Patients with sinusitis often have other conditions, or triggers, that make their symptoms worse. In this article, we discuss some of these triggers and review treatment options for treating sinusitis.
Know your allergies. Many patients with sinus trouble have environmental allergies (ie-“hay fever”). Allergic reactions often make sinus symptoms worse. Some patients believe they don’t have allergies because they don’t get itchy or watery eyes, but this is not always true. Sometimes the only symptoms are nasal and sinus symptoms. Other patients may think they don’t have allergies because their symptoms are year-round and not seasonal, but this also is not always true. Testing for allergies is very useful for managing sinusitis. If you have allergies and are able to identify the allergens, this opens up more options for treatment and avoidance. If you don’t have allergies it is good to find this out so that you don’t waste time and money taking allergy medications that are of little use. Allergy testing is performed by Philadelphia allergist specialists as well as most Otolaryngologists.
Know your anatomy. Sinuses drain through very small holes called ostia. When these ostia get blocked, the sinuses swell and infections can occur. Sometimes the sinus ostia don’t drain because of the swelling in the nose and sinuses that leads to blockage. Sometimes the ostia don’t drain because they are blocked by your anatomy. In other words, your anatomy may physically block your sinuses from functioning properly. In this case, your sinus medications may not be providing lasting improvement because they are not addressing the source of the problem.For patients with persistent sinus problems, it is prudent to see a trained Otolaryngologist who can evaluate your nose and sinus anatomy and help you get to the root of your problem and start treating sinusitis. Targeted treatment is the key to successful treatment.
Is it an infection? In 2013, the US Department of Health and Human Services’ Center for Disease Control (CDC) identified the emergence of Antimicrobial Drug Resistance as “one of our most serious health threats.” Drug resistance occurs when physicians over-prescribe antibiotics – often for ear and sinus infections. Antibiotics can be effective treatments for patients with sinus infections; yet they can also have significant side-effects, and should be used carefully. Patients who suspect they have a sinus infection should consider seeking the assistance of an Otolaryngologist. Specialized equipment is now available by which Otolaryngologists can acquire a magnified view of the sinus drainage areas to see if signs of infection are present. Under the guidance of these small endoscopes, cultures can be taken in the office in a matter of minutes to search for a bacterial source of infection as well as identify antibiotics that will target the bacteria isolated. The procedure is typically well-tolerated and is often performed on adults and children.
Trial and error… While it is unwise to use antibiotics in a “trial and error” fashion, there are some FDA-approved over-the-counter medications that can be used safely. Sinus rinse bottles, mucous thinning agents, oral antihistamines, and decongestants are readily available in the “Cold, Sinus, and Allergy” section of most drugstores and supermarkets.While these medications are unlikely to provide lasting relief for the sinus pain sufferer, they can be used to alleviate some symptoms. If these medications are used, notes should be made of their impact – positive and negative. When sinus pain sufferers finally seek the professional help of an Otolaryngologist, it can be very useful to know which medications helped to alleviate symptoms, how long the effects lasted, etc. The Otolaryngologist is trained to act as a detective – to track down the causes of a patient’s symptoms. How a patient responds to medical treatments are useful clues that can help the Otolaryngologist identify the source of the problem and, subsequently, provide targeted treatments that will provide lasting relief.