Lingering symptoms could require the help of a sinus specialist.
When you experience such symptoms as a runny nose, congestion, sneezing or a sinus headache, it can be difficult to identify the cause. It’s always best to schedule a visit with your physician and have it checked out.
If symptoms have been present for just a few days, a physician can help rule out the common cold and other respiratory viruses, the flu, and fall allergies. But remember that COVID-19 is still circulating in our community, slowly increasing in numbers as it did last fall and winter. Symptoms of COVID-19 variants, especially in those who have been vaccinated, can be mild and often mimic more moderate cold viruses, so testing is a must to curb spread.
Home antigen and/or office PCR tests on a symptomatic person offer a highly accurate and rapid diagnosis. However, when these possibilities have been ruled out -- and if your symptoms have been lingering for more than a few weeks, or seem to go away partially but then come back quickly -- you may be suffering from a recurrent or even chronic sinus infection.
Sinus infections are very common; just take a stroll through your local drugstore and you will find entire aisles devoted to antihistamines, decongestants, and pain relievers. Sinus problems affect 35 million people in the U.S. alone.
Symptoms of a sinus infection include:
- Congestion
- Facial pain and pressure
- Runny nose, sometimes with discolored mucus
- Postnasal drip
- Decreased smell/taste
When these symptoms last longer than three months in any respect -- or go away initially with medicine, only to quickly recur once that medication is finished -- more advanced care is typically necessary.
What are the sinuses?
The sinuses are four sets of air cavities situated around the nose. They contain mucus membranes that humidify the air we breathe and collect dust, microbes, and other pollutants. An important part of this process involves the cilia, the hair-like cells lining the sinuses that help to move the mucus out of the nose and into the throat, where it is swallowed and expelled through the stomach.
Sinuses can become inflamed through a virus like the common cold, bacteria, allergens or sometimes a fungus. When this happens, the air cavities can’t drain, the cilia can’t clear mucus properly, and the sinuses become the perfect breeding ground for bacteria, which can cause a constant or recurrent infection.
How are sinus infections treated?
Although sinus surgery has come a long way and is typically very successful, for me it is always the last resort. Oftentimes, if we can get to the bottom of the initial cause -- including what environmental or lifestyle factors might be involved -- surgery may not be necessary. The first-line treatment is usually nasal steroid sprays, oral antibiotics and steroids, and/or nasal washes to see how the sinuses respond.
What happens when medicine alone is not effective?
When all else fails, a minimally invasive procedure is a great option for many people suffering from a chronic or recurrent sinus infections. Office procedures such as balloon sinuplasty are an excellent method to improve sinus drainage and aeration without general anesthesia or days off from work.
With a moderate-to-severe chronic sinus infection, or when there are more structural issues such as a deviated septum or large turbinates (skin folds in the nose), minimally invasive sinus surgery is employed. Sinus surgery is not one-size-fits-all and can involve CT image guidance, micro-instruments and stents coated with medications for precision and faster recovery. Much of what we do in the surgical suite these days is geared toward preventing the need for a future procedure.
Surgery is different for each patient and is modified based on the cause of the infection, the severity of symptoms, and the physical structure of the nasal cavity. Think of the nose or nasal cavity as a long hallway with all the doors shut; the rooms are the sinuses and the doors are the narrow openings to those sinuses.
During the procedure, doctors surgically enlarge the openings of the air pockets by removing unnecessary bone, so there’s no longer a “door” and the sinus is completely open to the nasal cavity or “hallway.” This helps to relieve any blockages, prevent future clogs, and ensure we can get the medicines into the sinuses directly to treat infections before they start without affecting the rest of the body. After surgery, nasal washes are usually sufficient to maintain healthy sinuses.
There’s no bruising, change in appearance, or uncomfortable post-surgical packing, helping to make it seem like you haven't even had surgery. The initial discomfort fades quickly, and patients usually report feeling much better after the first week.
Can you prevent sinus infections? Yes. The best way is to practice the same good personal hygiene habits for avoiding a cold or flu. Wash your hands often to avoid getting sick in the first place, and treat symptoms as soon as you feel like something is coming on. Nasal irrigation bottles with distilled water work extremely well in preventing initial infections. However, sometimes there are factors out of your control; that is when the help of a sinus specialist can be most useful.
Dr. Ameet R. Kamat is an Otolaryngologist and Rhinologist currently seeing patients in our White Plains, Armonk and Somers locations. To make an appointment with Dr. Kamat, call (914) 849-3755.