Sinus Awareness & Treatments -- June 20, 2011 -- Dr. Stephen Mit - | Nashville News, Weather & Sports

Sinus Awareness & Treatments -- June 20, 2011 -- Dr. Stephen Mitchell


Monday, June 20, 2011    
Stephen Mitchell, Otolaryngologist
TOPIC: Sinus Awareness & Treatments


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What Causes Sinus Problems?

What to do when good sinuses turn bad.

If you are plagued by sinus problems, take a moment to consider these valuable parts of your head. What can turn good sinuses into problem sinuses?

Your sinuses are hollow air spaces within the bones between your eyes, behind your cheekbone, and in the forehead. They produce mucus, which helps keep the inside of your nose moist. That, in turn, helps protect against dust, allergens, and pollutants.

Interesting Sinus Facts

No one is completely sure why we have sinuses, but some researchers think they keep the head from being too heavy.

Sinuses are also are responsible for the depth and tone of your voice. This explains why you sound like Clint Eastwood when your sinuses are all stuffed up.

If the tissue in your nose is swollen from allergies, a cold, or environmental triggers, it can block the sinus passages. Your sinuses can't drain, you may feel pain, and you will be at much higher risk of sinus infections.

There are eight sinus cavities in total. They are paired, with one of each in the left and right side of the face.

  • Two sinus cavities are located in the forehead.
  • Two are behind each cheekbone.
  • Two sinus cavities are within the bones between your eyes.
  • Two are behind each eye.

Common Sinus Problems

Sinus Blockages

Each sinus has a narrow spot, called the transition space (ostium), which is an opening that's responsible for drainage. If a bottleneck or blockage occurs in the transition of any of the sinuses, you're at risk of developing a sinus infection. Mucus backs up behind the blockage, and acts as a breeding ground for bacteria.

An Extra Sinus

About 10% of people have an extra sinus, which raises their risks for sinus infections. The extra sinus "effectively narrows that transition space," says Ford Albritton, MD, FACS, chairman of otolaryngology at Presbyterian Hospital of Dallas.

Deviated Nasal Septum

Another common issue is a deviated nasal septum, the thin wall of bone and cartilage inside your nasal cavity that separates your two nasal passages. Ideally, your septum is situated in the center of your nose, equally separating the two sides. But whether from genetics or trauma (like a 6th grade fist fight), in about 80% of people, the nasal septum is displaced to one side, making one nasal passage smaller than the other. A deviated septum is one reason some people have chronic sinus issues. A deviated septum can also lead to obstructed breathing and snoring.

Narrow Sinuses

More widely, certain people just have variations in their anatomy that creates a longer, narrower path for the transition spaces to drain. "It's pure genetics, since it's the way we've inherited how our sinuses are put together and how easy or difficult it is for them to stay open or become blocked," Albritton says.

Sinus Sensitivity and Allergies

Finally, there are certain people who have sensitivity to things in the environment and to the foods they eat. This sensitivity triggers a dilation of blood vessels in the nose, and sometimes releases chemicals from cells in the nose that cause swelling.

Does drinking red wine or eating certain foods cause your nose to swell? This is a type of allergic reaction or food sensitivity that can make the sinuses ripe for infection. The inflammation causes tissue swelling that prevents the sinus cavities from clearing out bacteria. The blocked mucus creates a breeding ground for bacteria, which increases your chances of developing a sinus infection.

If you test positive for allergies, your physician can prescribe medications to control your symptoms and reduce the risk of developing an infection. People with sinus problems and allergies should avoid environmental irritants such as tobacco smoke and strong chemical odors, which may increase sinus problems.

Who Is Prone to Sinus Problems?

People who have very narrow sinus cavities can have a bottleneck for drainage so that any swelling or infection creates a blockage that causes sinus infection. If your sinus passageways are narrow to begin with then what happens is if you get any kind of inflammation whether it's from pollution, allergy or infection, the sinus shuts down, the mucus sits there and pools, and you become infected.

Those with allergies and food sensitivities are predisposed to sinus infections since the offending allergens like cigarette smoke, pollution or food triggers enter the body and turn on cells, make proteins and release chemicals that cause the sinuses to swell.

Also, those with lowered immunity (as when you've had a cold) may be at higher risk for developing sinusitis. Since your immune system helps fight infection, when its lowered from any cause they can't keep bacteria or viruses away. Then bacteria have an easier time coming in and causing a full-fledged infection.

Protecting Your Sinuses

Try these tips to reduce inflammation and prevent sinus problems:

  • Apply a warm, moist washcloth to your face several times a day to help open the transition spaces.
  • Drink plenty of fluids to thin the mucus.
  • Inhale steam 2 to 4 times per day (sit in the bathroom with the hot shower running).
  • Use a nasal saline spray several times per day.
  • Wash the nose with a salt water solution from a neti pot.
  • Try a humidifier to moisten the air you breathe and help open sinuses.

If your sinus problems are related to allergies, consider these steps:

  • Avoid your allergy triggers.
  • Take antihistamines.
  • Try nasal steroid sprays.
  • Consider allergy immunotherapy (shots).
  • If you develop a sinus infection that does not clear after 10 to 14 days, talk to your doctor about antibiotics.
  • Lastly, if you have recurrent sinus problems, you might talk to your doctor about surgery to clean and drain the sinuses.
  • Surgery is designed to take care of the anatomic issues and to remove the areas that are narrow and causing the blockage. The newest methods are less invasive and use a balloon catheter like an angioplasty to dilate the opening of the sinuses and create wider spaces. This procedure is the balloon sinuplasty.
  • Remember, most sinus infections can be treated with a combination of self-care measures, controlling allergies, and medical treatment. If self-care measures don't prevent sinus problems further testing or a referral to an ears nose and throat specialist maybe in order.


Survey Shows Many Americans Confuse Allergies and Sinus Infections

May 18, 2011 -- Many people misdiagnose themselves as having allergies when they actually have sinusitis, a survey shows, and skip a visit to the doctor.

The survey was conducted by the Asthma and Allergy Foundation of America (AAFA).

The AAFA says that when people confuse sinusitis symptoms with signs of allergies, they often suffer longer than they would if they visited a doctor, who could make a proper diagnosis.

The AAFA says symptoms of sinusitis are similar to signs of allergies, but that too many people try to diagnose themselves.

According to a survey of 621 people, conducted online from a database of asthma and allergy patients, about 70% of sinusitis sufferers most trust a primary care doctor to correctly diagnose symptoms, yet only 36% go to one for help.

Self-Diagnosis Can Be Counterproductive

Among the findings of the survey:

  • 47% of respondents with sinusitis admit to self-diagnosing when they have symptoms.
  • 37% are doing more self-diagnosing now than they were five years ago.
  • 41% of those who say it is not easy to distinguish signs of allergies from signs of sinusitis still go ahead and diagnose themselves when they have symptoms.
  • 51% admit they have misdiagnosed themselves as suffering from allergies when the cause turned out to be sinusitis.
  • 39% say they think it's hard to tell the difference between the symptoms of a cold, flu, allergies, and sinusitis.
  • 55% of people who have heard of chronic sinusitis underestimate the minimum number of weeks this condition may last; 39% admit they don't have a clue about duration.
  • Only 26% of respondents who had heard of chronic sinusitis were aware that a minimally invasive treatment option exists for the condition.
  • 49% of respondents have never seen an ear, nose, and throat doctor about their sinusitis.

Allergies vs. Chronic Sinusitis

There's a key difference between allergies and chronic sinusitis.

If you have allergy-like symptoms that last longer than 12 weeks, or symptoms that occur more than three times per year, with symptoms usually lasting more than 20 days despite treatment attempts, you may have chronic sinusitis and should see a doctor for a correct diagnosis and the right medical solution.

About 7 million Americans suffer from chronic sinusitis, resulting in some 32 million cases reported by doctors and other health care providers every year.

The survey was released to coincide with the peak of spring allergy season, which makes it important for people with symptoms to see a specialist, says the AAFA.

Chronic sinusitis has been underdiagnosed for many years.

Because so many people are confused about treatment of the chronic sinusitis and more than 50% of people do not respond adequately to medications, "it's important that they consult with an ear, nose and throat physician to get the most appropriate treatment to alleviate long-term suffering,"

Common symptoms of sinusitis include: 

  • Facial pain
  • Nasal congestion
  • Yellow or green mucus in the nose
  • Fever

Some cases of chronic sinusitis due to infection are treated with antibiotics.



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