ENT

The American Academy of Otolaryngology–Head and Neck Surgery estimates that 1 in 8 adults receive a diagnosis of a sinus infection each year, and annually $11 billion dollars is spent is on managing sinusitis in the U.S. That is around 31 million Americans afflicted annually, and the symptoms can linger for weeks.

The struggle is real when dealing with a sinus infection. Whether it’s fatigue during the day, interruptions during sleep or aching pressure and swelling, a sinus infection can make life miserable.

Greg DeSautel, MD., an ear, nose and throat (ENT) surgeon who outreaches to Windom Area Health, explains what a sinus infection is (also known as sinusitis), and when should you see an ENT specialist.

What is a sinus infection:

“A sinus infection is a bacterial infection of the sinus cavities. This is differentiated from a cold which is a viral infection of the nasal passages and sinus cavities. A bacterial infection is usually treated with antibiotics. However, studies suggest most sinus infections will get better in a similar timeframe with or without antibiotics.”

Risk Factors:

“Typically, most bacterial sinus infections start as viral infection (cold). Allergies can also predispose a person to developing a sinus infection,” according to Dr. DeSautel.  Symptoms of the cold may not improve or may get worse after 10 days. In this case, your doctor may recommend starting an antibiotic.

According to Mayo Clinic on-line, “You may (also) be at increased risk of getting sinusitis if you have:

  • Hay fever or another allergic condition that affects your sinuses
  • A nasal passage abnormality, such as a deviated nasal septum, nasal polyps or tumors
  • A medical condition such as cystic fibrosis or an immune system disorder such as HIV/AIDS
  • Exposure to smoke, either from smoking or through secondhand smoke exposure’

Symptoms of a sinus infection include:

  • Sinus pressure behind the eyes and cheeks
  • Purulent nasal drainage accompanied by a stuffy nose
  • Headache
  • Facial and/or tooth pain-pressure-fullness
  • Fever
  • Cough
  • Thick yellow or green mucus draining from the nose or back of your throat
  • Fatigue
  • Decreased sense of smell

 Acute sinusitis vs. chronic:

“A chronic sinus infection is a defined as a sinus infection lasting longer than 12 weeks. Surgery is recommended for a chronic sinus infection not responding to medical therapy, or if a person is getting frequent sinus infections. Surgery changes the drainage pathways and openings of the sinuses. Nowadays, we use balloons to help dilate the pathways of the sinuses. As a result, recovery is quicker, and with less pain, than in the past,” according to Dr. DeSautel.

When to see a doctor:

Most people with acute sinusitis don’t need to see a doctor, but when the symptoms persist, they are not improving, or an acute infection has lasted for 10 days beyond the initial onset of the upper respiratory infection, it is time to seek medical attention.

According to mayoclinic.org, “Acute sinusitis complications are uncommon, and serious complications are rare. If they occur, complications might include:

  • Chronic sinusitis. Acute sinusitis may be a flare-up of a long-term problem known as chronic sinusitis. Chronic sinusitis lasts longer than 12 weeks.
  • Meningitis. This infection causes inflammation of the membranes and fluid surrounding your brain and spinal cord.
  • Other infections. Uncommonly, an infection can spread to the bones (osteomyelitis) or skin (cellulitis).
  • Vision problems. If the infection spreads to your eye socket, it can cause reduced vision or even blindness that can be permanent.”

Seek medical attention immediately if you have signs or symptoms that may indicate a serious infection, such as:

  • Pain, swelling or redness around your eyes
  • High fever
  • Confusion
  • Double vision or other vision changes
  • Stiff neck

 When to see an ENT specialist:

Some patients have complications of sinusitis, have symptoms that never seem to go away after several weeks despite multiple courses of medications, or even experience multiple infections a year. These patients could benefit from evaluation by an ENT specialist.

What a specialist offers:

ENT surgeons provide care for difficult cases of sinusitis where conventional methods have failed. Medication and other options are always the first line of defense before resorting to surgery.

An evaluation is completed to identify the underlying problem for the chronic sinusitis. During the initial evaluation, the ENT may use:

  • Nasal endoscopy: placing a small camera into the nose. This allows the ENT to see if the patient may have a structural reason for their symptoms. In people who have had sinus surgery, it is sometimes possible to see into the sinuses themselves.
  • A CT scan, a special type of X-ray imaging technique, may be ordered. CT scans help doctors see into the sinuses, even in patients who have not had surgery.

Due to advancements in health care and technology, nasal surgery is more convenient than ever. Sinus surgery is usually a same-day surgery. Patients can go home after they have recovered enough from anesthesia, and patients are often able to return to a normal routine within a few days. Because surgery is done through the nostrils, there is often no outward sign patients even had surgery.

ENT specialists also care for:

A variety of other pediatric and adult conditions affecting hearing, sleep, speech and more, such as:

  • Placing of ear tubes
  • Tonsil and adenoid issues
  • Sinus and allergy issues
  • Hearing and balance issues
  • Hearing aids
  • Sleep and snoring
  • Head and neck cancer
  • Cleft lip and palate
  • Hemangiomas/birthmarks
  • Voice issues

Prevention is always the best medicine!

Mayo Clinic recommends you take these steps to help reduce your risk of getting acute sinusitis:

  • Avoid upper respiratory infections. Try to stay away from people who have colds. Wash your hands frequently with soap and water, especially before your meals.
  • Manage your allergies. Work with your doctor to keep symptoms under control.
  • Avoid cigarette smoke and polluted air. Tobacco smoke and other pollutants can irritate and inflame your lungs and nasal passages.
  • Use a humidifier. If the air in your home is dry, such as it is if you have forced-air heat, adding moisture to the air may help prevent sinusitis. Be sure the humidifier stays clean and free of mold with regular, thorough cleaning.

Dr. DeSautel also recommends, “An important treatment to help prevent and also treat sinus infections are sinus rinses. Regular use of a nasal steroid spray (ie. fluticasone) can also help prevent sinus infections.”

Click here for more information on Dr. DeSautel, or to schedule an appointment.

Written by: Brenda Muller, Outreach Clinic Manager, Windom Area Health

Sources: webmd, Sanford health.org, Mayoclinic.org, Dr. M. Greg DeSautel

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