FREQUENTLY ASKED QUESTIONS ABOUT SINUSITIS

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1 FREQUENTLY ASKED QUESTIONS ABOUT SINUSITIS

2 TABLE OF CONTENTS Chapter 1: Do I have acute sinusitis or chronic sinusitis? Chapter 2: Do I need antibiotics for my acute sinusitis? Chapter 3: What kind of chronic sinusitis do I have? Chapter 4: Why do I have chronic sinusitis? Chapter 5: What are my treatment options for chronic sinusitis? Chapter 6: When should I consider surgery? Chapter 7: I have hay fever allergies. Are they causing my chronic sinusitis? Chapter 8: Is there a connection between chronic sinusitis and asthma? Chapter 9: What can I do to keep my chronic sinusitis under control? 1

3 Chapter 1: Do I have acute sinusitis or chronic sinusitis? Acute sinusitis generally lasts up to four weeks, and can include some or all of the below symptoms: Thick, yellow or green nasal discharge Stuffy nose Pain and pressure in and around the face, eyes, and forehead A fever Pain in the mouth or teeth Bad breath Coughing Chronic sinusitis is a more serious problem. Although it mimics many of the same symptoms, chronic sinusitis will last for more than three months and often seems less severe at times. While acute sinusitis is caused by a simple infection, its chronic form is a product of severe inflammation and can dramatically worsen over time. In addition to losing your sense of smell, chronic sinusitis can cause pus to drain from your nose, or even nasal polyps, which are benign growths inside the sinus cavity itself that can be extremely uncomfortable. To confirm if you have chronic sinusitis, check for the following: Difficulty breathing due to severe nasal obstruction or congestion Drainage from the nose Decreased sense of smell and taste Pain, swelling, and tenderness around the eyes and forehead Differentiating chronic sinusitis from acute sinusitis involves much more then a simple doctors visit. Generally, your doctor will take either a CT scan of your sinuses or use an endoscope to confirm the presence of inflammation and/or polyps, which are indicative of the condition. 2

4 Chapter 2: Do I need antibiotics for my acute sinusitis? Among the general population, antibiotics are frequently thought of as the cure-all for most sicknesses we encounter. Sinus problems are no exception. Often times, doctors prematurely prescribe the medicines for sinusitis patients. Acute sinusitis can either be bacterial or viral. Antibiotics will only work for bacterial infections and prove to be an ineffective treatment for viral infections. Improper use of this class of medication may, in fact, prove harmful and lower your resistance to the drug. Proper treatment depends on recognizing the differences between bacterial and viral sinus infections. To further complicate the issue, the signs and symptoms are virtually identical to those of common colds. However, a cold virus normally runs it course in less than 10 days. Typically, bacterial sinus infections last longer than ten days. Before taking antibiotics, monitor your symptoms for up to seven days after you ve been diagnosed with acute sinusitis. If your sinusitis symptoms continue to deteriorate, it s likely you are dealing with a bacterial infection and should consider an antibiotic, like amoxicillin, to recuperate. To confirm your self-diagnosis of acute sinusitis, look for common symptoms such as: sneezing and nasal discomfort, ear problems, sleeping issues as well as emotional and mental health. 3

5 Chapter 3: What kind of chronic sinusitis do I have? You know you have a severe case of sinusitis, often referred to as chronic sinusitis or chronic rhinosinusitis, when you experience mucus buildup, drainage, and facial swelling among other symptoms that last for more than 8 weeks at one time. Three types of chronic sinusitis exist and in order to properly treat your condition, it s important to know exactly which one you have. Chronic rhinosinusitis without nasal polyps Chronic rhinosinusitis with nasal polyps Allergic fungal rhinosinusitis Chronic Rhinosinusitis without Nasal Polyps Responsible for 60% of people suffering from chronic rhinosinusitis, this condition is often confused with acute sinusitis because many of the symptoms are similar. Acute sinusitis is a temporary condition whereas chronic rhinosinusitis lasts for many weeks. Common, mild symptoms of chronic rhinosinusitis include: Reduced sense of taste Nausea Sore throat Fatigue Ear pain Severe symptoms of chronic rhinosinusitis include: Shortness of breath Confusion Severe headache Risk factors of this condition include: Frequent exposure to pollutants Asthma Hay fever Immune system disorder Chronic Rhinosinusitis with Nasal Polyps Chronic rhinosinusitis with nasal polyps affects as many as 1 5 to 1 3 of people who have chronic sinusitis. 4

6 Chapter 3: What kind of chronic sinusitis do I have? You know you have a severe case of sinusitis, often referred to as chronic sinusitis or chronic rhinosinusitis, when you experience mucus buildup, drainage, and facial swelling among other symptoms that last for more than 8 weeks at one time. Common, mild symptoms of chronic rhinosinusitis with nasal polyps include: Snoring Postnasal drip Facial pain Headache Decreased sense of smell Sever symptoms of chronic rhinosinusitis with nasal polyps include: Worsening symptoms Extreme swelling Serious difficulty breathing Risk factors of this condition include: Asthma Churg-Strauss Syndrome Cystic Fibrosis Aspirin sensitivity Allergic Fungal Rhinosinusitis Allergic fungal rhinosinusitis is an allergic reaction caused by environmental fungi that is finely dispersed in the air. This condition requires surgery in order to safely remove the mucin and fungal debris that develops in the sinus cavities. When this condition is left untreated, an individual may suffer vision loss and displacement of the eyeball. Common, mild symptoms of allergic fungal rhinosinusitis include: Loss of smell Pressure sensation Nasal discharge Nasal obstruction Severe symptoms of allergic fungal rhinosinusitis include: Double vision Vision loss Production of nasal crust Risk factors of this condition include: Atopy or hypersensitivity to common environmental elements Diabetes Cancer Immune deficiency diseases 5

7 Chapter 4: Why do I have chronic sinusitis? Chronic sinusitis continues for more than 12 weeks in spite of attempts to treat it. Infection may play an initial role in many cases, but researchers now believe that the cause is more complicated. The following are believed to contributing factors: Deviated septum or nose fracture The nasal septum is a wall made out of cartilage and bone, and it most often runs through the midline of your nasal cavity, dividing it into two equal passages. A septum that s off center, or deviated, could have been the case since birth or your nose may have been injured in a long-forgotten accident. The difference in sizes between the nasal passages can cause one or both nostrils to become blocked, ultimately leading to chronic sinusitis. Allergies Allergies can cause mucus blockage. Similar immune factors have been observed in people with chronic sinusitis and people with allergic rhinitis, which suggests that chronic sinusitis may result from an allergic response in some people. Fungus Researchers have found fungal organisms surrounded by inflammatory cells in the mucus of patients who had surgery for chronic sinusitis. They think this means that fungus causes an immune disorder that triggers this issue. Smoking Smoking and second-hand smoke contain chemicals that can damage the immune system. In addition, researchers think that smoke could make it more possible for allergens and toxins to enter the membranes that line the nose and sinuses. Other environmental pollutants Environmental pollutants such as industrial chemicals and dust can damage the cilia, which are small hair-like structures that move mucus through the sinuses. This may lead to a build-up of mucus and result in inflammation. Certain medical conditions Some medical conditions that weaken the immune system, produce inflamed nasal airways, or lead to increased mucus. These include cystic fibrosis, diabetes, and AIDS. Immunodeficiency problems Immune deficiency makes people more likely to acquire infections. IgA is a type of protein that helps protect the respiratory tract from infections, so if you re deficient in this type of protein, you may be more prone to chronic sinusitis, as well as ear infections and pneumonia. Biofilms These communities of bacteria can be resistant to antibiotics. Researchers are exploring the idea that they can cause the immune systems to react too strongly, causing the symptoms of sinusitis. Toxins Researchers are looking at the idea that Staph aureus bacteria release a toxin in people who have nasal polyps with chronic sinusitis. They think that this may cause severe inflammation, which results in recurring polyps and symptoms associated with asthma, like wheezing. 6

8 Chapter 5: What are my treatment options for chronic sinusitis? Treatments frequently used for chronic sinusitis include the following: Saline nasal rinses Irrigating the nose with saline solution helps thin out and remove excess mucus. Using a nasal rinse can feel strange at first, but it can often provide some relief. You can buy commercial sinus rinse devices that come with pre-measured packets, or you can make your own rinse at home. Steroid combined with nasal wash A steroid called budesonide can be added to nasal irrigation solutions. People with asthma use it to prevent asthma attacks, but it can also be used in a nasal wash to help treat chronic sinusitis. Antibiotics If your chronic sinusitis is caused by a bacterial infection, antibiotics can sometimes be used to treat it. Otherwise, antibiotics may be ineffective. Corticosteroids Steroid pills such as prednisone can help reduce or prevent inflammation in your nasal membranes. They are only taken for short periods of time since they can have serious side effects if they are taken long-term, such as high blood pressure, diabetes, or osteoporosis. Nasal steroid sprays These sprays can help reduce swelling and shrink polyps. Steroid sprays can be taken for longer periods of time than steroid pills, because they mainly affect only your nasal passages rather than your entire body. They can cause some side effects, such as nosebleeds or headaches, but these are usually mild. Surgery If your chronic sinusitis is resistant to treatment, sinus surgery is sometimes an option. This can be effective in removing polyps that are causing blockages or correcting a deviated septum that may be causing one or both of your nasal passages to become blocked. To start treatment If have sinus problems, consider making an appointment with one of our Board Certified eos sinus physicians. We can help you get an accurate diagnosis and develop a specialized treatment plan for your specific needs so you can get relief. 7

9 Chapter 6: When should I consider surgery? Nasal polyps are noncancerous growths, bumps, in the lining of your nose. They re usually found in the area where the sinuses open into the nasal cavity. These polyps often grow in response to long-term swelling and irritation caused by chronic sinusitis or chronic allergic rhinitis. Symptoms of nasal polyps They can be small and require no treatment, or they can be larger and cause ongoing issues and block mucus from draining from your sinuses. When this happens, nasal polyps can cause the following symptoms: Sinus infection Nasal congestion Nasal obstruction Persistent sinus discharge Sneezing Wheezing Sensitivity to dust, fumes, and odors Runny nose Reduced sense of smell or taste Itching around the eyes Facial pain Broadening of the nasal bridge (with particularly large polyps) Treating nasal polyps Nasal polyps are often treated with medications, which can help relieve the symptoms. They often fail to eliminate the polyps themselves, but even if they do, polyps can come back if their underlying cause remains. When to consider surgery Surgery may be considered if your polyps and their underlying cause aren t responding well to medication. This type of surgery lets your doctor remove the polyps and address any other issues that may be blocking mucus from draining properly from your sinuses. How it s performed The procedure is performed while you re under general anesthesia. Your surgeon will use an endoscope, a tube with a tiny camera at one end, to see inside your nose and sinuses. Surgical instruments are used to remove the polyps and any other blockages, such as scar tissue. The instruments are passed into your nostrils, so it won t be necessary to make any incisions to your face and you can generally go home the same day. You ll have increased airflow through your nose once the polyps are removed, so breathing should be significantly easier. 8

10 Chapter 7: I have hay fever allergies. Are they causing my chronic sinusitis? Allergic rhinitis, otherwise known as hay fever, is an illness that occurs when you breath in something that you are allergic to, making the inside of your nose to become inflamed and swollen. Sinusitis refers to an inflammation of the lining inside the sinuses. The moment your sinuses become blocked and fill with fluid, germs are encouraged to grow, which causes headaches in addition to nasal yellowish secretions. Nasal polyps, common cold and hay fever often cause blocked sinuses. What causes hay fever? Allergic rhinitis is caused by allergens, which can be found both indoors and outdoors. Outdoor allergens such as grass, mold, trees and weed pollens among others, cause seasonal allergies that are also referred to as hay fever. Allergic rhinitis may also be triggered by indoor allergens, including house dust mites, indoor mold and animal dander. Is there a link between hay fever and sinusitis? It is true that people suffering from allergies and hay fever are more likely to develop chronic sinusitis. Indeed, allergy is a prime risk factor that is involved in the development of the condition. The substances that trigger an allergic reaction, including pollen, cigarette smoke, dust mites and mold spores may cause chronic inflammation of the mucus membranes lining the sinus cavities. Such an inflammation can inhibit the removal of bacteria from the sinuses, increasing the risk factor of secondary bacterial infection. 9

11 Chapter 8: Is there a connection between chronic sinusitis and asthma? According to the Asthma and Allergy Foundation of America, chronic sinusitis is found in as many as 50% of patients who have severe and moderate asthma. Chronic sinusitis and asthma Medical practitioners have generally agreed that there is a connection between chronic sinusitis and asthma. Nearly a fifth of all patients with chronic sinusitis also have asthma. This represents a rate that is as high as four times compared to the rates in the general population. Patients with nasal polyps, asthma and sensitivity to aspirin have a high risk of chronic sinusitis. Non-surgical treatment of sinusitis If the following non-surgical methods fail to produce results for the patient, then usually a surgical treatment is attempted. Saline nasal irrigation where your nasal passages are rinsed by a saline solution spray Nasal corticosteroids where the aim is to prevent and relieve inflammation in the nasal passageway. Injectable or oral corticosteroids Decongestants or antihistamine medicines used to treat congestion of the nasal cavities Surgical treatment If you have had proper medical treatment for 4-6 weeks, a CT scan that shows the presence of chronic sinusitis, or any other condition of the sinuses that cannot be treated with medicine, you are a candidate for surgical treatment and should consider alternative options. Here are two surgery options for patients with chronic sinusitis: 1. Endoscopic sinus surgery: this is the common surgical procedure for the treatment of most serious sinus and nasal problems. Blocked or inflamed sinuses are repaired by this procedure. 2. Balloon Sinuplasty Surgery (BSP): In this procedure, special balloons are used to open the constricted sinuses and while recovery times vary by patient, most patients can return to work within a couple of days. 10

12 Chapter 9: What can I do to keep my chronic sinusitis under control? There are a number of things that can aggravate a person's sinusitis like weather, indoor temperatures, exposure to air pollutants, etc. Common symptoms can include pressure around the nasal passage, headache, and sinus inflammation. It is important to see a medical professional to officially diagnose your sinus problems to ensure that there are no other more serious medical issues. However, once you get an official diagnosis from your doctor, there are a number of things you can do on your own to keep your chronic sinusitis under control. Stop Smoking We all know that smoking affects your lungs. What you may not realize is that smoking has a direct affect on your nose as well. Your nose and sinuses have a membrane that constantly produces mucus, and it also has tiny hairs, called cilia, that protect you from airborne dirt and bacteria. Smoking can cause the cilia to stop doing its job, causing the mucus to collect in the back of your throat. As a result, bacteria multiply leaving you susceptible to further nasal congestion and infection. If you are a smoker and need further support in quitting, a number of programs and products on the market can help. Ask your primary doctor for more information. Nasal Irrigation You may want to also try rinsing your nose with saltwater two times a day. This simple remedy has been done in many cultures around the world for thousands of years. According to this study, scientific evidence shows that nasal irrigation with saline is an effective treatment to manage chronic sinusitis. Not only does the water keep your sinuses moist, it washes away excess air pollutants and bacteria. You can purchase a special tool called a neti pot or even a simple squeeze bottle to make the process of rinsing your nose a little easier. Simply pour or squeeze the saltwater solution from one nostril into the other. This will help to thin the mucus, reduce swelling, and wash out germs, allergens or inflammatory cells from the nostrils. 11

FREQUENTLY ASKED QUESTIONS ABOUT SINUSITIS

FREQUENTLY ASKED QUESTIONS ABOUT SINUSITIS FREQUENTLY ASKED QUESTIONS ABOUT SINUSITIS TABLE OF CONTENTS Chapter 1: Chapter 2: Chapter 3: Chapter 4: Chapter 5: Chapter 6: Chapter 7: Chapter 8: Chapter 9: Chapter 10: Do I have acute sinusitis or

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