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Demystifying Sinusitis

This common, chronic condition is often misunderstood

FRIDAY, Feb. 13, 2004 (HealthDayNews) -- Sinusitis afflicts at least 37 million Americans -- and perhaps many more. Yet there are still plenty of myths and misconceptions surrounding the condition.

They include:

  • Sinusitis will go away on its own, without treatment.
  • People who are young and healthy can't get it.
  • Doctors have no new treatments for chronic sinusitis.

First, some background.

Sinusitis is characterized by inflammation of the sinuses that can be caused by a number of factors, from a cold to allergies to an infection. The inflammation shrinks the nasal passages so mucus can't drain properly, causing pain, discomfort and, potentially, infection.

Doctors divide sinusitis into three categories: acute, which lasts three weeks or less; chronic, which typically lasts from three to eight weeks but can continue for months, even years; and recurrent, which means the sufferer is hit with several acute attacks within a year.

Sinusitis has been on the rise in the last decade. While reasons for the increase aren't known, doctors suspect that more pollution and increased resistance to antibiotics may be to blame.

Now, some answers to those misconceptions.

Can sinusitis go away on its own, without treatment?

Sinusitis shares some symptoms of a common cold, such as stuffy nose, headache and cough. In fact, acute sinusitis can start with a common cold, as the inflammation shrinks the nasal passages. And while a cold and the subsequent inflammation will usually go away without treatment, that's often not the case with sinusitis, doctors say.

If symptoms of acute sinusitis last more than a week, see a physician. The condition can persist and lead to chronic sinusitis, doctors say.

"If it's something that's cropping up for weeks at a time... then you need to see a specialist," says Dr. Jordan S. Josephson, an ear, nose, throat and sinus specialist at Lenox Hill Hospital in New York City.

Adds Dr. Alexander C. Chester, a clinical professor of medicine at Georgetown University Medical Center: "A lot of times, it simply does not get better. It's just something you live with, if untreated."

Are people who are young and healthy immune to sinusitis?

No, sinusitis afflicts people of all ages. Though people often associate the condition with adults, kids can be particularly susceptible, in part because their sinuses aren't fully formed until age 12 and are narrower than an adult's.

While the National Institute of Allergy and Infectious Diseases estimates that 37 million Americans are infected with sinusitis each year, statistics on children aren't available. But it's important to look for symptoms to determine if a child has the condition.

These symptoms can include a frequent runny nose; thick yellow-green nasal drainage; pain near the cheeks or eye area; difficulty staying awake at school; a low-grade fever; post-nasal drip; a sore throat, cough or bad breath; nausea; headache; irritability or fatigue, doctors say.

Young children, with immature immune systems, are prone to infections of the nose, sinus and ears, especially in the first several years of life, says the American Academy of Otolaryngology -- Head and Neck Surgery. When a child remains ill beyond a week to 10 days, a serious sinus infection is likely, the academy says.

Other risk factors such as allergies, secondhand smoke, air pollution and exposure to bacteria can increase susceptibility to sinusitis.

Is it true that doctors have no new treatments for chronic sinusitis?

No. There are effective treatments, including some newer ones that can help.

Doctors can start by taking your medical history, examining your ears, nose and throat, and recommending medications. They include decongestants; oral antibiotics to control bacterial infection; pain relievers; steroid nasal sprays to reduce inflammation in the nose; and intranasal topical medication therapy -- including antibiotics -- delivered by a nasal nebulizer.

If the problem persists, an otorhinolaryngologist can do a more thorough check of the nasal passages. An endoscopy, which uses a slim tube with a camera at the end, gives a doctor a close look at the sinuses. This lets a doctor check for polyps, which can block the nasal passages, or physical abnormalities that make the passages too narrow for mucus to flow normally.

Both problems can be corrected by surgery that enlarges the sinuses, letting them drain properly. Newer techniques make it possible to do a sinusitis procedure as outpatient surgery, Josephson says.

The vast majority of people who have surgery for sinusitis have fewer symptoms and a better quality of life afterward, the National Institute of Allergy and Infectious Diseases says.

"The take-home message for people who are new sufferers is there's an answer," Josephson says. "It may not be a cure, but it'll make them feel better."

A sinusitis sufferer himself, Josephson adds, "I empathize [with patients] and I understand that I'm not cured, but a lot better than I used to be. I know what people are going through."

More information

For more on sinusitis, visit the National Institute of Allergy and Infectious Diseases or American Academy of Otolaryngology -- Head and Neck Surgery.

SOURCES: Jordan S. Josephson, M.D., ear, nose, throat and sinus specialist, Lenox Hill Hospital, New York City; Alexander C. Chester, M.D., clinical professor, medicine, Georgetown University Medical Center, Washington, D.C.
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