39 year old male patient with a history of chronic and recurrent sinusitis. He would get 2 to 3 infections a year with symptoms of pressure in his face and head, nasal congestion, decreased sense of smell and blowing large amounts of thick mucous from his nose. In between infections he felt pressure and clogging in his nose and sinuses. The infections would leave him feeling fatigued and often he would miss work. Usually he ended up needing antibiotics from his primary Doctor to get better.
He decided that he wanted to visit with an ENT specialist to get a resolution of his sinus problems rather than taking antibiotics over and over again. The ENT examined him and got a CT scan which showed that his sinus passages were mild to moderately narrowed and the lining of the sinuses were chronically inflamed and swollen. The ENT also tested the patient and discovered that he had allergies to dust and ragweed.
The ENT advised the patient to start treating his allergies with nasal sprays and to use saline nasal rinses every day and to return in 1 to 2 months. The patient followed up as outlined and reported that he did notice less congestion in his nose and was breathing better but still had a feeling of pressure and fullness in his sinuses. The ENT advised the patient to keep doing what they were doing and to follow up in 2 months or sooner if they had another sinus infection.
The patient developed another sinus infection in 1 month. This time the severity of the infection was much less than usual but still caused him discomfort to the point he needed antibiotics again.
The ENT advised the patient to undergo a balloon sinuplasty in the office to improve his sinus problems. The ENT felt that given the degree of sinus disease present on exam and on the CT scan in combination with the recurrent infections despite medical treatment that this would be a good option for the patient. The patient also wished to avoid general anesthesia and was looking for a quicker recovery from a minimally invasive procedure given his busy work schedule.
A balloon sinuplasty was done in the office using local anesthesia and oral valium. The patient’s maxillary and frontal sinuses were dilated on both sides and large anterior ethmoid sinus cells were removed from both sides. The patient did well with the procedure and was able to go back to work after relaxing at home over the weekend.
The patient was placed on medicated sinus rinses for 4 weeks after the surgery and referred to an allergist for continued treatment of their allergies. Patient had no further sinus infections and found that they had more energy, were sleeping better and were in a better mood around family and co-workers. They were also very happy not to be taking any more antibiotics.