Faulkner Lifestyle Aug/Sept 2020

health
What is Sinusitis?
Sinusitis is an infection, inflammation,
or swelling or the sinuses and nasal
cavity. The sinuses hollow spaces in the
bones surrounding the nose and eyes. Sinus
infections typically include cloudy or colored
discharge from the nose accompanied by
nasal congestion or facial pain/pressure. Other
symptoms can include fever, cough, reduced
sense of smell, and upper tooth pain.
Sinus infections can be caused by viruses,
bacteria, or fungi. A viral infection has
symptoms similar to a bacterial infection,
but generally improve within 10 days. A
bacterial sinus infection is typically more
severe and can last a longer period of time.
An acute bacterial sinus infection typically
fails to improve over 10 days or suddenly
gets worse after an initial period of getting
better. A chronic sinus infection is when the
symptoms last for greater than 12 weeks. A
fungal sinus infection is typically a chronic
infection associated from mold or yeast.
There are also other causes of sinusitis, such
as upper tooth infections and exposure to
nasal irritants such as wood dust or smoke.
How do you diagnose sinusitis?
A healthcare provider can typically
diagnose a sinus infection through a
medical history and exam. This includes
noting which symptoms are present
and for how long. Other conditions can
seem like a sinus infection, but in fact be
something else. For example, facial pain
or headache with minimal accompanying
nasal symptoms is often not a sinus infection.
Dizziness is not typically associated
with sinus problems.
There are several physical findings associated
with sinusitis as well. These include
swelling or inflammation in the nasal
cavity, nasal or sinus drainage, or even nasal
polyps. Ear, Nose, and Throat physicians
will commonly use a nasal endoscope to
examine further back in the nasal cavity
and sinuses. Finally, a CT scan can be
ordered to look inside the sinuses and
will usually confirm the diagnosis or help
determine if surgery would be indicated.
How do you treat sinusitis?
The best course of action for acute
sinusitis is “watchful waiting” for the first
10 days. Most symptoms will resolve over
that time, especially if they are from a viral
infection. Medications to control symptoms
include nasal saline, over-the-counter pain
relievers, decongestants, and nasal steroid
sprays. For symptoms extending beyond 10
days, antibiotics with or without steroids
are commonly prescribed.
Chronic sinusitis is treated differently from
acute sinusitis, especially if nasal polyps are
present. This usually includes treatment of
any underlying problem such as allergies or
nasal irritants. Mainstays of therapy include
nasal steroids, antihistamines, and nasal
rinses. Antibiotics or steroids are sometimes
used for worsening symptoms. If symptoms
persist, nasal procedures such as balloon
sinuplasty or sinus surgery can be considered.
These procedures both involve opening the
sinuses, allowing them to drain and ventilate
properly. Whereas medications address the
inflammatory aspect of sinusitis, procedures
address the “plumbing” aspect.
What are Balloon Sinuplasty and
Endoscopic Sinus Surgery?
Balloon sinuplasty is a minimally-invasive
procedure that dilates or stretches the openings
to the nasal sinuses. Small balloons
are placed in the sinuses and then inflated,
opening the sinuses by fracturing the bone
around the openings to provide lasting
benefits. The balloons are then removed.
Endoscopic sinus surgery also expands the
openings to the sinuses, but does so by
removing bone and soft tissue with forceps
or shavers. This is typically used for more
severe sinus problems or when nasal polyps
are present. Both balloon sinuplasty and
sinus surgery can be performed in the office
setting or operating room. It is important
to remember that neither are not a cure
for sinus problems, but only a tool to help
treat them. It is often necessary to continue
medications afterward to control nasal
inflammation, allergies, or polyps.
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