Chronic Sinusitis Treatment

Introduction: Reclaiming Your Life from Chronic Sinusitis

For countless individuals in Frisco and the surrounding communities, life is dictated by the relentless pressure, congestion, and pain of chronic sinusitis. This isn’t just a recurring cold; it’s a persistent inflammatory condition that can last for months, profoundly impacting your ability to breathe, sleep, and enjoy daily life. Many resign themselves to a frustrating cycle of temporary remedies that never address the underlying problem.

I’m Dr. Justin Cable, and in my practice, I see the toll that chronic rhinosinusitis (CRS) takes on my patients every day. My philosophy is built on the principle that you don’t have to “just live with it.” Lasting relief is not only possible but expected when we move beyond surface-level symptom management. Achieving this requires a partnership between patient and physician, grounded in a precise diagnosis and a personalized, sophisticated treatment plan. This guide is designed to empower you with a clear understanding of CRS and the comprehensive, tiered approach we use to help our patients in Frisco breathe freely and permanently break the cycle of sinus suffering.

Understanding the Condition: What is Chronic Rhinosinusitis (CRS)?

To effectively treat a condition, we must first define it with clinical precision. Chronic rhinosinusitis is far more than a simple sinus infection. It is formally defined as a persistent inflammation of the nasal passages and paranasal sinuses that lasts for 12 consecutive weeks or longer, despite attempts at treatment.

The diagnosis of CRS requires the presence of at least two of the following four primary symptoms:

1. Nasal Obstruction or Congestion: A persistent feeling of stuffiness or blockage that makes breathing through your nose difficult.
2. Mucopurulent Drainage: Thick, discolored (yellow or green) mucus, which may present as a runny nose or as postnasal drip down the back of the throat.
3. Facial Pain, Pressure, or Fullness: A dull, aching, or pressure-like sensation over the sinuses—around the eyes, across the cheeks, or in the forehead.
4. Reduced or Lost Sense of Smell (Hyposmia/Anosmia): A diminished ability to detect odors, which can also significantly impact the sense of taste.

Crucially, these symptoms must be accompanied by objective, documented evidence of inflammation. This confirmation is a critical step that separates a true CRS diagnosis from other conditions with similar symptoms.

The Cornerstone of Relief: Dr. Cable’s Diagnostic Approach in Frisco

Guesswork has no place in modern sinus care. The foundation of any successful treatment plan is an accurate and comprehensive diagnosis. At our Frisco practice, we employ a systematic, multi-step process to uncover the precise cause and extent of your sinus disease, ensuring that your treatment is tailored specifically to your anatomy and condition.

1. Comprehensive Patient History: Our diagnostic journey begins with a conversation. I will listen carefully as you describe your symptoms, their duration and severity, and how they impact your quality of life. We will discuss your medical history, previous treatments you’ve tried, and potential contributing factors like allergies or environmental exposures. This detailed history provides the essential context for all subsequent findings.

2. Physical Examination: A thorough head and neck examination is performed to identify any obvious physical signs of inflammation or structural issues.

3. Nasal Endoscopy: This is one of the most important tools in diagnosing CRS. A nasal endoscopy is a simple, in-office procedure that provides a highly detailed, real-time view of your nasal passages and sinus openings. Using a very thin, flexible tube with a light and camera (an endoscope), I can directly visualize the sinus tissues to identify:

* Inflammation and swelling

* The presence and nature of drainage

* Nasal polyps (soft, non-cancerous growths)

* Structural issues like a deviated septum

4. Computed Tomography (CT) Scan: If endoscopy reveals signs of significant inflammation or if your condition has been resistant to initial therapies, a CT scan of the sinuses is the gold standard for imaging. This non-invasive scan provides a detailed, cross-sectional “roadmap” of your sinus anatomy. It allows me to see deep into the sinus cavities that are not visible during endoscopy, revealing the full extent of the inflammation and identifying any anatomical blockages that may be preventing proper drainage.

5. Allergy Testing: Because allergies are a frequent underlying trigger for the inflammation that leads to CRS, identifying these triggers is critical. We may recommend allergy testing (either a skin test or a blood test) to determine if specific allergens are contributing to your condition. A positive test allows us to incorporate targeted allergy management into your overall treatment plan.

By integrating the findings from each of these steps, we can build a complete picture of your sinus health and design a treatment strategy that addresses the root cause of your suffering.

A Tiered Approach to Treatment: Your Personalized Path to Sinus Health

My commitment to you is to provide the most effective, least invasive treatment possible. We will always begin with conservative medical management and only proceed to more advanced interventions if necessary. This tiered approach ensures you receive the right level of care at the right time.

Tier 1: Advanced Medical Management

The goal of medical therapy is to control inflammation, reduce symptoms, and restore normal sinus function without surgery.

• Saline Nasal Irrigation: A simple yet powerful tool. Daily rinsing with a saline solution helps to flush out mucus, allergens, and irritants while moisturizing the nasal passages.
• Nasal Corticosteroid Sprays: These are the first-line treatment for reducing the inflammation that drives CRS. When used consistently, they are highly effective at controlling congestion and swelling.
• Oral Corticosteroids: For severe inflammation or large nasal polyps, a short course of oral steroids (like prednisone) can provide rapid and significant relief by systemically reducing swelling.
• Appropriate Use of Antibiotics: While CRS is primarily an inflammatory disease, bacterial infections can occur during flare-ups. If an acute bacterial infection is confirmed, a targeted course of antibiotics may be prescribed. However, routine or long-term antibiotic use is not the standard of care for CRS itself.
• Biologic Therapies: For patients with severe CRS with nasal polyps driven by a specific type of inflammation (Type 2), we now have revolutionary injectable medications called biologics. These advanced therapies target the specific inflammatory molecules that cause polyps, shrinking them and providing profound relief without traditional surgery.

Tier 2: Minimally Invasive In-Office Procedures

When medical management alone is insufficient, or if there is a clear structural blockage, we can turn to state-of-the-art, minimally invasive procedures performed right here in our Frisco office. These techniques offer significant relief with minimal downtime.

• Balloon Sinuplasty: This groundbreaking procedure is designed to gently and permanently open blocked sinus pathways. A small, flexible balloon catheter is guided into the blocked sinus opening. The balloon is then inflated, carefully restructuring and widening the sinus passage without the need to remove any tissue or bone. The balloon is then deflated and removed, leaving behind an open sinus that can drain properly. It is an excellent option for patients with recurrent or chronic sinusitis who have not responded to medications.
• Turbinate Reduction: The turbinates are structures inside the nose that warm and humidify air. If they become chronically swollen (hypertrophied) due to allergies or irritation, they can cause significant nasal obstruction. Using advanced techniques like radiofrequency or coblation, we can gently shrink the turbinate tissue in a quick, in-office procedure, dramatically improving nasal airflow.

Tier 3: Functional Endoscopic Sinus Surgery (FESS)

For patients with extensive sinus disease, significant nasal polyps, or anatomical issues that cannot be resolved with less invasive means, Functional Endoscopic Sinus Surgery (FESS) is the definitive solution.

The primary goal of FESS is not to remove all sinus tissue, but to restore function. Using an endoscope for visualization and specialized instruments, I carefully remove the blockages (such as polyps or thin bone partitions) that are obstructing the natural drainage pathways of the sinuses. This creates a more open and functional sinus system, allowing mucus to drain, air to circulate, and topical medications to reach the inflamed tissues more effectively. FESS is a highly successful procedure that can dramatically reduce the frequency and severity of sinus infections and significantly improve a patient’s quality of life.

Long-Term Sinus Wellness: Lifestyle and Preventative Strategies

Your journey to sinus health doesn’t end with treatment. Adopting certain lifestyle habits can help you maintain your results and prevent future problems.

• Stay Hydrated: Drinking plenty of water helps to keep mucus thin and flowing easily.
• Use a Humidifier: Especially during dry winter months, using a humidifier can prevent your nasal passages from becoming dry and irritated. Be sure to keep the unit clean to prevent mold growth.
• Avoid Environmental Irritants: Steer clear of tobacco smoke, strong chemical fumes, and other pollutants that can inflame your nasal passages.
• Manage Allergies: If allergies are a contributing factor, diligent management through avoidance, medication, or immunotherapy is key to long-term success.
• Elevate Your Head While Sleeping: Propping your head up with an extra pillow can help promote sinus drainage overnight.

Begin Your Journey to Relief in Frisco

You do not have to let chronic sinusitis control your life. With a precise diagnosis and a personalized, comprehensive treatment plan, lasting relief is within reach. If you are tired of the endless cycle of sinus pain and pressure, I invite you to schedule a consultation at our Frisco office. Together, we will find the solution that allows you to breathe easier and live better.