15:48 PM

Sinusitis – A Common Ailment So Easily Confused

It’s one of the most common conditions in health care, affecting from 10 to 30 percent of people in the U.S. in some form each year. Yet sinusitis (sinus infections) continues to be misunderstood.

“Many people assume allergies and sinus problems are one in the same,” says Lehigh Valley Health Network otolaryngology specialist Kevin Kriesel, MD, with LVPG Ear, Nose and Throat. “Some symptoms can be similar, but these are two distinct disease processes. Nasal allergy issues can lead to sinusitis, but there are many other factors that can lead to chronic sinus disease.”

Sinusitis and its many causes

Sinusitis occurs when fluid gets trapped in the sinuses and causes inflammation. It’s usually triggered by a virus, about 90 percent of the time in adults and 50 to 70 percent of the time in children according to the Centers for Disease Control and Prevention. Otherwise, it’s a bacterial infection. Most sinus infections can be treated by primary care doctors, but an ear, nose and throat (ENT) specialist is consulted when the frequency, duration, and severity of the infections become problematic.

Allergies can be a cause of sinusitis, and they are certainly a familiar culprit in the Lehigh Valley area where a variety of allergy triggers are widespread. But a cold or other respiratory tract infection can lead to sinusitis as well, as can nasal polyps, structural issues with the sinuses or a weakened immune system. Regular exposure to pollutants, chemicals, and irritants such as cigarette smoke also can cause sinusitis.

Getting relief from symptoms

Symptoms include headaches, fever and facial pain over the affected sinus areas, sometimes accompanied by a thick nasal discharge which could include pus or blood. Over-the-counter pain relievers and nasal sprays often help. Antibiotics will only help if the infection is bacterial. They do not aid in viral cases.

Sinusitis should get better on its own. But if symptoms remain for a week to 10 days, it’s approaching the acute sinusitis stage and a visit to a primary care physician for evaluation is recommended, perhaps for some prescription medication if the infection is bacterial. A specialist such as Kriesel will get involved when cases become chronic sinusitis, which means symptoms last more than six-to-eight weeks, or recurring sinusitis if multiple sinus infections occur in a given year.

When to see a sinus specialist

“Essentially, I’ll see a patient when he or she has exhausted all other options,” Kriesel says. “They’re not responding to antibiotics or saline flushes, or anything else that’s been tried to correct the problem, or it’s occurring again and again. We have a number of minimally invasive intranasal surgical options available depending on the problem that will correct it.”

ENTs have several options at their disposal, including maximizing medical therapy with combinations of anti-inflammatories and longer antibiotic courses. This combination is often required to eradicate very persistent sinus disease.

If that is not successful, sinus surgery may be required. The surgery spectrum includes everything from minimally invasive balloon sinuplasties which are used to open up the sinus with special dilating balloons, to extensive surgery using endoscopes.

Think you may have a hearing loss? Get more information at LVHN.org/ENTguide