Posted on: December 18, 2014
Oh, the Pressure! Relief from Sinusitis
by Dr. John Scott
A runny nose may seem par for the course in winter. The dry air, colds and flu all add up to sinus troubles. But occasionally nose problems veer into more serious territory. The term “sinusitis” refers generally to inflammation in the nasal passages that persists. The glands in the nose become irritated and produce excess mucus. The cause can be a cold virus, infection from bacteria that reside in the nasal passages, irritants in the air or a combination of these factors. Whatever the source, about 37 million Americans suffer from at least one episode of sinusitis yearly, according to the Mayo Clinic.
There are varying degrees of sinusitis: Acute sinusitis comes on suddenly and lasts 10 to 14 days. Subacute sinusitis refers to inflammation that lasts for four to eight weeks. Sinusitis becomes chronic when it lasts longer than two months. Along with a runny nose, patients often suffer from headaches, fatigue, and facial pain.
Often, sinusitis can be treated with mucus-thinning drugs, antibiotics, and sometimes steroids. The goal is to get the nose draining, to decrease the inflammation, and to treat any underlying infection. When the sinusitis persists and moves into the chronic category, an otolaryngologist may schedule a CT scan to check for nasal polyps. Polyps trap mucus and make a person more susceptible to infections.
If the patient has polyps, excess tissue, or trapped mucus, an otolaryngologist can use special surgical tools to access the sinus and clear up the problem. We do the procedures trans-nasally — there’s no need for incisions in the face.
Only a small percentage of patients with sinusitis wind up needing surgery. In fact, many people manage their congestion with over-the-counter remedies. I suggest using saline rinses, decongestants, and acetaminophen/ibuprofen combination painkillers. However, I recommend people avoid so-called neti pots, which irrigate the sinuses. The amount of saline is too high and the pressure is too forceful. The pots can actually worsen the infection by pushing bacterial-laden mucus deeper into the sinuses. Stick to room-temperature rinses. If those fail you, your internist can prescribe stronger measures such as the antibiotics and steroids. If you’re still suffering or have recurrent infections, it may be time to consider making an appointment with an otolaryngologist.
Advanced Sinus Care
Northern Westchester is on the leading-edge of nasal surgery. The use of advanced technology such as the Brainlab system allows surgeons access to narrow, incredibly sensitive areas of the nasal cavity. The instruments are CT-scan guided; during the operation surgeons can see exactly where the instrument is in the nose. This allows them to comprehensively remove damaged tissue and work more safely. We’re working incredibly close to the eyes and brain tissue, and you really want to be sure you’re not encroaching on those areas. The CT-scan guidance provides new levels of precision.
Another exciting development at Northern Westchester Hospital is Balloon Sinuplasty which is used to treat blocked sinuses. In this procedure, the doctor guides a balloon similar to those used for cardiac angioplasty into a blocked passage, gently inflating it and dilating the sinus opening. The balloon widens the passage, allowing mucus to drain more readily. Because there’s no cutting, the procedure leaves an undisturbed lining behind. This means there’s no scar tissue, and that will help keep the sinuses open.
Editor’s Note: Dr. John Scott is the Chief of the Division of Otolaryngology at Northern Westchester Hospital. He is a physician with the Mount Kisco Medical Group, and a 2013 New York Magazine Best Doctor and a Best Doctors in America recipient. In 2013 and 2014 he was recognized as a Castle Connolly and Westchester Magazine Top Doctor. Dr. Scott is board certified in Facial Plastic and Reconstructive Surgery and Otolaryngology Head and Neck Surgery.