Procedure cuts suffering from sinusitis


Kennedy at work on a sinusitis patient

Photo by Daniel R. Burke

If you could compare suffering which do you think is worse—chronic lower back pain or chronic sinusitis? Surprisingly, the answer is sinusitis. “When it is severe and chronic,” explained David Kennedy, chairman of the department of Otorhinolaryngology/Head and Neck Surgery, “it can have greater impact on quality of life than such other common conditions that are recognized as debilitating, such as asthma, angina, chronic pulmonary disease and chronic lower back pain.”

The symptoms of sinusitis include repeated bouts of severe inflammation of the membrane in one or more of the sinus cavities, persistent congestion, headaches, and facial pain. It affects approximately 30 to 35 million people a year. For most people it is not a crippling disease. For a minority, however, it is. Each year about 250,000 people turn to surgery to for help. Kennedy and his team of researchers have found that surgery combined with postoperative care can significantly improve the quality of life for people who suffer from chronic sinusitis.

In a paper delivered in September to the annual meeting of the American Rhinologic Society, researchers found that functional endoscopic sinus surgery (FESS) improves quality of life to normal levels in three years.

Kennedy, who has been at Penn since 1991, was trained at the Royal College of Surgeons in Ireland and at Johns Hopkins. He introduced FESS to this country in 1985. “Since then, we have been able to expand endoscopic techniques to other skull-based surgery,” Kennedy explained.

The study, “Long-term Quality of Life Measures Following Endoscopic Sinus Surgery,” surveyed patients and found significant differences between chronic sinusitis sufferers and others on quality of life questions such as bodily pain, general health, social function, vitality and mental health. Following surgery and postoperative therapy, patients reported a return to normal in these areas.

Now is the height of the cold and flu season, so the Current asked Kennedy’s advice on how to avoid sinus problems. “The winter is the sinus season,” said Kennedy. “About 0.5 percent of viral colds and flu result in bacterial sinus infections and a very small percentage become the kind of chronic infections that require surgery.” He suggested using oral decongestants, topical decongestants like Afrin—but for not more than three days—and avoiding environmental factors such as smoke. “If a cold lasts more than 10-15 days or seems to be getting worse after the first week,” he concluded, “see a doctor.”

Originally published on January 16, 2003