What are sinus headaches?
Problems with the sinuses can cause a wide variety of head and face discomfort, but most of the time headaches related to sinus problems are a feeling of pressure or aching between and/or behind the eyes, in the temples, or in the face, cheek and teeth. Sinus problems can also cause ear pain and pressure. However, all headaches are not from sinusitis and migraine headaches in particular can sometimes closely mimic sinus headaches. Sinusitis can also trigger migraines in people with both problems.
Often careful examination can determine the true cause of headaches. Often careful examination combined with a CT scan is needed to accurately determine the cause of “sinus” headaches and plan effective treatment.
What is the difference between sinus infections and allergies?
Sinus infections and allergic sinus problems often overlap and are closely related. For this reason, it is often difficult to separate the two. Classic symptoms of allergy are seasonal episodes of clear drainage, nasal congestion, sneezing, and itching and watering eyes. These symptoms also occur when exposed to something you are allergic to, such as a dog or cat. Classic symptoms of infection are nasal congestion, yellow-green drainage, headache and face pain, tooth pain, eye pain and pressure, and mild fever. In many cases, these symptoms will follow a cold or flare in allergy symptoms.
The overlap between the two often comes up because people with allergies are more likely to have problems with infections. The allergies can cause blockage of the sinuses, inflammation and accumulation of fluid that forms a great “Petri dish” for germs to grow.
It is important to determine what each person suffers from because treatment can be very different. For example, in a patient with no allergy but with chronic infection allergy treatment will be of little to no benefit. On the other hand, for a patient with both allergy and infection treatment of the allergy can sometimes clear up the infections as well, or at least make them much less frequent.
What can be done for sinus infections?
As specialists in sinus disease, we evaluate each person we see with sinus problems and come up with a plan for making them better. The first treatment for almost everyone with sinus infections is antibiotics and other medicines designed to help with drainage. If these medicines do not work, or if the infections keep coming back over and over again, then surgery can be considered. We also consider surgery in very severe cases, such as where the infection has spread out of the sinuses and is out into the eye or up into the brain.
Modern sinus surgery is done using primarily minimally-invasive endoscopic techniques. With the patient asleep, a scope is passed into the nose so that we can see the problems and take care of them, usually without the need for breaking the nose or packing the nose as was done in the past.
Why do some people get more sinus infections than others?
Some people are uniquely susceptible to sinus infections. This can be because of problems with the drainage and ventilation of their sinuses, and surgery to relieve these blockages can be beneficial. In some people, the lining of the sinuses is simply more prone to infection. In others, blockages develop because of polyps, cysts or even tumors (although cancerous tumors are very rare). Some people have immune system weaknesses that make them more susceptible to all infections, including sinus infections.
Do I need to be in the hospital for sinus surgery?
Only in very rare and unusual cases does sinus surgery require hospitalization. Most sinus surgery can safely be done on a “day surgery” basis – in and out the same day. Hospitalization is usually reserved for patients who have not only chronic sinusitis but also other conditions such as severe asthma, heart problems or severe obstructive sleep apnea. Some of these patients are hospitalized in order to observe them closely after surgery to prevent problems with these other medical conditions.
How do you do sinus surgery?
Modern minimally-invasive sinus surgery as we carry it out is done through the nose. We use endoscopic telescopes to see and a variety of micro-instruments to remove and/or reshape tissue. Using this type of equipment the surgery can usually be very precise and limited to those areas causing infection, blockage or other problems.
Will I look different after sinus surgery?
Only if unusual problems occur will the shape of the nose or face change following surgery. In the past, significant temporary facial bruising was very common, but although this can occur it is now rare. Since most minimally-invasive sinus surgeries do not involve breaking the nose it is rare for the shape of the outside of the nose to change.
One desirable change that does occur in some cases is related to the problems caused by chronic infection. Chronic infection can cause swelling under the eyes and problems with excess tearing due to obstruction of tear ducts. Following successful surgery, these problems will often, though not always, disappear.
How do you decide who needs sinus surgery?
There are several reasons, often called “indications”, for performing sinus surgery. The most common reason is years of repeated infections or an infection that will not respond to medications such as repeated antibiotics. Another is blockage that cannot be treated successfully with medicine, such as large polyps or a deviated septum. Other more rare reasons for surgery include cancerous sinus polyps and infections that are so severe they have invaded the eye or brain and require emergency or near-emergency drainage.
Are sinus infections dangerous? How can they effect the rest of the body?
Sinus infections, though very bothersome to many people, are only rarely life-threatening. However, they can be dangerous under certain circumstances. In people with severe asthma and sinusitis, sinus infections can cause dangerous flare-ups of asthma that can require hospitalization. Also, infections in the sinuses can invade out into the eye or up into the brain causing blindness, brain abscess, or meningitis. This is fortunately very rare.
Can sinus polyps be cancerous?
Sinus polyps can be cancerous, but the benign form of sinus polyps is much more common. Sinus cancer is rare, and fortunately only very rarely a problem in the patient with polyps.