Sinusitis  101

It is uncommon for sinus infections to spread outside of the sinus into the eye or brain, but certainly the possibility exists and must be treated urgently.

This week I was called to assess a patient with infection spreading into the eye and causing thrombosis (clotting) of the veins draining the eye. All from a sphenoid sinusitis. The sphenoid is located smack in the middle of your head, right below your brain and between the area that the optic nerves and eye blood vessels enter and exit the skull.

The eye was extremely swollen and could not move well in the socket.

The treatment was to drain the sinus by enlarging the sinus opening with a balloon, under image guided conditions. Watch this video!!

We went to the OR for anesthesia, and I carefully led a balloon catheter into the sinus (sort of like using in heart vessels) using previous CT scans which allowed me to know that the balloon had entered the sinus. After inflating the balloon, I then looked with an endoscope and suctioned out infected material. In the recovery room the eye pressure and headache from the infection was immediately greatly improved.

Techniques such as balloon sinuplasty, used routinely on an elective basis (not urgent or emergent), have become quite useful to these emergency conditions.
The more routine balloon cases performed, the more prepared is the surgeon is to handle these more challenging cases.

I use sinus balloons often, and am ready for any challenge.