SINUS DISORDERS 2017-05-22T18:05:09+00:00

Sinus Disorders

Feel free to contact Dr. Economou

for further information or a consultation.


Functional Endoscopic Sinus Surgery (FESS)


Sinus problems are among the most common health conditions seen in Europe. Fortunately, a broad variety of medical and surgical therapies are available to treat these diseases, and new approaches are constantly being developed. Dr Economou’s approach is used to fully investigate every case and determine the best possible treatment. Treatment options may include medical (non-surgical) management, as well as surgical options if all medical treatments have failed to ease your symptoms. Our goal is to preserve or improve function of the nose and sinuses.

Sinuses are spaces inside the face and skull that are lined with delicate mucosal tissue (nasal mucosa). These spaces range in size from several centimeters in the maxillary and frontal sinuses to only a few millimeters in the ethmoid sinuses.  Tiny channels (osteomeatal complexes) connect these sinuses with each other and the inside of the nose.


When the nose becomes congested from allergies, dust, or a viral infection, the sinuses may not drain normally. When this happens, a sinus infection (sinusitis) can occur. Because the passages and sinus spaces  inside the nose are only millimeters or less in size, even a minute amount of inflammation can cause a sinus infection. A deviated nasal septum or enlarged nasal turbinates can decrease the passage area inside the nose and predispose to sinus infections. What appears to be a regular “cold” lasting a week or more can be undiagnosed sinus infection.

Inflammation that causes an infection of the paranasal sinuses lasting up to four weeks is known as acute sinusitis. The beginning of this infection may be caused by a virus and might go away without antibiotics. If the infection lasts over a week or the nose becomes severely congested with thick green or yellow nasal discharge, the infection may have progressed to a bacterial acute sinus infection.

An infection of the sinuses lasting greater than 3 months is termed a chronic sinus infection. The types of bacteria in a chronic sinus infection tend to be more varied than the bacteria of an acute sinus infection. Antibiotics for chronic sinusitis are much less likely to work and therefore antibiotic treatment is controversial. Decreasing  inflammation and swelling within the sinuses is currently the most accepted and preferred management. Chronic sinus infections can be one of two variations; Chronic sinusitis with or without nasal polyps. Nasal polyps occur when the nasal mucosa grows inside the nose in an uncontrolled manner that can further obstruct the nose.

What are the signs and symptoms of a sinus infection?

Thick colored nasal discharge– Bacterial infections of the nasal mucus are generally thick, yellow or green in color, and can have a very bad odor. The viscous mucus will either drain from the nose, be coughed up, or can be difficult to blow from the nose and sinuses.

Headache or facial pain– The delicate lining of the inside of the nose is very sensitive. The pressure from inflammation and mucus pressing on these tiny passages and spaces can cause severe headaches, toothaches, cheek and forehead pain,  nasal congestion, or jaw and neck stiffness.

Recurrent infections– Repeated episodes of sinusitis can thicken the passages inside of the sinuses. This can predispose the nose to infections any time there is swelling inside the nose. The strains of bacteria inside the sinuses and nasal cavities may self-select become more hardy and resistant to antibiotics.

Fatigue– An infection takes a lot of energy to fight and not being able to breathe can limit your ability to get a good night’s sleep.

Successful treatment of an acute sinus infection is often possible using antibiotics directed toward the most likely causes of infection. Failure of antibiotics may require further testing, including a CT scan of the sinuses. Additional improvement can come from a combination of anti-allergy medication, decongestants, nasal sprays, and saline rinses. Environmental controls, such as removing your carpet or using an air purifier can also decrease symptoms.

When medical treatment has failed, treating sinusitis with sinus surgery can dramatically improve your quality of life and sense of well-being. Functional endoscopic sinus surgery (FESS) removes blockages, allowing each sinus to ventilate and drain through its natural opening.

Functional endoscopic sinus surgery (FESS) is the current standard of care for minimally invasive sinus surgery.The excess and infected tissue is removed and the natural circulation within the sinuses is re-established during a FESS. For a small select group of patients, the balloon sinuplasty surgery may be appropriate where a guide-wire and balloon are used to open a sinus without tissue removal. Rarely, for more complex and stubborn cases, traditional sinus surgery with skin or intraoral incisions are needed.

With Dr. Economou’s advanced surgical techniques, patients experience a more rapid and comfortable recovery period. Dr. Economou does not pack the nose following surgery, eliminating the possibility of extra scarring inside the nose.  Our patients experience less bruising and swelling as a result and are typically back to regular activity within 7-10 days.

Whether or not you experience pain after your surgery is different for every patient. Each person has his or her own level of pain tolerance. Some may need to take prescription pain medication, while others do not need any pain medication whatsoever. It is common for patients to feel severe nasal congestion like it is the worst cold of your life.  Your doctor will provide you with oral pain pills to take in the event that you are feeling pain after surgery, and will explain to you what type of discomfort you should expect after your procedure.

The type of pain that patients experience is usually a sore and swollen feeling inside of the nose. Dull throbbing pains may occur where bone was removed. Facial swelling or bruising is usually mild after sinus surgery.

Doctor Economou rarely needs to place packing inside the nose. This can prevent additional severe congestion, pressure and pain that packing may cause. Postoperative visits begin at 6 to 7 days after surgery. Patients may experience pain on postoperative visit when crusting and sutures are removed from inside the nose.

Whether your doctor performs an ethmoidectomy, a maxillary antrostomy, or a septoplasty with turbinate reduction, there will be similar symptoms that you are likely to experience.

It may take a few weeks before you feel back to normal. You will also notice swelling and tenderness inside your nose. You may also experience either a slight cold, due to dry blood, inflammation, mucus, and crusting in your nose. To help decrease this, it is important to stick to a regime of using nasal irrigation, saline gels, antibiotic ointments, or a combination of the three to promote proper healing.

DO: Meet with your doctor for post-op visits

The post-operative care is essential to your receiving the best results after sinus surgery. Patients are seen starting one week after surgery in the office and then as frequently as necessary to examine the sinus area with an endoscope, clean your nose and sinuses, and to make sure you are healing properly.

Postoperative visits are perhaps the most important after-surgery care a patient can receive.

DO:  Follow at-home instructions. (will be given to you at your day of release)

In addition, you must also be sure to irrigate your sinuses twice daily, using sterile saline. Sleeping in an elevated position for the first two to three weeks following surgery is also recommended, since it will make for better nasal airflow and less nasal congestion.You should call your doctor if you feel as if you are bleeding excessively or head towards the closest hospital.

DON’T: Blow your nose for the first 14 days after surgery, to allow for the delicate tissues to heal properly. If you have to sneeze, try your best to sneeze with your mouth open. You are advised also to avoid to engage in contact sports for six weeks after surgery.

Furthermore, it is recommended that you skip the gym and take care not to sign up for any physically demanding contact sports or work for a period of at least 2-3 weeks, otherwise you are susceptible to nasal bleeding due to the stress placed on your body.

DON’T: Take aspirin or ibuprofen.

Do not take aspirin or NSAIDs while your nose is healing. They will prevent clotting and potentially increase bleeding.

Special post-operative instructions is given in written form to each patient after surgery.