptoms on one side only, particularly with bleeding
- Loss of smell that has not returned after an infection
If an operation is ever needed
Surgery comes in when three things are true. Symptoms have lasted more than twelve weeks. Medical treatment has had a fair run. And the CT shows disease that matches. Then sinus surgery with a thin camera (endoscopic sinus surgery) opens the natural drainage pathways from inside the nose, with nothing cut on the face. Polyps are removed at the same time. It is a one day procedure done by Dr. Santosh at Sinocare ENT Hospital. The aim is drainage that works, not sinuses stripped out. A CT showing changes in someone with no symptoms is not a reason to operate. You are told when yours is one.
Questions patients ask
Do I need a CT scan?
Only if the history and the camera point to sinusitis that has gone on for months. A scan for a one-off infection that is settling is not needed.
Will my sense of smell come back?
Often, once the inflammation or polyps that were blocking the smell area are treated. Where it has been blocked for years, recovery can be partial.
Is my headache from my sinuses?
Possibly, and possibly not. Pain over a blocked sinus with discharge is sinus pain. A headache with a clear nose and light sensitivity is more likely migraine. Treating the sinuses will not help it.
Will the polyps come back?
They can, particularly with asthma or aspirin sensitivity. That is why the nasal steroid continues after treatment. Steady medical care afterwards keeps them away longest.
Is sinus treatment possible without an operation?
For most people, yes. A steroid spray used properly, saline irrigation and the right antibiotic settle most sinusitis that has gone on for months. Surgery is for the sinuses that have not settled after a proper run of that.