At West Michigan ENT & Allergy, we are experts at diagnosing your sinus problems and providing the most appropriate treatment, to get you feeling better. Our physicians have treated thousands of patients with sinus problems. Treatment options include medications, allergy treatment, sinus surgery, and balloon sinus dilation. We are highly experienced in all of these treatments and can provide you the best, most up-to-date care.
Q. How common is sinusitis?
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 the paranasal sinuses. Acute sinusitis is a short-term condition that responds well to antibiotics and decongestants; chronic sinusitis is characterized by over 12 weeks of symptoms. At least four recurrences of acute sinusitis is described as recurrent acute sinusitis.
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 antibiotics. 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. Chronic sinusitis involves 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, and fever are common symptoms. 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. A humidifier or steam from a pan of boiled water (removed from the heat) can help. Warm compresses are useful in relieving pain in the nose and sinuses. Saline nasal spray or irrigations (Neti Pot, Neil Med Sinus Rinse) 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 (look for oxymetazoline on the bottle) could aggravate symptoms and should not be used beyond their label recommendation. Steroid nasal sprays like Flonase, Nasocort, or Rhinocort are important treatments for chronic sinusitis, but a physician should direct your use if you are using them for more than two weeks. 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. Imaging with a CT scan is helpful to evaluate chronic sinusitis or recurrent acute sinusitis. Allergy is often considered to determine if allergy is causing or worsening your sinus symptoms.
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. The physician may feel and press the sinuses for tenderness. The physician will look inside your nose, and check the back of your throat for drainage.
Q.What other diagnostic procedures might be performed?
A. Other diagnostic tests may include a culture to test for bacteria, nasal endoscopy, allergy testing, or a CT scan of the sinuses.
Q. What is nasal endoscopy?
A. An endoscope is a small camera for the examination inside your body. It allows a visual examination of the nose and sinus drainage areas. First, the patient' s nasal cavity is anesthetized; and the endoscope is then placed in a position to view the nasal cavity. It is usually painless, and if it is uncomfortable it is only brief. You can drive home after the procedure.
Q. Why does an ear, nose, and throat specialist perform nasal endoscopy?
A. Nasal endoscopy provides a view of the sinus drainage pathways. The procedure is utilized to observe signs of obstruction as well as detect nasal polyps or other problems hidden from routine nasal examination.
Q. What medications are commonly used to treat sinusitis?
A. To reduce congestion, the physician may prescribe nasal sprays, antihistamines or oral decongestants. Antibiotics are prescribed for bacterial infection. For chronic sinusitis, longer courses of antibiotics are usually prescribed (2 to 4 weeks).
Q. Will any changes in lifestyle be suggested during treatment?
A. Smoking is particularly bad when you have an infection, because it reduces the blood flow and weakens your immune system. A special diet is not required, but drinking extra fluids helps to thin mucus. It is best to avoid drinking alcohol and get plenty of rest to help your body fight off infection.
Q. When is a sinus procedure necessary?
A. Medical management should always be attempted before moving to surgery. The decision to proceed with sinus surgery is largely based on how severe your symptoms are. For people that have chronic sinusitis or recurrent acute sinusitis, and are not feeling well enough with medications, sinus procedures have been proven to be effective in improving symptoms.
Q. What are the different sinus procedures available?
- Endoscopic sinus surgery (also called "functional" endoscopic sinus surgery, or "ESS," or "FESS") involves removal of tissue to open your sinuses. This procedures was developed in the late 1980s to 1990s, and techniques have been refined and improved since then. A variety of surgical instruments are used. Endoscopic sinus surgery can address all areas of your sinuses. Polyps and tumors can be removed through these techniques.
- Balloon sinus dilation, also known as "balloon sinuplasty," involves stretching open the small openings of your sinuses. Balloon catheters for the sinuses are newer technology, developed in the 2000s. Most of your sinuses can be addressed with a balloon catheter, but some areas can not be addressed with a balloon. Balloon sinus dilation is usually able to be performed in the office under mild sedation. This procedure is less invasive and has a fast recovery time. You are usually feeling well and able to go back to work the next day. Balloon sinus dilation is great for mild to moderate sinus disease.. Sometimes it is appropriate to mix balloon sinus dilation with traditional sinus surgery to treat small areas of severe disease.
Q. What does endoscopic sinus surgery entail?
A. The basic endoscopic surgical procedure is performed under local or general anesthesia. The sinus openings are enlarged and the crowded areas of your sinuses are cleared out to create more open sinus cavities. Pain is usually not severe. Most people take pain medication for one or two days after surgery.
Q. What does sinus surgery accomplish?
A. Sinus surgery "optimizes" your sinuses by helping your sinuses drain, reducing the amount of sinus lining that can become infected or inflamed, and allowing you to rinse your sinuses or use nasal sprays more effectively.
Q. What is balloon sinus dilation?
A. Sinus balloon catheters are a newer technology that allow minimally invasive enlargement of the sinus drainage pathways. Balloon sinus dilation can be effective for patients with mild to moderate sinus disease. This procedure can be done in the office, and has benefits of faster recovery and avoidance of general anesthesia. Depending on the extent and type of sinus disease, this procedure may be recommended.
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, spread of infection in the face, neck or brain can occur.