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Sinus Disease

 

Sinus conditions include acute sinusitis, chronic sinusitis and sinus infections.  Sinusitis accounts for approximately 20% of office visits to specialists in allergy and immunology*

What are sinuses?

The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other germs. Normally, mucus is able to drain out and air is able to circulate.

What is sinusitis?

Sinusitis refers to inflammation of the sinuses that occurs with or without a viral, bacterial, or fungal infection.When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.

Acute sinusitis is usually caused by a bacterial infection in the sinuses that results from an upper respiratory tract infection. Chronic sinusitis refers to long-term swelling and inflammation of the sinuses that may be caused by bacteria or a fungus.

What are the symptoms of sinusitis?

The classic symptoms of acute sinusitis in adults usually follow a cold that does not improve, or one that worsens after 5 – 7 days of symptoms. Symptoms include:

  • Bad breath or loss of smell
  • Cough, often worse at night
  • Fatigue and generally not feeling well
  • Fever
  • Sinus headache pressure-like pain, pain behind the eyes, toothache, or facial tenderness
  • Nasal congestion and discharge
  • Sore throat and postnasal drip

Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 12 weeks.

Symptoms of sinusitis in children include:

  • Cold or respiratory illness that has been improving and then begins to get worse
  • High fever, along with a darkened nasal discharge, for at least 3 days
  • Nasal discharge, with or without a cough, that has been present for more than ten days and is not improving

How is sinusitis diagnosed?

The asthma and allergy doctor will examine you or your child for sinusitis by:

  • Looking in the nose for signs of polyps
  • Shining a light against the sinus (transillumination) for signs of inflammation
  • Tapping over a sinus area to find infection
  • A CT scan of the sinuses may also be used to help diagnose sinusitis or to evaluate the anatomy of the sinuses to determine whether surgery will be beneficial.
  • If sinusitis is thought to involve a tumor or fungal infection, an MRI of the sinuses may be necessary.

If you or your child has chronic or recurrent sinusitis, other tests may include:

  • Allergy testing
  • Blood tests for poor immune function
  • Ciliary function tests
  • Nasal cytology
  • Cystic fibrosis tests

Who is at risk for developing sinusitis?

The following conditions and situations increase your risk for sinusitis:

  • Frequent colds which may cause excess mucus production or block the opening of the sinuses.
  • Allergic rhinitis or hay fever which also may cause excess mucus production or block the opening of the sinuses.
  • A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.
  • Diseases that prevent the cilia from working properly, such as Kartagener syndrome and immotile cilia syndrome.
  • Changes in altitude (flying or scuba diving)
  • Large adenoids
  • Smoking
  • Weakened immune system from HIV or chemotherapy
  • Tooth infections (in rare cases)

How is sinusitis treated?

Treatment is determined on an individual basis as prescribed by your physician.  Please contact our office to schedule an appointment with one of our allergy and asthma specialists.

Are Sinus infections curable?

Sinus infections are usually curable with self-care measures and/or medical treatment.  Recurrent attacks may occur when underlying causes exist such as nasal polyps or  allergies.

When should I contact my asthma and allergy specialist?

  • Your symptoms last longer than 10 – 14 days or you have a cold that gets worse after seven days
  • You have a severe headache, unrelieved by over-the-counter pain medicine
  • You have a high fever
  • You still have symptoms after taking all of your antibiotics properly
  • You have any changes in your vision during a sinus infection

Complications

Although very rare, complications may include:

How can I prevent Sinusitis?

The best way to prevent sinusitis is to avoid, or quickly treat, flus and colds.  Other tips to prevent infections include:

  • Eat plenty of fruits and vegetables, which are rich in antioxidants and other chemicals that could boost your immune system and help your body resist infection.
  • Get an influenza vaccine each year.
  • Reduce stress.
  • Wash your hands often, particularly after shaking hands with others.
  • Avoid smoke and pollutants.
  • Drink plenty of fluids to increase moisture in your body.
  • Take decongestants during an upper respiratory infection.
  • Treat allergies quickly and appropriately.
  • Use a humidifier to increase moisture in your nose and sinuses.

*Hamilos DL. Chronic sinusitis. J Allergy Clin Immunol 2000;106:213-27.

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