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No more headaches

Sinusitis is a common cause for headaches. Dr. SUNDHAR KRISHNAN writes about the latest techniques of dealing with the problem.


HEADACHES may be due to Neurological causes; Ophthalmic causes; ENT causes; Vascular causes or Dental causes.

Those arising out of neurological disorders are usually associated with symptoms like nausea, vomiting, blurred vision and fits. This type of headache may be a warning of increased intra cranial tension or intracranial tumours. Ophthalmic disorders like glaucoma and refractory errors may cause headaches. Dental caries and other disorders in the teeth may cause severe headache, which can mimic sinusitis. Migraines cause more trouble and are usually episodic associated with an aura. They are also one-sided.

Common cause

The commonest cause of headache, however, is Sinusitis. This may be associated with nasal obstruction, running nose, postnasal discharge, dry cough and other such factors. With the nose being subject to various environmental pollutants and infections, sinusitis has become an increasingly common problem.

Sinuses are normal spaces or cavities within our skull. Ventilation and drainage of their secretions is essential for proper functioning. Our nose acts as a common drainage point for all sinuses. When the sinus pathway is obstructed, secretions collect in sinuses leading to bacterial and fungal infections. The nasal obstruction may be caused by variations in the anatomy of the nose like deviation of the septum and formation of soft tissues like polyps.


Evaluation of patients with sinusitis requires a detailed examination. The advent of nasal endoscopes has revolutionised the treatment of sinusitis. This reveals the complex anatomy and the changes causing disease in the nose and sinuses. The patient can also see all this on the monitor. Blood tests, x-rays and a CT scan of the sinuses complement the endoscopy and play a vital role in evaluation.

The use of nasal endoscope has revolutionised treatment of sinusitis.

Patients are initially treated with appropriate antibiotic therapy. The use of nasal endoscopes has brought about a great change in the treatment of the disease and surgical aspects. The earlier surgical methods like puncturing and lavage, which did not establish adequate drainage, are all obsolete now.

The latest surgical procedure called Functional Endoscopic Sinus Surgery (FESS) uses the advanced nasal endoscope. This procedure precisely eliminates the blockage of natural pathways of the sinuses restoring the normal flow of secretions. It also has a cosmetic advantage in that it produces no external scar. The surgery can be performed as a day care procedure. Deviation of the septum, when present, is also corrected in the same sitting. There is no need for repetitions as in the older procedures.

Advanced surgical tools like Microdebrider help in adequate and efficient treatment making FESS a safe and advanced technique in the management of sinusitis. The use of Microdebrider provides good mucosal preservation, reduced complications like bleeding and hence good postoperative results. Microdebrider plays a vital role in polyp surgeries reducing the recurrence rate.

The nasal endoscope is also a great tool in performing other surgeries and its role in minimally invasive removal of orbital tumours and in neurosurgery has revolutionised these fields. With these advanced options available, sinusitis no longer needs to be a headache.

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