BACKGROUND: Sinuses are air-filled spaces in the bone, around the nose, that connect to small openings in the nose area. Normally, air passes in and out of the sinuses and mucous and fluid drain out of them into the nose. When the sinuses become inflamed because of a viral, bacterial or fungal infection, sinusitis takes place. Each year, over 30 million adults and children develop this condition. It can either be acute, lasting two to eight weeks, or chronic, sometimes lasting years. Symptoms include coughing, fatigue, bad breath, fever, headache, pressure-like pain, facial tenderness, nasal congestion and sore throat. Sinusitis is most often caused by colds and allergies because excess mucous blocks the sinus openings, providing a breeding ground for bacteria and other organisms. To prevent sinusitis, it is important to prevent and treat colds and the flu.

A CHRONIC PROBLEM: According to the Mayo Clinic, chronic sinusitis is one of the most common chronic conditions diagnosed in the United States. When sinusitis persists and becomes chronic, all of the symptoms remain except a fever. These persistent symptoms can damage a person's emotional health, energy level and performance at work. Beyond physical examination, there are several ways to test for chronic sinusitis, including nasal endoscopy, during which a tube with a fiber-optic light is inserted through your nose to allow the doctor to see the inside of your sinuses; X-ray, CT or MRI images; nasal and sinus cultures; and allergy testing if your doctor suspects the cause to be allergies.

TREATMENT OPTIONS: Initial treatment of sinusitis often includes antibiotics to treat the infection. Treatment also often includes oral or nasal corticosteroids to reduce swelling and inflammation, decongestants and antihistamines to clear up the nasal passages, and saline nasal washes to loosen up dried mucous. In severe cases of chronic sinusitis, surgery is sometimes needed. Surgery is required when drugs are not effective at unblocking the sinuses or if other complications exist, like structural abnormalities or fungal sinusitis. Traditional surgery involves scalpels to remove infected material, but a procedure called functional endoscopic sinus surgery is taking its place; however, a new type of procedure called balloon sinuplasty is the least invasive surgery option. Balloon sinuplasty is an FDA-approved technology that uses a small, flexible, sinus balloon catheter to open up blocked sinus passageways. The sinus balloon is inflated, widening the sinus passageway and gently restructuring it. "The opening is enlarged," Ashley Sikand, M.D., an otolaryngologist at Ear, Nose and Throat Consultants of Nevada, in Las Vegas, told Ivanhoe. "It allows for drainage for mucus and the ventilation of the sinus and restores it to normal health." Dr. Sikand says the benefits of this new procedure outweigh the risks in the traditional surgery. "Currently, we are advising patients that the risks are similar to regular sinus surgery, but it's proven beneficial is decreasing the healing time, decreasing the recovery time, the postoperative pain and discomfort."