Sinusitis

It refers to the obstruction and inflammation of the paranasal sinuses—normally air-filled, mucosa-lined cavities situated within the facial skeleton—resulting in the accumulation of purulent or mucopurulent exudate and inflammatory cells.

Acute sinusitis generally develops secondary to an upper respiratory tract infection and completely resolves within 4 weeks. If the clinical manifestations (such as nasal congestion and anosmia) persist beyond 12 weeks, the condition is classified as Chronic Sinusitis.

Symptoms include facial or cranial pain that exacerbates upon leaning forward, a sensation of pressure or fullness over the cheeks and retro-orbital regions, thick yellow or green postnasal drip, nasal obstruction, and a consequent diminution of the olfactory sense (hyposmia).

Unlike a migrainous throbbing ache, sinus headache is predominantly experienced as a heavy, oppressive pressure. It creates a severe sense of pressure in the frontal or maxillary regions (overlying the sinuses), particularly upon awakening or when tilting the head forward.

Diagnosis is established by an ENT specialist utilizing nasal endoscopy to directly visualize purulent discharge originating from the sinus ostia. If nasal polyposis is suspected or surgical intervention is planned, a Paranasal Sinus Computed Tomography (CT) scan is performed to map the precise anatomical pathology.

For chronic, medically refractory cases, FESS is conducted minimally invasively via the nostrils using an endoscope. The obstructed natural ostia of the sinuses are surgically enlarged, the accumulated purulence is evacuated, and physiological mucociliary clearance and aeration are restored.