Nasal and Sinus Disorders

Nasal Disorders

Nasal Function

Your Nose, the Guardian of Your Lungs

You might not think your nose is a vital organ, but indeed it is! To understand its importance, all that most people need to experience is a bad cold. Nasal congestion and a runny nose have a noticeable effect on quality of life, energy level, ability to breathe, ability to sleep and ability to function in general.

Why is the nose so important?

It processes the air that you breathe before it enters your lungs. Most of this activity takes place in and on the nasal turbinates, located on the sides of the nasal passages. In an adult, 18,000 to 20,000 liters of air pass through the nose each day.

Your Nose Protects Your Health By:

  • Filtering all that air and retaining particles as small as a pollen grain with 100% efficiency.
  • Humidifying the air that you breathe, adding moisture to the air to prevent dryness of the lining of the lungs and bronchial tubes.
  • Warming cold air to body temperature before it arrives in your lungs.

For these and many other reasons, normal nasal function is essential. Do your lungs a favor; take care of your nose.

​Because the connection between the nose and lungs is so important, paying attention to problems in the nose can reduce or avoid problems in the lungs such as bronchitis and asthma. Ignoring nasal symptoms such as congestion, sneezing, runny nose or thick nasal discharge can aggravate lung problems and lead to other problems:

  • ​Nasal congestion reduces the sense of smell.
  • Mouth breathing causes dry mouth, which increases the risk of mouth and throat infections and reduces the sense of taste. Mouth breathing also pulls all pollution and germs directly into the lungs; dry cold air in the lungs makes the secretions thick, slows the cleaning cilia and slows down the passage of oxygen into the blood stream
  • Ignoring nasal allergies may increase the chance that you will develop asthma; it also makes asthma worse if you already have it.

So, it is important to treat nasal symptoms promptly to prevent worsening of lung problems.

​Tips To Improve The Health Of Your Nose And Lungs

​If your nose is dry, its various functions will be impaired. Try over-the-counter salt-water (saline) nasal mists and sprays to help maintain nasal health. These can be used liberally and at your discretion.

​Beware of over-the-counter nasal decongestant sprays (eg. Afrin). Prolonged use of these sprays may damage the cilia that clear the nose and sinuses. Decongestants nasal sprays can become addictive and actually cause nasal congestion to get worse.

Think of your nose when you’re traveling. In airplanes and air-conditioned cruise ships the air is very dry and contains a lot of re-circulated particles and germs; a dry nose is more susceptible to germs. Use saline nasal mist frequently during the flight, and drink lots of water.

Medications Prescribed To Treat Nasal Problems

The foundation of the treatment of chronic nasal conditions is determining the cause.

Intra-nasal steroid sprays (now over the counter) specifically help nasal allergy and are safe if used as directed. This is in contrast to medications that are inhaled by mouth into the lungs, which often have high levels of absorption into the blood stream. Always aim nasal sprays to the side of the nose; spraying into the center of the nose can cause too much dryness.

Antihistamines effectively relieve sneezing, itching and runny nose, but they have minimal effect on nasal congestion at least in the short term. Some antihistamines cause drowsiness, slow the cleaning function of the cilia and increase the stickiness of nasal mucus – causing germs and pollens to stay in the nose longer.

Decongestants help to unclog stopped-up noses but do very little for runny noses and sneezing. They work much faster to unclog the nose, but to achieve this quick action, there are often side-effects such as dry mouth, nervousness and insomnia. The correct dose often has to be customized to get the benefit without the side-effects.

Be aware of medication side effects; no medicine works well for all people, and all medications can cause side effects.

Be aware of the nasal effects of other medications

  • Diuretic blood pressure medications cause dryness in the nose and throat, making them more susceptible to germs and pollens.
  • Many anti-anxiety medications also have a drying effect on the nose and throat.
  • Birth control pills, blood pressure medicines called beta-blockers and Viagra can cause increased nasal congestion.
  • Eye drops can aggravate nasal symptoms when they drain into the nose with tears.

Be sure you understand their purpose. Each one is important and plays a separate role in treating nasal symptoms.

​The Stuffy Nose

Nasal stuffiness or congestion and/or obstruction to nasal breathing is one of the oldest and most common human complaints. For some, it may only be a nuisance; for others, nasal congestion can be a source of considerable discomfort and it can detract from the quality of their lives.

Nasal stuffiness can be classified into four main causal categories:

  1. ​Infection
  2. Structural abnormalities
  3. Allergic
  4. Non-allergic (vasomotor) rhinitis.

It should be recognized that overlap exists between these categories and that it is not unusual for a patient to have more than one factor involved in his particular case.

​What are the causes of nasal congestion?

  1. Infection

    ​An average adult suffers a “common cold” two to three times per year. These viral infections occur more often in childhood because immunity strengthens with age. A cold is caused by one of many different viruses, some of which are airborne, but most are transmitted by hand-to-nose contact. Once the virus is absorbed by the nose, it causes the body to release histamine, a chemical which dramatically increases blood flow to the nose and causes nasal tissue to swell. This inflames the nasal membranes which become congested with blood and produce excessive amounts of mucus that “stuffs up” the nasal airway. Antihistamines and decongestants help relieve the symptoms of a cold, but no medication can cure it. Ultimately, time is what is needed to get rid of the infection.

    During a viral infection, the nose has poor resistance to bacteria, which is why infections of the nose and sinuses often follow a “cold”. When the nasal mucus turns from clear to yellow or green, it usually means that a bacterial infection has set in. In this case, a physician should be consulted.

    Acute sinus infections produce nasal congestion and thick discharge. Pain may occur in cheeks and upper teeth, between and behind the eyes, or above the eyes and in the forehead, depending on which sinuses are involved.

    ​Chronic sinus infections may or may not cause pain, but usually involve nasal obstruction and offensive nasal or postnasal discharge. Some people develop polyps (fleshy growths in the nose) from sinus infections, and the infection can spread to the lower airways, leading to a chronic cough, bronchitis or asthma. Acute sinus infections generally respond to antibiotic treatment; chronic sinusitis may require surgery.
  2. Structural abnormalities

    These include deformities of the nose and nasal septum – the thin, flat cartilage and bone that divides the two sides of the nose and nostrils. These deformities are usually the result of an injury, often unrecognized, many having occurred in childhood and long forgotten. In fact 7% of newborn babies suffer significant nasal injury in the birth process. Therefore, deformities of the nose and the deviated septum are fairly common problems, and can obstruct breathing.

    In addition enlargement of the nasal turbinates – large structures along the inside of the nose, can be a major cause of nasal obstruction. They are often enlarged from chronic nasal allergy, nasal septum abnormalities and chronic nasal infection.

    Sometimes this turbinate enlargement needs treatment to make them smaller and expand the nasal passages. This turbinate enlargement can easily be corrected by a simple, painless, in office procedure called radiofrequency turbinate reduction. This simple procedure often improves nasal congestion without undergoing surgery to correct a deviated septum.

    In children, one of the most common causes of nasal obstruction is enlargement of the adenoids. These are a tonsil-like tissue located in the back of the nose, behind the palate. Children with this problem may experience noisy breathing at night and may snore. Children who are chronic mouth breathers may develop a sagging face and dental deformities. In this case, surgery to remove the adenoids and/or tonsils may be advisable.

    Children are often known to insert small objects into their noses. If a foul-smelling discharge is observed draining from one nostril, a physician should be consulted.

    Other causes in this category include nasal tumors and foreign bodies. Children are prone to inserting various objects such as peas, beans, cherry pits, beads, buttons, safety pins, and bits of plastic toys into their noses. Beware of one-sided foul smelling discharge, which can be caused by a foreign body. A physician should be consulted if any of these symptoms exist.
  3. Nasal Allergies

    Hay fever, grass fever and summertime colds are various names for allergic rhinitis. Allergy is an exaggerated inflammatory response to a substance which, in the case of a stuffy nose, is usually pollen, mold, animal dander or some element in house dust. Pollen may cause problems during spring, summer and fall, whereas dust mite allergies are often most evident in the winter. Molds may cause symptoms year-round. In the allergic patient, the release of histamine and similar substances results in congestion and excess production of watery nasal mucus.

    See the ALLERGY section on this website.
  4. Non-allergic or Vasomotor Rhinitis

    “Rhinitis” means inflammation of the nose and nasal membranes. “Vasomotor” means pertaining to the nerves that control the blood vessels. Membranes in the nose have an abundant supply of arteries, veins and capillaries, which have the ability to expand and constrict. This particularly affects the nasal turbinates, which are extremely vascular. Normally these blood vessels are in a half-constricted or half-open state. When a person exercises vigorously, hormone (adrenaline) levels increase. Adrenaline causes constriction of the nasal membranes so that the air passages open up and the person breathes more freely.

    The opposite takes place when an allergic attack or a “cold” develops. During a cold, blood vessels expand, membranes become congested, and the nose becomes stuffy or blocked.

    In addition to allergies and infections, certain people are born with or develop this condition without cause, whereby certain circumstances can cause nasal blood vessels to expand, leading to vasomotor rhinitis. The most common causes are changes in the weather, barometric pressure and/or temperature. Many people have a “runny” nose in cold weather and nasal congestion when it’s about to rain.

    Other conditions include psychological stress, inadequate thyroid function, pregnancy, certain anti-high blood pressure drugs, prolonged overuse of decongesting nasal sprays, and exposure to irritants such as perfumes and tobacco smoke.

    In the early stages of these disorders, nasal stuffiness is temporary and reversible. It usually improves when the primary cause is corrected. However, if the condition persists, the blood vessels lose their capacity to constrict, much like varicose veins. When the patient lies down on one side, the lower side becomes congested, which often can interfere with sleep.

    It is helpful to sleep with the head of the bed elevated two to four inches.

    This chronic turbinate enlargement can easily be corrected by a simple, painless, in office procedure called radiofrequency turbinate reduction. This option can provide dramatic and permanent relief.

Are there any risks when treating congestion?

​Patients who get sleepy from antihistamines should not drive an automobile or operate dangerous equipment after taking them. Decongestants increase pulse rate and elevate blood pressure and therefore should be avoided by those with high blood pressure, irregular heart beat, glaucoma or difficulty urinating.

​Pregnant patients should consult their obstetricians before taking any medicine.

​Cortisone is a powerful anti-inflammatory and decongestant. The use of steroid nasal sprays minimize the risk of serious side effects associated with other dosage forms. Patients using steroid nasal sprays should follow instructions carefully, and consult a physician immediately if they develop nasal bleeding, crusting, pain or vision changes.

​Summary

​Stuffy nose is one symptom caused by a remarkable array of different disorders, and San Francisco ENT and Allergy, with its unique approach and special interest in to managing nasal disorders, offers the appropriate treatment(s) based on the specific causes.

​Post-Nasal Drip

​The glands in your nose and throat continually produce mucus (1 to 2 quarts a day). It moistens and cleans the nasal membranes, humidifies air, traps and clears inhaled foreign matter, and fights infection.

​Although mucus normally is swallowed unconsciously, the feeling that it is accumulating in the throat or dripping from the back of your nose is called post-nasal drip.

​This feeling can be caused by excessive or thick secretions or by throat muscle and swallowing disorders.

​What Caused Abnormal Secretions – Thin & Thick

​Increased thin clear secretions can be due to colds and flu, allergies, cold temperatures, bright lights, certain foods/spices, pregnancy, and other hormonal changes. Various drugs (including birth control pills and high blood pressure medications), and structural abnormalities can also produce increased secretions. These abnormalities might include a deviated or irregular nasal septum or turbinate enlargement.

​Increased thick secretions in the winter often result from too little moisture in our heated buildings and homes. They can also result from sinus or nose infections and some allergies, especially to certain foods such as dairy products. If thin secretions become thick and green or yellow, it is likely that a bacterial sinus infection is developing. In children, thick secretions from one side of the nose can mean that something is stuck in the nose (such as a bean, wadded paper, or piece of toy, etc.).

​Chronic sinusitis occurs when sinus blockages persist and the lining of the sinuses swell further. Polyps (growths in the nose) may develop with chronic sinusitis. Patients with polyps tend to have irritating, persistent post-nasal drip

​Smell & Taste

Insight into important senses

  • How do smell and taste work?
  • What causes loss of smell and taste?
  • How are smell and taste loss diagnosed?
  • and more...

Problems with these senses have a big impact on our lives. Smell and taste contribute to our enjoyment of life by stimulating a desire to eat. When smell and taste become impaired, we eat poorly, socialize less and feel worse. Smell and taste warn us of dangers, such as fire, poisonous fumes and spoiled food.

​Loss of the sense of smell may indicate sinus disease, growths in the nasal passages, or at times, brain tumors.

​How do Smell and Taste Work?

​Smell and taste belong to our chemical sensing system (chemosensation). The complicated process of smelling and tasting begins when molecules released by the substances around us stimulate special nerve cells in the nose, mouth or throat. These cells transmit messages to the brain, where specific smells or tastes are identified.

  • ​Olfactory (smell nerve) cells are stimulated by the odors around us – the fragrance from a rose, the smell of bread baking. These nerve cells are found in a tiny patch of tissue high up in the nose, and they connect directly to the brain.
  • Gustatory (taste nerve) cells are clustered in the taste buds of the mouth and throat. They react to food or drink mixed with saliva. Many of the small bumps that can be seen on the tongue contain taste buds. These surface cells send taste information to nearby nerve fibers, which send messages to the brain.

Our body’s ability to sense chemicals is another chemosensory mechanism that contributes to our senses of smell and taste. In this system, thousands of free nerve endings – especially on the moist surfaces of the eyes, nose, mouth and throat – identify sensations like the sting of ammonia, the coolness of menthol and the “heat” of chili peppers.

​What Causes Loss of Smell and Taste?

​Scientists have found that the sense of smell is most accurate between the ages of 30 and 60 years. It begins to decline after age 60, and a large proportion of elderly persons lose their smelling ability. Women of all ages are generally more accurate than men in identifying odors.

​Some people are born with a poor sense of smell or taste. Upper respiratory infections are blamed for some losses, and injury to the head can also cause smell or taste problems.

​Loss of smell and taste may result from polyps in the nasal or sinus cavities, hormonal disturbances or dental problems. They can also be caused by prolonged exposure to certain chemicals such as insecticides, and by some medicines.

​Tobacco smoking impairs the ability to identify odors and diminishes the sense of taste. Quitting smoking improves the smell function.

​Radiation therapy patients with cancers of the head and neck often complain of lost smell and taste. These senses can also be lost in the course of some diseases of the nervous system.

​How are Smell and Taste Loss Diagnosed?

​The extent of loss of smell or taste can be tested using the lowest concentration of a chemical that a person can detect and recognize. A patient may also be asked to compare the smells or tastes of different chemicals, and how the intensities of smells and tastes grow when a chemical concentration is increased.

​Can These Disorders be Treated?

​Sometimes certain medications are the cause of smell or taste disorders, and improvement occurs when that medicine is stopped or changed. Although certain medications can cause chemosensory problems, others – particularly anti-allergy drugs – seem to improve the senses of taste and smell. Some patients, notably those with serious respiratory infections or seasonal allergies, regain their smell or taste simply by waiting for their illness to run its course. In many cases, nasal obstructions, such as polyps, can be removed to restore airflow to the receptor area and can correct the loss of smell and taste. Occasionally, chemo-senses return to normal just as spontaneously as they disappeared.

​How Do You Cope with Smell or Taste Problems?

​If you experience problems in smelling or tasting, try to identify and record the circumstances surrounding it. When did you first become aware of it? Did you have a cold or flu then? A head injury? Were you exposed to air pollutants, pollens, danders or dust to which you might be allergic? Is this a recurring problem? Does it come in any special season, like hay fever time?

​Bring all this information with you when you visit us

​Proper diagnosis by a trained professional can provide reassurance that your illness is not imaginary. You may even be surprised by the results. For example, what you may think is a taste problem could actually be a smell problem, because much of what you taste is really caused by smell.

​Diagnosis may also lead to treatment of an underlying cause for the disturbance. Remember, many types of smell and taste disorders are reversible.

​Flavor

​Four commonly identified taste sensations:

  • ​sweet
  • sour
  • bitter
  • salty

Certain tastes combine with texture, temperature and odor to produce a flavor that allows us to identify what we are eating.

​Many flavors are recognized through the sense of smell. If you hold your nose while eating chocolate, for example, you will have trouble identifying the chocolate flavor, even though you can distinguish the food’s sweetness or bitterness. This is because the familiar flavor of chocolate is sensed largely by odor. So is the well known flavor of coffee. This is why a person who wishes to fully savor a delicious flavor (e.g., an expert chef testing his own creation) will exhale through his nose after each swallow.

​Taste and smell cells are the only cells in the nervous system that are replaced when they become old or damaged. Scientists are examining this phenomenon while studying ways to replace other damaged nerve cells.

​Nosebleeds

​The nose is an area of the body that contains many tiny blood vessels (or arterioles) that can break easily. In the United States, one of every seven people will develop a nosebleed some time in their lifetime. Nosebleeds can occur at any age but are most common in children aged 2-10 years and adults aged 50-80 years. Nosebleeds are divided into two types, depending on whether the bleeding is coming from the front or back of the nose.

​What is an anterior nosebleed?

​Most nosebleeds (or epistaxes) begin in the lower part of the septum, the semi-rigid wall that separates the two nostrils of the nose. The septum contains blood vessels that can be broken by a blow to the nose or the edge of a sharp fingernail. Nosebleeds coming from the front of the nose, (anterior nosebleeds) often begin with a flow of blood out one nostril when the patient is sitting or standing.

​Anterior nosebleeds are common in dry climates or during the winter months when dry, heated indoor air dehydrates the nasal membranes. Dryness may result in crusting, cracking and bleeding. This can be prevented by placing a light coating of petroleum jelly or an antibiotic ointment on the end of a fingertip and then rubbing it inside the nose, especially on the middle portion of the nose (the septum).

​How do I stop an anterior nosebleed?

  • ​Stay calm, or help a young child stay calm. A person who is agitated may bleed more profusely than someone who’s been reassured and supported.
  • Keep head higher than the level of the heart. Sit up.
  • Lean slightly forward so the blood won’t drain in the back of the throat.
  • Gently blow any clotted blood out of the nose. Spray a nasal decongestant in the nose.
  • Using the thumb and index finger, pinch all the soft parts of the nose. Do not pack the inside of the nose with gauze or cotton.• Hold the position for five minutes. If it’s still bleeding, hold it again for an additional 10 minutes.

What is a posterior nosebleed?

​More rarely, a nosebleed can begin high and deep within the nose and flow down the back of the mouth and throat, even if the patient is sitting or standing.

​Obviously, when lying down, even anterior (front of nasal cavity) nosebleeds may seem to flow toward the back of the throat, especially if coughing or blowing the nose. It is important to try to make the distinction between the anterior and posterior nosebleed, since posterior nosebleeds are often more severe and almost always require a physician’s care. Posterior nosebleeds are more likely to occur in older people, persons with high blood pressure, and in cases of injury to the nose or face.

​What are the causes of recurring nosebleeds?

  • ​Allergies, infections or dryness that cause itching and lead to picking of the nose.
  • Vigorous nose-blowing that ruptures superficial blood vessels.
  • Clotting disorders that run in families or are due to medications.
  • Drugs (such as anticoagulants or anti-inflammatories).
  • Fractures of the nose or the base of the skull. Head injuries that cause nosebleeds should be regarded seriously.
  • Tumors, both malignant and nonmalignant, particularly in the older patient or in smokers.

When should an otolaryngologist be consulted?

​If frequent nosebleeds are a problem, it is important to consult an otolaryngologist. An ear, nose and throat specialist will carefully examine the nose using an endoscope, a tube with a light for seeing inside the nose, prior to making a treatment recommendation. Two of the most common treatments are cautery and packing the nose. Cautery is a technique in which the blood vessel is burned with an electric current, silver nitrate or a laser. Sometimes, a doctor may just pack the nose with a special gauze or an inflatable latex balloon to put pressure on the blood vessel.

​Tips to prevent a nosebleed

  • ​Keep the lining of the nose moist by gently applying a light coating of petroleum jelly or an antibiotic ointment with a cotton swab three times daily, including at bedtime. Commonly used products include Bacitracin® A and D Ointment, Eucerin®, Polysporin® and Vaseline®.
  • Keep children’s fingernails short to discourage nose-picking.
  • Counteract the effects of dry air by using a humidifier.
  • Use a saline nasal spray to moisten dry nasal membranes.
  • Quit smoking. Smoking dries out the nose and irritates it.

Tips to prevent rebleeding after initial bleeding has stopped

  • ​Do not pick or blow nose.
  • Do not strain or bend down to lift anything heavy.
  • Keep head higher than the heart.

If rebleeding occurs:

  • ​Attempt to clear nose of all blood clots.
  • Spray nose four times in the bleeding nostril(s) with a decongestant spray.
  • Repeat the steps to stop an anterior nosebleed.
  • Call a doctor if bleeding persists after 30 minutes or if nosebleed occurs after an injury to the head.

Sinus Disorders

Have you ever had a cold or allergy attack that wouldn’t go away? If so, there’s a good chance you actually had sinusitis. Experts estimate that 37 million people are afflicted with sinusitis each year, making it one of the most common health conditions in America. That number may be significantly higher, since the symptoms of bacterial sinusitis often mimic those of colds or allergies, and many sufferers never see a doctor for proper diagnosis and treatment.

​Symptoms of Acute Sinusitis:

  • ​symptoms of upper respiratory infection lasting ten days or more
  • facial pressure or pain
  • nasal discharge that is yellow or green
  • post-nasal drip
  • cough

Unlike a cold, or allergy, bacterial sinusitis usually requires a physician’s diagnosis and treatment with an antibiotic to cure the infection and prevent future complications.

​When does acute sinusitis become chronic?

​When you have frequent sinusitis, or the infection lasts three months or more, it could be chronic sinusitis. Symptoms of chronic sinusitis may be less severe than those of acute; however, untreated chronic sinusitis can cause damage to the sinuses and cheekbones that sometimes requires surgery to repair.

​What treatments are available?

​A Physician Visit for Your Sinus infection will:

  • ​determine if you have an infection requiring an appropriate antibiotic
  • discover if you require intensive medical treatment for a more underlying chronic condition such as a nasal obstruction or allergy, which may require more intensive and/or long term treatment.

At-Home Treatments

​Saline nasal sprays that moisturize the nasal cavity, reduce dryness and help clear thick or crusty mucus.

​Humidification (moisturizing the air) of living spaces in dry climates will to aid the movement of mucus through the sinuses

Antibiotic therapy – Therapy for bacterial sinusitis should include an appropriate antibiotic. If you have three or more symptoms of sinusitis (see chart), be sure to see your doctor for diagnosis. In addition to an antibiotic, an oral or nasal spray decongestant may be recommended to relieve congestion, although you should avoid prolonged use of nonprescription nasal sprays. Inhaling steam or using saline nasal sprays or drops can help relieve sinus discomfort.

​Antibiotic resistance means that some infection-causing bacteria are immune to the effects of certain antibiotics prescribed by your doctor. Antibiotic resistance is making even common infections, such as sinusitis, challenging to treat. You can help prevent antibiotic resistance. If the doctor prescribes an antibiotic, it is important that you take all of the medication just as your doctor instructs, even if your symptoms are gone before the medicine runs out.

Intensive antibiotic therapy – If your doctor thinks you have chronic sinusitis, a more intensive antibiotic therapy may be prescribed. This may mean taking stronger more broad-spectrum antibiotics and for a longer period of time.

Steroid Therapy – Alone, or in addition to antibiotics, you may be given a oral coarse of steroids, tapering the dose over a period of time, or an injection of steroids.

Surgery is sometimes necessary to remove physical obstructions that may contribute to sinusitis.

​Sinus surgery for chronic sinusitis should be considered only if medical treatment fails or if there is a nasal obstruction that cannot be corrected with medications. The type of surgery is chosen to best suit the patient and the disease.

​Functional endoscopic sinus surgery (FESS) is recommended for certain types of sinus disease. With the endoscope, the surgeon can look directly into the nose, while at the same time, removing diseased tissue and polyps and clearing the narrow channels between the sinuses.

​What are the symptoms of sinusitis vs. a cold or allergy?

​Because the symptoms of sinusitis sometimes mimic those of colds and allergies, you may not realize it.

​Do I Have Sinusitis?

​If you suspect you have sinusitis, review these signs and symptoms.

SIGN/SYMPTOM

SINUSITIS

ALLERGY

COLD

Facial Pressure /Pain

Yes

Sometimes

Sometimes

Duration of Illness

Over 10-14 days

Varies

Under 10 days

Nasal Discharge

Thick, yellow-green

Clear, thin, watery

Thick, whitish or thin

Fever

Often

No

Sometimes

Headache

Often

Sometimes

Sometimes

Pain in Upper Teeth

Sometimes

No

No

Bad Breath

Sometimes

No

No

Coughing

Sometimes

Sometimes

Yes

Nasal Congestion

Yes

Sometimes

Yes

Sneezing

No

Sometimes

Yes

If you answered “Yes” to three or more of the symptoms listed in the sinusitis column above, and you have had them for ten days or longer, you may have a sinus infection.

​An examination by your physician or an ear, nose and throat specialist may be warranted.

​Can children suffer from sinus infections?

​Your child’s sinuses are not fully developed until age 20. However, children can still suffer from sinus infection. Although small, the maxillary (behind the cheek) and ethmoid (between the eyes) sinuses are present at birth. Sinusitis is difficult to diagnose in children because respiratory infections are more frequent, and symptoms can be subtle. Unlike a cold or allergy, bacterial sinusitis requires a physician’s diagnosis and treatment with an antibiotic to prevent future complications.

​The following symptoms may indicate a sinus infection in your child:

  • ​a “cold” lasting more than 10 to 14 days, sometimes with low-grade fever
  • thick yellow-green nasal drainage
  • post-nasal drip, sometimes leading to or exhibited as sore throat, cough, bad breath, nausea and/or vomiting
  • headache, usually not before age 6
  • irritability or fatigue
  • swelling around the eyes

If despite appropriate medical therapy these symptoms persist, care should be taken to seek an underlying cause. The role of allergy and frequent upper respiratory infections should be considered.

​Tips to prevent sinusitis

​As always, an ounce of prevention is worth a pound of cure. To avoid developing sinusitis during a cold or allergy attack, keep your sinuses clear by:

  • ​using an oral decongestant or a short course of nasal spray decongestant
  • gently blowing your nose, blocking one nostril while blowing through the other
  • drinking plenty of fluids to keep nasal discharge thin
  • avoiding air travel. If you must fly, use a nasal spray decongestant before take-off to prevent blockage of the sinuses allowing mucus to drain
  • If you have allergies, try to avoid contact with things that trigger attacks. If you cannot, use over-the-counter or prescription antihistamines and/or a prescription nasal spray to control allergy attacks

Allergy testing, followed by appropriate allergy treatments, may increase your tolerance of allergy-causing substances.