NW LA Times

People who suffer from facial pain may have chronic sinusitis, sinus infections and other sinus ailments -- possibly having suffered for years -- and may not know that the relatively new balloon sinuplasty procedure can provide them with relief.

"Facial pain is a very common symptom of chronic sinusitis, and it's mediated by the trigeminal nerve," Dr. Jeffrey Feinfield of Bella Vista ENT & Facial Plastic Surgery in Thousand Oaks told the NW LA Times. "It's interesting that there could be pain on your upper forehead, but then you have sinus disease on your cheek, and so our pain receptors aren't very specific sometimes, but just an indicator."

Dr. Jeffrey Feinfield | Bella Vista ENT

For instance, tooth pain may have more to do with chronic sinusitis than with the tooth itself, and the cause can be seen in Computed Tomography (CT).

"A very common indicator pain is tooth pain," Feinfield said. "If you've ever looked at a sinus CT, you can see that your maxillary tooth roots descend right into the sinus, and so your nerve endings are exposed. If there is inflammation at the bottom maxillary sinus, which is your cheek sinus, very commonly your teeth will hurt."

Treating tooth pain caused by chronic sinusitis has traditionally been done with antibiotics, but if that doesn't work, a CT scan is usually ordered, Feinfield said.

"Oftentimes a balloon sinuplasty can solve the problem and put an end to, not only the pain and suffering, but the chronic antibiotic use," he told the NW LA Times.

Chronic sinusitis affects 28.9 million American adults, or 11% of the adult population in the United States, according to the Centers for Disease Control and Prevention. A 2017 National Institutes of Health (NIH) study found that 60 to 75% of chronic sinusitis sufferers also suffer from poor sleep. A 2018 NIH study found that people suffering the pain and pressure of sinus infections have a 34% increased risk of stroke.

A 2017 NIH study of sleep disruption in chronic rhinosinusitis tracked multiple chronic symptoms in a large number of patients with sleep impairment. A 2015 NIH study found that people who were suffering from chronic rhinosinusitis had more facial pain compared to the control subjects across several pain measures.

Chronic sinusitis symptoms include yellow or green nose drainage, facial pain and pressure, stuffy nose, bad breath, coughing up mucus and sometimes fever and chills, according to Merck Manual.

Balloon sinuplasty was developed in 2005 and has been shown to be as effective as traditional functional endoscopic sinus surgery, providing relief to patients who suffer from sinus-related ailments.

This procedure has many benefits over endoscopic sinus surgery, which is traditionally is done in a hospital or surgery center. Feinfield described endoscopic sinus surgery as "the surgeon knocking down walls."

"Imagine, when you have to knock down a wall," he said. "That's going to lead to a lot more recovery, more inflammation. With balloon sinuplasty, we preserve natural tissue because all we're doing is dilating the opening of where the sinus drains out, reducing the need for healing and much less pain. Someone can be back on their feet and back to work in a day or two, whereas the traditional sinus surgery -- a week."

People who think they might be suffering from chronic sinusitis can take the Bella Vista sinus quiz to help decide whether they should see a doctor.