You’ve got the cough, the congestion and, yikes, the headache.
Is it just a cold? Maybe that viral infection that’s been creeping around the office?
That’s likely the correct diagnosis — unless after a week or so you’re still going through Kleenex tissues like crazy.
Then, says, Dr. Neil Van Leeuwen, an ENT specialist at Tanner Clinic, the ailment is likely chronic sinusitis — a sinus infection that just keeps on running.
“If someone has one sinus infection, that’s pretty normal. Two, OK,” said Dr. Van Leeuwen. “But if you start getting three or more, it tells you there’s something wrong inside there.”
Chronic sinusitis occurs when sinuses — the cavities around the nasal passages — become inflamed and swollen, and stay that way despite treatment.
There are multiple factors behind the chronic infection, says Dr. Van Leeuwen. Fungus. Bacteria. Allergic reactions. It may be, he adds, the use of too many antibiotics. Most often, it’s a respiratory tract infection — that is, a cold.
The symptoms of a sinus infection all fall into the “yucky” camp. And
you’re likely to have them in multiples.
Dr. Van Leeuwen has seen many patients who come to him with sinus concerns, but they only have one symptom, such as headache or post-nasal drip, which is a symptom of acid reflux. Without more of the symptoms, it’s likely not sinus-related, and the ailment is treated differently.
“We have people come to see us who have what they think is terrible sinus disease,” said Dr. Van Leeuwen. “When we look at them, it might not be sinus disease — they have migraine headaches, or they just have a runny nose. People sometimes just have a runny nose that’s not caused by sinuses.”
The many symptoms of sinusitis
So, here’s what else to look for when your brain seems stuffed and frozen:
▸ Post-nasal drip: A sensation that something’s draining down the back of your throat. If it’s originating in the sinuses, it’s likely thick mucus.
▸ Drainage: A thick, yellow or greenish discharge from the nose — or as the doctor explains it: “Green junk coming out of the nose.”
▸ Headaches: Pain, tenderness and swelling around your eyes, cheeks, nose or forehead.
▸ Congestion: Difficulty breathing through your nose.
▸ Sore throat
▸ Reduced sense of smell
▸ A general feeling of fullness or tenderness over the entire face
Treatment may include antibiotics, or, if it’s chronic and debilitating, surgery.
High success rate after sinusitis surgery
There are two reasons that will influence the choice to undergo surgery: a long-lasting sinus infection or multiple infections in a year. Surgery, explains Dr. Van Leeuwen, “opens up the sinuses so they function better and so the inflammation won’t block the sinuses and cause infections.”
Sinus surgery is done endoscopically, with the scope and instruments inserted through the nostrils. Nothing appears on the face following this usually two-hour surgery.
And, the post-surgery success rate is high, said Dr. Van Leeuwen. “By and large, you never see those patients in your clinic again, because they get better.”
Family doctors treat sinusitis
So, now that you’ve determined you likely have a sinus infection, do you go straight to an ENT specialist?
No, says Dr. Van Leeuwen. Family practice doctors should be the
“Normally, people with a sinus infection will go to their family doctor, he gives them the antibiotics, they get better, and they don’t get another sinus infection for several years,” he said.
An ENT becomes helpful when you’ve been to your family doctor and you’ve gone through the antibiotic without feeling better. Or, said Dr. Van Leeuwen said, “Your family doctor says, ‘You’ve had three infections this year. Maybe you need to see the ENT.’
“If you’re having antibiotics three or four times a year, that’s too many sinus infections,” he said. “Then we have to look deeper.”
AFTERTHOUGHT ON SINUSITIS AND ALLERGIES — People who suspect they have chronic sinusitis should look at the calendar. If the symptoms are prevalent in the fall, the culprit may actually be seasonal allergies.
“The person who says ‘This is my summer sinus infection’ probably has summer allergies,” said Dr. Van Leeuwen.
Allergies do play a role, however. Treating allergies will decrease sinus infections. “By testing and treating allergies, you can often help prevent further sinus problems,” he said.