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Sinus Infections

Dr. Anne Getz

Question:Dr. Getz
I get a lot of colds. Some-times the congestion and pressure in my face is so bad that I have to miss work. How do I know when I should see an Ear, Nose and Throat specialist?

Sinus infections are one of the most common reasons for visits to the doctor. Approximately one billion cases are diagnosed each year in the United States. Symptoms usually include a stuffed-up nose, clear nasal drainage, and facial pain or pressure, usually in the cheeks and/or forehead. Other symptoms may include fever, fatigue, toothache, and decreased or loss of the sense of smell.

The majority of sinus infections (98 percent) are due to the same viruses that cause common colds. These infections typically will go away on their own after 7 to 10 days, and do not require antibiotics. Treatment is based on symptoms and includes pain medication such as ibuprofen, salt water nasal washes for cleansing and to soothe nasal tissue, and short courses of nasal decongestants and nasal steroid sprays to decrease swelling.

Sinus infections caused by bacteria tend to last longer than viral infections, usually two or more weeks. While the symptoms are similar, the nasal drainage usually has a white, yellow or greenish color. Bacterial infections are treated with antibiotics in addition to pain relievers, decongestants and nasal sprays.

A sinus infection that resolves within four weeks is classified as acute sinusitis. Recurrent acute sinusitis is defined as four or more sinus infections per year. Chronic sinusitis is defined as nasal obstruction, facial pressure or pain, and drainage lasting for longer than 12 weeks at a time, and is caused by an underlying inflammation of the lining of the nose and sinuses. Chronic sinusitis may be associated with nasal polyps.

While acute sinusitis is common and routinely treated by your primary care physician, recurrent acute sinusitis and chronic sinusitis may involve a more complicated underlying problem that requires the care of a specialist.

Most cases may be treated with medicine alone, but some situations may be improved with sinus surgery to widen the natural drainage pathways of the sinuses. This surgery is performed through the nose with special telescopes (termed endoscopes) and does not require incisions on the face.