What is the relationship of asthma to sinusitis?

About 70% of people with chronic sinusitis have asthma as well, but it doesn't necessarily have to debilitate you. It has been found that about 15% of Olympic athletes have asthma.

Can sinus problems be due to an immune deficiency?

It is unusual, but sometimes sinus infections are caused by immune problems. In patients who have persistent sinus infections, it is important to have the immune system evaluated by an allergist/immunologist, especially before surgery is done. You may need to have allergy tests done, as well as tests done to make sure that you can form antibodies normally to common bacteria. Rarely, it can be due to AIDS, but don't jump to conclusions: 99.9% of people with sinusitis don't have AIDS.

What other problems happen as a result of sinusitis?

I have seen patients with problems like hives which wouldn't get better, they had no other symptoms. The hives got better immediately with treatment of sinusitis. I was amazed. Sinus problems may also cause all kinds of allergies to worsen (it seems that sinusitis turns on the immune system) and can cause problems with asthma, intestinal symptoms, and a wide variety of other medical problems. I have had patients who have toothaches and have numerous dental procedures to no avail. "Migraines" are an especial...

How is treatment different after surgery?

It doesn't mean that you won't get sinusitis any more, but it is often easier to treat. Surgery is not meant to cure the disease. Once the sinuses have been opened up by surgery, it is possible to wash out the sinuses if necessary , and as a result, sometimes oral antibiotics don't have to be used. It is often possible to do an endoscopy and find out exactly where the cause of the problem is, since it is possible to examine the inside of the sinuses once surgery has been done. Elsewhere on this website, the...

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...

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 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 ...

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...

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...

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...

How do I find a doctor to treat my sinus problems?

That is a very difficult question to answer. Assuming that you are not from New York, I would suggest that you go over the information in the website carefully and discuss it with your doctor. You might want to ask him to look at the information in the physicians section, or print it out for him or her. Hopefully you can get them to be receptive to the ideas which I have compiled here. If you feel that you are not getting better, and your doctor is not receptive to trying some of the treatments in here, I w...

How is sinusitis diagnosed?

It may be extremely difficult to diagnose a sinus infection early in the course of the disease. After taking a careful history, which is extremely valuable in helping diagnose sinusitis, and doing a physical exam, the diagnosis is typically made by looking inside the nose with a flexible rubber or rigid steel tube called an endoscope. Depending on what is found at the time of the endoscopy, an x-ray (CT scan) of your sinuses may need to be done. Previously, x-rays of the sinuses were done. Now CT scans are ...

What causes sinusitis?

Sinusitis starts as a result of blockage of the hole (actually a short hairpin shaped tube) into the sinuses, called an ostium. This blockage can occur as a result of an anatomical obstruction, swelling due to a cold or allergy, drying of the mucus, or a foreign body. When this occurs, mucus that normally is expelled from the sinus builds up in the sinus. This can cause pressure or pain. In addition the mucus is an excellent culture medium for bacteria. If the mucus is not cleared immediately, an abscess ca...