Traditionally we think sinusitis is caused by bacteria infection or obstruction of sinus ostium, so the treatment of chronic sinusitis is mainly by antibiotics at first. Medical doctors will recommend operation to make patent the obstructed sinus ostia if medical therapy is in vain. Antibiotics-surgery cycle repeats again if the sinus symptoms persist or recur after operation. The incidence of sinusitis or the sinusitis patients should be less and less with the development of newer more effective antibiotics and more advanced surgical technique and devices, however the fact is that more and more people are suffered from chronic sinusitis year by year. Why?
Is chronic sinusitis a medical disease and can be managed by medical therapy or a surgical disease that can only be cured by operation? The therapeutic guidance by the Academy of Oto-rhino-laryngology today recommends medical therapy for the management of chronic rhinosinusitis, while surgical treatment is only recommended if medical therapy is in vain. So it seems that chronic sinusitis should be a medical disease and can be managed well by non-surgical method. Why there are still so many sinusitis operations performed today?
Dr. David S. Parsons, a well-known ENT professor in the university of Missouri school of medicine, pointed out in a medical journal about the topic of pediatric chronic rhinosinusitis that he strongly believed that chronic sinusitis was a surgical disease and can be cured only by operation during his earlier practice. However he changed the conclusion after the use of MMT-- the use of a more inclusive history and an expanded work-up that " chronic sinusitis in children is generally a medically treatable disease and surgery is not often required." He said that the sinusitis patients should wait for 2 years to accept operation previously ( too many patients waiting for surgery ), however only three sinusitis sufferers during 2 years period should have surgical treatment when his group treated the sinusitis patients by MMT. It is a very dramatic and unbelievable change, isn't it?
Miracles happened often after we treat sinusitis patients by maximal medical therapy. Many patients thanked us that we saved their health to avoid the complications of long term medications or surgery. They had more time and money to enjoy their lives. So if your doctor suggests you or your loved one long term antibiotics or surgical treatment for chronic rhino-sinusitis, remember to ask your doctor " can we try the maximal medical therapy before operation?"
What you think determines what you do! You can save you or your loved one!
Dr. Hung Cheng Tseng