Sinusitis

When your sinuses aren’t working properly, you feel miserable. You can’t breathe clearly or enjoy the foods you typically crave. Motivation declines at work and during exercise. And throbbing sinus pain can consume you.

At Beaumont Health, compassion and dedication to clinical excellence guide our approach to sinus care. We help you manage your condition and get you back to your life quickly and free of pain and discomfort. Your care team will be led by specialists in otolaryngology, also known as ENT (ear, nose and throat) services, and experts across specialties like pulmonary medicine and radiology. Your team partners with you, the patient, to respond to your condition with a care plan that reflects your individual needs.

What is sinusitis?

Your face contains hollow spaces around your nose called sinuses. The sinuses all connect to the nose through narrow passages. These passages allow the sinuses to ventilate and drain properly. You have four pairs of sinuses. They are located at the bottom of your forehead (frontal sinuses), between your eyes (ethmoid sinuses), behind your nose (sphenoid sinuses) and by your cheekbones (maxillary sinuses). Sinus inflammation or an infection caused by viruses or bacteria is called sinusitis. This condition causes the passages to your sinuses to swell, making it difficult for air and mucus to pass through. The sinuses can fill with mucus, which becomes a breeding ground for bacteria.

There are four types of sinusitis. The kind you have depends on how long your symptoms last.

• Acute – symptoms last up to four weeks.
• Subacute – symptoms last four to 12 weeks.
• Chronic– symptoms last more than 12 weeks.
• Recurrent – you experience symptoms episodically throughout a year.

Causes

Sinusitis often results from a viral infection or sometimes just a cold. You have a greater chance of developing sinusitis if you:

• Are exposed to areas high in germs, like daycare.
• Experience changes in altitude, like on an airplane flight or during scuba diving.
• Have abnormal sinus structures, like a deviated nasal septum.
• Have an illness that affects your breathing, like cystic fibrosis.
• Have an immune system weakened from HIV or chemotherapy.
• Have seasonal allergies like allergic rhinitis or hay fever, caused by irritation to pollen and dust.
• Smoke cigarettes or are exposed to secondhand smoke.

What are the symptoms of sinusitis?

Many have a hard time recognizing a sinus infection versus a cold. However, if your symptoms persist for several days or improve and then reappear, you likely have a sinus infection.

Sinusitis symptoms affect your daily life, much like a cold. Clogged sinuses impact your breathing, and constant pain from your sinuses can make even the smallest tasks seem impossible. For example, children who develop sinusitis are often considered picky eaters, but actually, they are struggling to eat and breathe through their mouths at the same time. Just like during a cold, daily activities like exercising and sleep can feel labored.

Reach out to your family physician if you experience any of the following symptoms for several days or if your symptoms have returned after clearing up:

• Bad breath
• Cough, especially for children.
• Difficulty breathing or shortness of breath.
• Difficulty with smell
• Fever that lasts more than three days.
• Green or yellow mucus drainage from your nose.
• Nasal congestion or stuffy nose.
• Postnasal drip, where overproduced mucus runs down your throat.
• Sinus headache
• Sinus pain or pressure, like a toothache.
• Swelling around the eyes.
• Uncomfortable sinus pressure.

Diagnosis of Sinusitis

We usually diagnose sinusitis based on symptoms alone. However, if you’re concerned about your symptoms, and they have lasted several days or improved and then worsened, you may want to make an appointment with your family physician. Your physician will review your medical history and ask how often you feel sinus pain, how long your episodes last and what you are doing at home to treat your symptoms. They may recommend you see an ENT specialist who treats sinusitis.

During a physical examination, your ENT will inspect your ears, nose and mouth. Often, they can conduct a nasal endoscopy right there in the office. In this simple procedure, they use a thin, flexible tube attached to a camera (endoscope) to inspect the inside of your nose. Using images from the camera, your doctor will search for nasal polyps (growths), structural abnormalities and signs of infection like pus, swelling or redness.

Other forms of testing include:

• Allergy testing, like skin prick exam.
• Bloodwork
• Ciliary function test, inspecting cilia (hair-like structures in your respiratory system) using a microscope.
• Nasal culture (cytology), studying results from a nasal swab.

Imaging Tests

In some cases, your ENT specialist may recommend you undergo an imaging exam. This noninvasive screening scans your body and translates the findings into images. These images help us identify polyps and structural abnormalities that would keep your body from draining fluid properly. They also show where fluid is being retained and which areas of your face are most affected by inflammation.

Computerized tomography (CT) scans are the most common imaging tests. In this procedure, you lie on a moving exam table that glides into a cylinder-shaped imaging machine. The equipment rotates around you, using radiation to X-ray your body. A CT scan, typically only used on adults, most clearly shows the bony structures around your sinuses.

Like fingerprints, the shape of your sinuses and how they connect to your nose are unique to you. Imaging allows us to become experts in your sinuses. That way, if you need surgery after trying all other medical efforts, we are ready to help.

Treatment of Sinusitis

Nonsurgical treatment

You can care for mild cases of sinusitis without having to see your family physician. Drinking fluids and resting help your body hydrate and recharge, and over-the-counter nasal decongestants contain medication in aerosol form that often clear sinuses within a few days.

If your condition worsens or does not improve, your family physician may prescribe antibiotics. Your physician will monitor your care and may refer you to an ENT specialist for more specialized care.

Because there is no “one right answer” for care, your team will design a care plan that addresses your specific needs. We consider factors like your age, other chronic conditions and the kinds of treatments you have already tried.

Surgery

At Beaumont, we do our best to clear your sinusitis with noninvasive techniques that cause little discomfort. But if those do not work, you may need to consider surgical therapy. Surgical therapy improves the opening between the nose and sinuses, which allows relief of sinus pressure, improved sinus drainage, and better access of medications to the sinuses.

Doctors review high resolution CT scan images to see your unique facial structure and functions. This technology allows us to pinpoint the affected area and treat your airways more precisely than ever before. If the images indicate that the sinuses are blocked, your ENT specialist may recommend expanding the passageway between your nose and your sinuses. There are different ways this can be done. For example, endoscopic sinus surgery can remove tissue blocking your sinuses. Or, balloon sinuplasty can allow for better airflow by expanding a tiny balloon in your sinus passages.

During any sinus procedure, Beaumont ENT specialists use the most up to date endoscopy equipment, utilizing 4K technology for viewing the sinus passageways. Image guidance permits the ENT specialist to very precisely target the areas that require opening.

At Beaumont, your comfort and safety is important during any procedure. So, we continually research the most effective ways to perform surgery with low or no opioid drugs. And when needed, our highly trained anesthesia specialists play an essential role in your care team.