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Clear the way for easier breathing this summer

Hay fever may well get the blame for many sinus problems this summer but on many occasions a blocked nose has very little to do with a rise in the pollen count.

Mr David Howe an Ear, Nose and Throat Consultant Surgeon at Spire Parkway Hospital in Solihull, Birmingham, West Midlands, explains about sinusitis and the treatments available.

Sinus infections arise from a combination of blockage within the sinus and infection forming within it. This obstruction of the tiny ducts that drain the sinus into the nose leads to the symptoms of pain, pressure, discharge and congestion that people report with acute sinusitis.

Chronic sinusitis is a rather different condition and in the UK is often associated with nasal polyps. This tends to cause patients to have a very blocked nose, loss of sense of smell and recurrent discharge from the nose. It can affect men or women but is certainly more common in people who have asthma, cystic fibrosis or aspirin sensitivity.

When treating acute sinusitis, often all that is needed is painkillers such as paracetamol, decongestants such as 'otrivine' nasal drops or sudafed can help. Using a saline nasal douche can also make patients feel better.

Antibiotics are rarely needed unless the patient becomes toxic or gets frontal headaches suggesting perhaps a frontal sinusitis.  If the episode lasts more than a few days then antibiotics might be appropriate.

Chronic sinusitis is more complex and this often needs input from a specialist. Confirmation of the diagnosis is key with often the need for a nasoendoscopy to be certain. Then a combination of antibiotics and steroids may be used to treat the sinusitis. Approximately 50% of patients will respond to this but a minority may require surgery eventually.

Surgery is generally done for patients with chronic sinus disease which doesn't respond to medication. Occasionally patients with recurrent acute sinusitis may need treatment.

Surgery in the UK is now almost always done endoscopically (up the nostril) without the need for any incisions. Advances in technology now means that surgery utilises image guided navigation and balloon sinuplasty to try and make the surgery as safe and minimally invasive as possible. This is often done as a day-care procedure, under local anaesthetic.

If surgery is successful and opens the sinuses effectively then often the infections will subside.

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Clear the way for easier breathing this summer
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