Sinus Conditions

The sinuses are open chambers within the head lined by a mucous membrane and function to lighten the skull by 6 to 10 % making it easier for humans to walk upright. In addition, they function to add resonance and tonal quality to a person's voice. A normal set of sinuses can drain up to 2 quarts of mucus per day. This mucus coats the upper airway so it can effectively moisten the nose and throat, filter and warm the air going into the lungs, and provide an effective surface to trap viruses and bacteria.

Sinus problems occur when these chambers become blocked or infected. This is typically called sinusitis. Sinusitis can be acute (lasting 4 weeks), sub-acute (lasting 4-8 weeks) or chronic (lasting more than 8 weeks). Colds typically are self-limited and last for 7 to 10 days. Although colds are a very common cause of sinusitis, people with allergies or allergic disease are at greater risk for developing sinusitis.

Common symptoms of sinusitis can include nasal congestion or obstruction, headache or sinus pressure, upper teeth pain, discolored nasal mucus, postnasal drip, cough, sore throat, voice changes, bad breath and fatigue.

Sinusitis is diagnosed by a combination of an in-depth history and physical examination, microscopic examination of the nasal mucus and direct visualization of the sinus openings by fiberoptic nasal endoscopy. Sometimes, sinus CT scans are required.

When sinusitis is caused by a bacteria, antibiotics may be used to treat the infection although many cases of sinusitis will resolve on their own. Ensuring proper drainage of the sinuses is critical for clearing a sinusitis. This includes a combination of nasal saline washes or irrigations, mucus thinners, hydration and occasionally, decongestants. The most important aspect is treating any underlying nasal disease such as nasal allergies which makes one more susceptible to sinusitis. The best way to diagnose allergies is by getting an evaluation by an Allergist Certified by the American Board of Allergy and Immunology. Treatment of allergic disease with avoidance, medicines and immunotherapy (allergy shots) can reduce the frequency of sinus infections.

Although chronic sinusitis involves different bacteria and infecting organisms, the basic principles are the same such as medicinal therapy, moisturization and hydration, and treatment of underlying allergic disease, potential structural abnormalities and possible immunodeficiency.

If all medicinal and allergic treatments fail, endoscopic sinus surgery may be considered. Before having sinus surgery, one should consider carefully all the options and expected outcome. This is a very complicated decision so discuss this fully with your Board Certified Allergist and ENT surgeon. Surgery is a last resort in the case of children. Before you have sinus surgery performed for your child, consider obtaining a second opinion from a Board Certified Allergist who treats pediatric sinus conditions.

Typically, patients who undergo sinus surgery will still need medicinal therapy and treatment of any underlying allergic or immunodeficiency disease to try to prevent the recurrence of sinusitis.