When should surgery be considered?

A small percentage of patients with chronic sinusitis will fail to improve even with the best medical treatment. In most studies of patients treated by allergists who specialize in treatment of chronic sinusitis, this is less than 10% of patients who have had optimal medical treatment. It is important to realize, however, that surgery is frequently performed on patients who have not had the best medical treatment prior to surgery. This web site is one of many attempts to educate physicians and the public ab...

What role do food allergies play in sinusitis

The effects of food allergies in treatment of sinus infections are very controversial. This is something that the patient needs to discuss with an allergist well acquainted with treatment of sinusitis. Briefly, food allergies are much more common in children than in adults and can sometimes cause problems with sinusitis, but much less commonly than environmental agents like dust, molds, pollen, animals and believe it or not: cockroaches. Milk may cause problems in some patients, but probably less than 15% o...

Do allergy shots help with sinus infections?

In patients who have chronic sinus infections, I think it makes sense to do  anything  to avoid worsening of symptoms or surgery. If we find a patient is allergic and has chronic sinusitis, we often suggest getting allergy shots to desensitize them to the various things to which they are allergic, in the hope that it will help with the sinusitis. Because allergy shots take 6-24 months to work, they must be used in conjunction with other treatment, including controlling exposure to environmental agents.

What role do allergies play in sinusitis?

Many patients with chronic sinusitis have allergies which may partially complicate sinusitis. Allergies cause swelling and blockage of the tiny holes which allow drainage of mucus from the sinuses. In addition, the allergies may cause swelling inside the sinuses and inside the nose. It is critical that patients with allergies control their environment in order to control their sinusitis. Because so many patients with sinusitis have allergies, we have included a section on allergies later in this website as ...

What effect do nasal polyps have on sinus problems?

Nasal polyps are not true polyps but rather are probably caused by inflammation in the nose. They look like peeled grapes but are basically fluid-filled sacs. They can be found anywhere in the sinuses or nose and commonly are associated with sinus infections. They can cause a blockage of the drainage holes (ostia) from the sinuses, causing a back-up of mucus in the sinuses. Nasal polyps are often associated with asthma and can be made worse in some people by ingesting aspirin or related drugs. Treatment inv...

What kind of effects do tobacco smoke and other irritants have on the sinuses?

Tobacco smoke and various other irritants may cause worsening of symptoms. Those irritants include auto exhaust, gasoline fumes, paint fumes, perfume, roach spray and household chemicals such as bleach, etc. Cigarette smoke paralyzes the tiny hairs (cilia) which move mucus out of the sinuses. It also causes irritation and inflammation in the nose and respiratory tract. There is no good way to effectively treat these exposures, and as a result they must be avoided. Sometimes using an air filter will be helpf...

What role does a deviated septum play in sinusitis?

The septum is the bone and cartilage which separates the two sides of the nose. A deviated septum is simply a crooked septum. A deviated septum commonly can cause or exacerbate chronic sinusitis by causing a blockage of the nose and also of the drainage area from the sinuses. Most people have a somewhat deviated septum. Just because your septum is deviated, it doesn't mean that it is causing a problem-but it does need to be evaluated. There are some patients who have such a severe deviated septum that they ...

Why do I have to keep my nose clear? I can breathe through my mouth.

Believe it or not, your nose is not just a decorative object found on your face, it really has a purpose. It is extremely important to keep the nose clear so it is possible to breath through the nose. It has been found that air exchange into the sinuses occurs twice as rapidly with nasal breathing. The air exchange will reduce the likelihood of bacteria growing in the sinuses.

Can I drink alcohol?

Alcohol very commonly causes worsening of sinusitis, often not so much because of an allergy, but because alcohol functions as a diuretic. It often causes patients to become dehydrated, leading to drying and thickening of the mucus which may, in turn, cause a blockage of the opening of the sinuses and a worsening of the infection. In addition, when patients come home after having several drinks, they often may forget to take their medications and don't turn on their vaporizer leading to worsening of the sin...

What is the place of acupuncture in sinusitis?

A wide variety of non-traditional treatments have been used in treatment of sinusitis. Acupuncture has been used to help open the sinuses allowing the mucus to drain better. I had acupuncture before surgery. It helped, but I still had to have surgery. Most patients we have seen have felt that it has helped open their sinuses up, but no studies have confirmed this. A CT scan (x-ray) done before and after on our several of our patients has not shown any substantial change.

How long does sinusitis have to be treated?

Because of the fact that we are dealing with an abscess which can not be adequately drained without doing a major surgical procedure, it often takes an extended period of time for the sinus infection to be completely treated by what we can call medical drainage. Some physicians often will only treat patients with sinus infections for a week or ten days and as a result patients are partially cured, but never get complete relief of symptoms. It is critical that treatment occur for a minimum of several weeks, ...

Can I use antihistamines to treat sinusitis?

Under some circumstances, antihistamines are used, if allergies play an especially prominent part in the symptoms. Because of the fact that antihistamines tend to be drying, we usually try to avoid them in treatment of sinusitis. The mucus in the sinuses may then get dried out and is plastered up against the wall of the sinuses. The bacteria love it because they are trapped inside the sinuses with nowhere to go. They reproduce like crazy and since the mucus is dried out, a blockage in the small drainage can...

Can you do a culture to find out what bacteria are causing sinus infection?

Unlike most infections ( for example a strep throat), where it is possible to determine the exact bacteria by doing a simple culture, it is not possible to simply take a culture from your nose to determine what the cause is of the sinus infections. The bacteria inside the nose which we could theoretically culture are not the same as the bacteria growing in the sinuses unless you have previously had sinus surgery. It is possible to take a culture from the drainage area of the sinuses, but this is something w...

A vaporizer for sinus treatment

It is also extremely important for most people to use a humidifier, especially in the winter. I prefer a hot mist vaporizer, as long as there isn't any reason not to use one, such as someone around who might get burned. It should preferably be placed at your bedside every night, to thin out the mucus. Short of a vaporizer, breathing in steam on a regular basis by boiling water can be used but is not as satisfactory. We use a special apparatus in the office called a Rhinotherm. This machine blows out a heate...

Can I use an over-the-counter nasal spray?

Judicious use of a decongestant nasal spray such as Neosynephrine, used according to directions for three to seven days, is also advisable in many patients. Extreme caution must be used in order to prevent worsening of symptoms or addiction to these sprays. Note that there is no risk of addiction with the prescription nasal sprays, but there can be other side effects - check with your doctor.

What about side effects from medications?

Approximately two-thirds of the patients with sinus infections that we see have some problems from medications. Common side effects include lightheadedness, dizziness, spaciness, difficulty concentrating, jitteriness, being hyper, rapid heart beat, difficulty sleeping, nausea, bloating, rectal itching, burning on urination, fatigue, and so forth. A lot of these side effects can also be due to the sinusitis. And because side effects occur so commonly, it takes an experienced physician to be able to deal with...

How long do I have to take antibiotics for sinus treatment?

Because penetration of antibiotics inside the sinuses is poor, an extended treatment is often necessary. Antibiotics do not penetrate well into bone and the bacteria in chronic sinusitis are located inside bone. Typically a minimum of three weeks or more of antibiotic treatment is necessary for patients with chronic sinusitis. Sometimes 6-8 weeks of treatment may be necessary. In some cases multiple different antibiotics need to be used. In some cases where patients do not get better after they have been tr...

      1      2      3