The maxillary sinuses, ethmoid sinuses, frontal sinuses and sphenoid sinuses are summarised under the term paranasal sinuses. These are air-containing cavities lined with mucous membrane above the eyes (frontal sinuses), between the eyes (ethmoid cells), under the eyes (maxillary sinuses) and under the base of the skull (ethmoid cells, sphenoid sinus). They are connected to the nasal cavity via narrow ducts. The mucus from the paranasal sinuses is transported towards the excretory ducts via cilia located on the mucosal cells and drained into the nasal cavity.
Inflammation from the nose can spread to the sinuses and lead to blocked ventilation and chronic inflammation due to the narrow connecting passages. A curvature of the nasal septum and/or an enlargement of the turbinates as well as polyp formation can also have this effect.
The aim of sinus surgery is to remove the obstruction to the main nasal cavity, thereby ensuring better ventilation and removing the pathologically altered mucous membrane. Accompanying measures such as correction of the nasal septum and reduction of the turbinates may be necessary.
In the case of nasal polyposis, it is essential to carry out strict follow-up treatment of the nasal mucous membranes with nasal sprays containing cortisone, as the underlying disease and therefore the cause of polyp formation is not eliminated by the operation!
The operation is performed under general anaesthetic and as an inpatient procedure. The nasal openings are usually chosen as the access route. If necessary, after straightening the nasal septum and/or reducing the size of the turbinates, the natural ducts of the affected paranasal sinuses are located and widened with microscopic and endoscopic support and structures that are anatomically too narrow are removed using special instruments.
Pathologically altered mucous membranes and polyps are removed while carefully protecting the surrounding important structures (eyes, brain, vessels). The aim is to permanently improve drainage of the paranasal sinuses into the nasal cavity.
Coated foam tamponades are inserted for postoperative haemostasis, and silicone splints may also be used if the nasal septum has been corrected.
The tampons are removed on the second postoperative day. As a rule, discharge from inpatient treatment also takes place on this day.
This is followed by a two-week healing phase with measures to care for the mucous membrane and physical rest in order to prevent secondary haemorrhage due to an increase in blood pressure.
Sport should only be resumed after three weeks.
It takes about a month for the mucous membrane to fully regenerate and for the wound to heal.
In the case of nasal polyposis and/or allergic symptoms, it is necessary to take appropriate local measures (topical cortisone sprays) over a longer period of time in order to prevent recurrence.
In order to determine the disease and its severity or to find out whether there is an indication for sinus surgery, the first step is the classic ENT examination: an endoscopy of the nose using a nasal speculum. It is also possible to ENT endoscopy. Ultrasound examinations of the paranasal sinuses and other imaging procedures such as CT, MRI or X-ray can also be used.
During the procedure, the paranasal sinuses are opened and the anatomical conditions within them are improved (e.g. by removing polyps). This provides relief for the patient: They can breathe more easily through their nose again. Furthermore, an improvement or normalisation of an existing olfactory disorder can also be achieved.
The term Rhinosinusitis refers to a simultaneous inflammation of the nasal mucosa (rhinitis) and the mucous membrane of the paranasal sinuses (sinusitis).
Acute rhinosinusitis is usually caused by bacteria or viruses and manifests itself as a blocked nose with mostly yellowish mucus. The disease is often accompanied by a pressing headache and a pressing sensation in the facial area. Acute rhinosinusitis does not usually last longer than 12 weeks.
If this illness period of 12 weeks is exceeded and there is no complete recovery, this is referred to as chronic rhinosinusitis (CRS). The symptoms of the chronic variant are less pronounced, but are permanent or recurrent. Patients with CRS often complain of obstructed nasal breathing and a feeling of pressure and swelling in the facial area. They are also often more susceptible to infections.
The severity of the disease can be assessed through examinations and, if necessary, additional imaging procedures. This can be categorised as mild, moderate or severe. If the patient finds CRS very stressful and their quality of life is limited as a result, sinus surgery can help.
We humans may not be able to smell as well as many animals, but we can still distinguish between up to several thousand odours. If our ability to smell is inadequate, this can lead to a significant reduction in our quality of life.
The causes can be varied: they are often located in the nose and paranasal sinuses themselves (sinunasal causes), occur after a viral infection, after head trauma or in neurodegenerative diseases (e.g. Parkinson's disease or multiple sclerosis). Sometimes the reasons that can negatively affect the sense of smell are also unclear (idiopathic olfactory disorders).
If olfactory disorders can be attributed to diseases of the nose or paranasal sinuses (e.g. chronic rhinosinusitis or polyps), it is possible that treatment of the underlying disease will lead to a significant improvement in odour perception. In many cases, the ability to smell can even be completely restored by sinus surgery if conservative treatment with medication does not work.
Soft, benign growths on the nasal mucosa are known as nasal polyps. They are often only a few millimetres in size and do not cause any symptoms. Other polyps can grow into extensive formations and narrow the nasal cavities. Patients who have polyps in their nose or paranasal sinuses therefore often find it difficult to get enough air through their nose. They speak nasally and breathe through their mouth more often, which means that the air they breathe is not filtered. Affected patients also snore frequently at night and suffer from sleep disorders. The condition can also be accompanied by frequent inflammation of the paranasal sinuses. Patients often have (sometimes significantly) reduced performance and quality of life.
Nasal polyps can often be treated with the use of certain medications. For example, nasal sprays containing cortisone or cortisone in tablet form can be used. However, polyps can also be removed by surgery, especially if they are very pronounced. The procedure usually improves nasal breathing immediately and significantly. In some cases, the sinus ducts can be widened during the procedure. The positive effect: they are better ventilated and less likely to become inflamed in future.
Mucoceles are stubborn accumulations of mucus in one or both paranasal sinuses that form due to adhesions at the junction of the paranasal sinuses and the nasal cavity. These adhesions can be caused by previous inflammation, injuries/surgery in the nasal area or polyps, among other things. The mucoceles are usually surrounded by a kind of capsule and cannot drain on their own. If these accumulations of mucus become infected with bacteria and pus forms, they are referred to as pyoceles.
The accumulations can increase in size if the outflow of mucus is obstructed over a longer period of time. The larger the mucoceles/pyceles become, the more they press on the walls of the paranasal sinus. This can lead to a thinning of the bony boundaries. In extreme cases - although this is very rare - the mucus accumulations can extend into the neighbouring structures (usually the eye or cranial cavity).
Mucoceles and pyoceles can not only lead to restricted nasal breathing, but also - depending on where they are located in the nasal area - to swelling of the face, visual disturbances or headaches.
The state-of-the-art procedure is the surgical removal of mucus accumulations. In certain cases, it may make sense to enlarge the connection between the affected paranasal sinus and the main nasal cavity. This can prevent new accumulations of mucus.
A blocked nose can have a considerable impact on everyday life. Many people then turn to nasal sprays, which can provide quick relief. But what happens if the medication doesn't work? There can be various reasons for this.
Recurrent sinusitis can have a significant impact on quality of life and is often associated with persistent symptoms such as a feeling of pressure in the centre of the face, headaches and a blocked nose.
Free, undisturbed nasal breathing contributes significantly to quality of life and well-being. However, anyone who suffers from restricted nasal breathing knows the effects on sleep, concentration and general fitness only too well. In the following, we will show you effective options and modern treatment methods that will allow you to breathe freely again.
Interrupted breathing during sleep is a serious condition that often goes unrecognised. Sleep apnoea can significantly impair quality of life and lead to long-term health problems. It is important to recognise the signs early and take appropriate measures.
Some people suffer repeatedly or even permanently from the feeling of a blocked nose. In this case, you may have enlarged turbinates. During a laser conchotomy, we can laser the inside of your nose and allow you to breathe freely.
Loud snoring can turn sleep into torture. In some cases, snoring surgery can be the solution so that you can sleep peacefully again. We offer this form of snoring therapy at our ENT clinic in Frankfurt.
Many people are unhappy with the size and/or shape of their nose. Anyone who suffers from their appearance may consider a nose job. In some situations, health insurance will even cover the costs of rhinoplasty or subsidise the procedure. You can find out when this is the case below.
Various triggers can lead to a so-called septal perforation. You can find out below how a septal perforation can occur, how a hole in the nasal septum manifests itself and how we can treat it at our ENT practice in Frankfurt.
As the central feature of the face, the nose is a real eye-catcher. If the nose is crooked, it is not only this unit of attractiveness that can be disturbed. A crooked nose can also lead to functional disorders such as breathing problems. In this article, we explain how we can help you here.
The lateral wall of the nasal cavity contains a lower, a middle and an upper turbinate. If they swell and become permanently enlarged, we ENT specialists speak of turbinate hyperplasia. You can find out what this means and how we can help you here.
Snoring can affect your health, but it can also have an impact on your partner's healthy sleep. You should therefore have it checked why you snore. In this article, we explain what treatment is possible and when you need an operation to stop snoring.
Epistaxis - that's the medical term for something you've probably had before: A nosebleed. In most cases, it looks worse than it is. In this article, we explain when nosebleeds can be a sign of a (serious) illness and when you need to see a doctor.
You may be familiar with the situation: your nose is constantly running and tissues are in constant use. Even though it's not hay fever season and you don't suffer from any allergies. In this article, we explain the possible causes of a runny nose.
Nasal polyps are soft, benign tissue proliferations of the nasal mucosa. Some polyps are only a few millimetres in size, others can grow into extensive formations. In this article, we will inform you about when and how we remove nasal polyps.
When the nose is blocked, it is very unpleasant and annoying. Treatment varies depending on the underlying cause. It ranges from nasal irrigation to the use of nasal sprays and tablets. In some cases, surgery may also be necessary.
Many patients with chronic sinusitis suffer from troublesome symptoms for years. Even if sinusitis is chronic, this does not mean that it cannot be treated. In this blog post, we show you various treatment methods.
Sympathy, empathy, experience, expertise: these are some of the main qualities that patients looking for a nasal specialist want from their doctor. In this article, we will show you why Dr Thomas Fischer is your ideal partner for rhinology.
The lateral wall of our nasal cavity is home to a lower, a middle and an upper turbinate. If the turbinates are enlarged or swollen, this is referred to as turbinate hyperplasia. We explain exactly what this means and how it can be treated in this blog post.
Almost everyone has a vice, big or small: some people love to eat but don't exercise enough, others smoke and others drink too much alcohol. There are also people who are addicted to medication. Tens of thousands of Germans resort to nasal sprays because they are addicted.
Patients who come to us are often unaware of their deviated nasal septum or the symptoms it can cause. Yet this phenomenon is not at all uncommon. You can find out more about the possible consequences and treatment approaches in this article.
Our nose is a fascinating organ: it has a multitude of different tasks. This enormous performance can also lead to problems and limitations. Here you can find out what nasal complaints there are, how they affect the activity of the nose and when an operation is necessary.
In addition to preventive measures relevant to all ENT areas, such as endoscopies and sampling, we also carry out specific diagnostic and treatment measures in the area of the throat, nose and ears. In this article, we will show you which measures our ENT medicine includes in detail.
Have you ever wondered why the person who snores is always the first to fall asleep? This "tree-sawing" can have serious consequences for a partnership. If one person snores constantly, there is the threat of an unromantic consequence: separate beds.
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