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Oh, My Aching Sinuses!

09/03/2009 in news

Article from the Daily

Question: I have allergies that set off severe sinus infections that persist for weeks and keep coming back. I have nasal congestion, trouble breathing and headaches that make my life miserable. Is there anything that can be done?

Answer: Your problem, unfortunately, is very common-one you share with some 32 million Americans who suffer from chronic sinusitis. It is, in fact, one of the most common chronic diseases in the United States.
The good news is that there is an answer. Today, we have an array of medication and procedures that can bring relief and improve the quality of your life. Your doctor can help you find the treatment that works for you.
The sinuses are membrane-lined cavities filled with air that communicate with the nose and outside environment through narrow channels. Sinus infections occur when these small channels become obstructed by inflammation and swelling, which can cause many symptoms.
What causes the obstruction? It may be triggered by allergies, as in your case or by viral and other infections. It also can stem from a climate change or anatomical problem, such as a deviated septum or nasal polyps.
There are two forms of sinusitis. The acute form has a more rapid onset often characterized by pain, headaches, tenderness and swelling over the sinuses, fever, nasal obstruction, and nasal discharge.
Sinusitis becomes chronic, like yours, when it persists for more than eight weeks or keeps coming back. It causes a myriad of symptoms, ranging from headaches and nasal congestion to post-nasal drip, chronic cough, clogged ears, and even bad breath. It impairs the patient's physical and social functioning, vitality and general health.

Question: How is sinusitis treated?

Answer: The initial treatment for both acute and chronic sinusitis is aimed at clearing the infection. Your doctor may prescribe antibiotics and other therapies to decrease the inflammation, including topical or systematic steroids, antihistamines, decongestants, or mucus thinning agents. With chronic infections, the course of antibiotic therapy is longer from three to six weeks, using a broad spectrum drug. For persistent symptom, you may be referred to a specialist in treatment of the ears, nose, and throat, or ENT.
Your ENT physician will look for an underlying cause for your problems, such as polyps, sinus swelling, a deviated septum or enlargement of the turbinates. Fiberoptic nasal endoscopy performed in the physician's office allow your doctor to visually inspect the deeper recesses of the nasal cavities and sinus drainage areas.
Your doctor may order a CT scan. This is the gold standard in sinus imaging as it gives a three dimensional view of what's really going on in the sinuses. With this information, your doctor can prescribe a treatment plan that meets your needs.
The recommended treatment may involve a more aggressive medical regimen or, if needed, interventional surgical treatment. Sinus surgery has undergone a revolution in the last 20 years, with minimally invasive procedures being standard protocol. Among the common procedures are reduction of obstructing nasal tissue and functional endoscopic, catheter-based procedure which uses a small, flexible balloon catheter to open up blocked sinus passageways-much like the balloon therapy used to open up coronary arteries. All of these procedures are performed entirely through the nostrils. There are no external scars, little swelling and only mild discomfort.
If your symptoms persist, ask your physician about the options available. With the treatments we now have, we can help people like you become more comfortable and achieve a better quality of life.

Karen Wirtshafter, M.D., is board-certified in otolaryngology, or ENT doctor, and is a member of the Medical Staff of Saint Clare's Hospital.

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