By: Todd A. Schneiderman, M.D. F.A.C.S.
Sinusitis is such a common problem that almost everyone has experienced congestion, facial pain and runny nose. Most will do well with comfort measures only, or a trip to the doctor for a course of antibiotics. But what about those who continue to experience these symptoms, without relief, for weeks or longer? When these symptoms do not go away, what else can be done?
Many cases of sinusitis, formally called rhinosinusitis, are viral, and comfort measures usually suffice. Staying well hydrated by drinking a lot of water, taking pain relievers, and getting rest is often all that is needed. If a bacterial infection is present, antibiotics are helpful. Fever, severe facial and tooth pain, and dark, thickened mucous may indicate bacterial infection. Antibiotics act against these infections directly, but other medicines help, too. Decongestants can be used to help the sinuses clear the infection more quickly. Over the counter nasal saline is used to wash the nose, clearing the mucous and crusting that can block the airway. This also may help clear the infection more rapidly. Some physicians will prescribe nasal steroid sprays and antihistamines as well, but these treatments do not always work.
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Other problems may be present that can make these measures less successful. The nasal septum, the wall separating the left and right nasal passages, may be severely deviated, or twisted. This can block air flow. Polyps may be present, decreasing the natural drainage of the sinuses. Underlying inhalant allergy, to trees, grass, mold, or dust, may play a role. When the patient does not follow an expected course of improvement, other options must be considered.
Most patients are treated medically for several weeks if they don’t get better with an initial treatment. Surgery is considered in the sinusitis patient after medical measures are no longer of benefit. This is directed to the patient’s specific nasal and sinus anatomy, and may consist of opening the sinus passages and straightening the septum to open the nasal airway. A sinus CT scan is done prior to surgery to evaluate the specific site of the problem. The surgery can be done as an outpatient, with small telescopes, through the nostrils. Surgery may also be done in the office, after numbing the nose, a balloon can be used to open the sinuses. Most patients find great relief following sinus surgery, with less obstruction.
A bad cold can be a terrible experience. Although the facial pressure, congestion and fatigue are rarely life threatening, frequent episodes can seriously impair your quality of life. Most people simply expect to get over it and feel better after a few days, but some experience these symptoms for weeks or longer. For these patients, sinus surgery can offer significant long term relief.
For more information and descriptions of various nasal and sinus conditions please look on the web www.drschneiderman.com
Todd A. Schneiderman, MD FACS |215 Union Avenue Suite C, Bridgewater, NJ 08807 |908-725-5050