A.
More than 37 million Americans suffer from at least one episode of
acute sinusitis each year. The prevalence of sinusitis has soared in
the last decade possibly due to increased pollution, urban sprawl, and
increased resistance to antibiotics.
Q. What is sinusitis?
A.
Sinusitis is an inflammation of the membrane lining of any sinus,
especially one of the paranasal sinuses. Acute sinusitis is a
short-term condition that responds well to antibiotics and
decongestants; chronic sinusitis is characterized by at least four
recurrences of acute sinusitis. Either medication or surgery is a
possible treatment.
Q. What are the signs and symptoms of acute sinusitis?
A.
For acute sinusitis, symptoms include facial pain/pressure, nasal
obstruction, nasal discharge, diminished sense of smell, and cough not
due to asthma (in children). Additionally, sufferers of this disorder
could incur fever, bad breath, fatigue, dental pain, and cough.
Acute
sinusitis can last four weeks or more. This condition may be present
when the patient has two or more symptoms and/or the presence of thick,
green or yellow nasal discharge. Acute bacterial infection might be
present when symptoms worsen after five days, persist after ten days,
or the severity of symptoms is out of proportion to those normally
associated with a viral infection.
Q. How is acute sinusitis treated?
A.
Acute sinusitis is generally treated with ten to 14 days of antibiotic
care. With treatment, the symptoms disappear, and antibiotics are no
longer required for that episode. Oral and topical decongestants also
may be prescribed to alleviate the symptoms.
Q. What are the signs and symptoms of chronic sinusitis?
A.
Victims of chronic sinusitis may have the following symptoms for 12
weeks or more: facial pain/pressure, facial congestion/fullness, nasal
obstruction/blockage, thick nasal discharge/discolored post-nasal
drainage, pus in the nasal cavity, and at times, fever. They may also
have headache, bad breath, and fatigue.
Q. What measures can be taken at home to relieve sinus pain?
A.
Warm moist air may alleviate sinus congestion. Experts recommend a
vaporizer or steam from a pan of boiled water (removed from the heat).
Humidifiers should be used only when a clean filter is in place to
preclude spraying bacteria or fungal spores into the air. Warm
compresses are useful in relieving pain in the nose and sinuses. Saline
nose drops are also helpful in moisturizing nasal passages.
Q. How effective are non-prescription nose drops or sprays?
A.
Use of nonprescription drops or sprays might help control symptoms.
However, extended use of non-prescription decongestant nasal sprays
could aggravate symptoms and should not be used beyond their label
recommendation. Saline nasal sprays or drops are safe for continuous
use.
Q. How does a physician determine the best treatment for acute or chronic sinusitis?
A.
To obtain the best treatment option, the physician needs to properly
assess the patient' s history and symptoms and then progress through a
structured physical examination.
Q. What should one expect during the physical examination for sinusitis?
A.
At a specialist' s office, the patient will receive a thorough ear,
nose, and throat examination. During that physical examination, the
physician will explore the facial features where swelling and erythema
(redness of the skin) over the cheekbone exist. Facial swelling and
redness are generally worse in the morning; as the patient remains
upright, the symptoms gradually improve. The physician may feel and
press the sinuses for tenderness. Additionally, the physician may tap
the teeth to help identify an inflamed paranasal sinus.
Q. What other diagnostic procedures might be taken?
A.
Other diagnostic tests may include a study of a mucous culture,
endoscopy, x-rays, allergy testing, or CT scan of the sinuses.
Q. What is nasal endoscopy?
A.
An endoscope is a special fiber optic instrument for the examination of
the interior of a canal or hollow viscus. It allows a visual
examination of the nose and sinus drainage areas.
Q. Why does an ear, nose, and throat specialist perform nasal endoscopy?
A.
Nasal endoscopy offers the physician specialist a reliable, visual view
of all the accessible areas of the sinus drainage pathways. First, the
patient' s nasal cavity is anesthetized; a rigid or flexible endoscope
is then placed in a position to view the nasal cavity. The procedure is
utilized to observe signs of obstruction as well as detect nasal polyps
hidden from routine nasal examination. During the endoscopic
examination, the physician specialist also looks for pus as well as
polyp formation and structural abnormalities that may cause recurrent
sinusitis.
Q. What course of treatment will the physician recommend?
A.
To reduce congestion, the physician may prescribe nasal sprays, nose
drops, or oral decongestants. Antibiotics will be prescribed for any
bacterial infection found in the sinuses (antibiotics are not effective
against a viral infection). Antihistamines may be recommended for the
treatment of allergies.
Q. Will any changes in lifestyle be suggested during treatment?
A.
Smoking is never condoned, but if one has the habit, it is important to
refrain during treatment for sinus problems. A special diet is not
required, but drinking extra fluids helps to thin mucus.
Q. When is sinus surgery necessary?
A.
Mucus is developed by the body to act as a lubricant. In the sinus
cavities, the lubricant is moved across mucous membrane linings toward
the opening of each sinus by millions of cilia (a mobile extension of a
cell). Inflammation from allergy causes membrane swelling and the sinus
opening to narrow, thereby blocking mucus movement. If antibiotics are
not effective, sinus surgery can correct the problem.
Q. What does the surgical procedure entail?
A.
The basic endoscopic surgical procedure is performed under local or
general anesthesia. The patient returns to normal activities within
four days; full recovery takes about four weeks.
Q. What does sinus surgery accomplish?
A.
The surgery should enlarge the natural opening to the sinuses, leaving
as many cilia in place as possible. Otolaryngologist--head and neck
surgeons have found endoscopic surgery to be highly effective in
restoring normal function to the sinuses. The procedure removes areas
of obstruction, resulting in the normal flow of mucus.
Q. What are the consequences of not treating infected sinuses?
A.
Not seeking treatment for sinusitis will result in unnecessary pain and
discomfort. In rare circumstances, meningitis or brain abscess and
infection of the bone or bone marrow can occur.
