In most cases, sinus infection goes away on its own. However, if it lingers or keeps rearing its ugly head and you still keep overlooking it, a sinus infection can lead to potentially grave complications.

The possibility for serious health risks stems from the fact that your sinuses are too close to other parts of your body, especially your brain and eyes.

Here’s a list of some important complications that can arise as a result of an untreated sinus infection.

1. Reduced or Complete Loss of the Sense of Smell

Untreated sinus infection can diminish or completely deprive you of your sense of smell (called anosmia). This can be due to inflammation and blockage of your nasal passages, or damage to the olfactory nerve.

Though the loss of smell from a sinus infection is often transient, it can be permanent in severe cases, wreaking havoc on the quality of your life and overall wellbeing. 

2. Difficulty Breathing

Sinusitis causes nasal and sinus congestion, which can make it difficult for you to breathe through your nose. If the inflammation gets better and the blocked sinuses start to drain, the breathing will become easier.

Difficulty breathing from a long-standing sinus infection can also make you feel fatigued, as it interferes with the delivery of enough oxygen to your body.

3. Inflammation of your Voice Box, aka Larynx (Laryngitis)

Untreated sinusitis can cause the thickened mucus to continuously drip down the back of your throat, which, over time, can irritate your voice box and contribute to dry cough and hoarseness.

4. Dacryocystitis

It is an inflammation or infection of the tear sac usually due to blockage of your tear duct. Long-standing sinus infection can spread to your eyes, including your tear sac — a tiny chamber draining your tears, located in the inner corner of your eye. Tears drain through this sac as they exit the surface of your eyes.

Dacryocystitis causes tearing, along with pain, redness, and swelling in the inner corner of the affected eye and warrants antibiotic treatment.

5. Orbital cellulitis/abscess

Another rare but serious complication of an untreated sinus infection is an inflammation or infection of the eye socket (aka orbit) — a condition called orbital cellulitis. This sight-and-life-threatening condition may arise because of the direct spread of infection from your sinuses via their thin walls, or as a repercussion of dacryocystitis.

Infection of the ethmoid sinuses — that lie between your nose and eyes — is more likely to spread to your eye socket because of their thin walls.

While this condition typically affects kids and young adults, a delay in diagnosis and treatment is a threat to both vision and life in all age groups. Untreated orbital infection can spread to the protective coverings around your brain and spinal cord as well as past your brain.

Orbital cellulitis causes fever, along with extreme pain, swelling, redness, and bulging of your eyelid, and possibly eyebrow and cheek. It may also lead to the formation of pus inside the eye socket.

Orbital cellulitis requires prompt hospitalization and may even necessitate surgery if the response to appropriate antibiotics has been poor within 24-48 hours.

6. Cavernous sinus thrombosis

When the sinus infection spreads to your brain, your body’s defense mechanisms create a clot in an attempt to contain the infection.

Though a very rare complication of chronic sinusitis, cavernous sinus thrombosis is a threat to life when it does emerge. It is a condition in which a blood clot forms inside the cavernous sinus — a hollow space at the base of the brain that functions to drain blood from your brain and face.

Cavernous sinus thrombosis presents with:

•   a sharp, severe headache that worsens progressively, and often occurs with tearing
•   facial pain, more localized around your eyes
•   high-grade fever
•   double vision
•   paralysis of eye muscles, resulting in an inability to move your eyes or causing your eyelids to droop
•   a bulging and swollen eyelid
•   loss of vision
•   seizures and death (in severe cases)

The cornerstone of treatment for cavernous sinus thrombosis is early and aggressive antibiotic therapy.

7. Meningitis

Left untreated, a sinus infection has the potential to spread to your meninges (the protective coverings around your brain and spinal cord), causing them to become inflamed — a condition called meningitis.

Meningitis gives rise to the following signs and symptoms:

•   Sudden, high-grade fever
•   Neck stiffness
•   Extremely severe headache, often accompanied by nausea and vomiting
•   Unusual sensitivity to bright light
•   Drowsiness and lethargy
•   Seizures

The condition requires intervention by a neurologist and is diagnosed by its clinical signs and symptoms. Meningitis is confirmed by withdrawing the clear fluid that bathes your brain and spinal cord — a procedure called lumbar puncture, in addition to imaging modalities, such as CT and MRI scans.

While the early institution of antibiotic therapy can help address the problem, sinusitis complicated by meningitis may still pose a serious threat.

8. Subdural Abscess

A chronic sinus infection can often lead to the collection of pus (aka abscess) in a potential space between the outer and middle layers of your meninges (the subdural space), defining a condition known as the subdural abscess.

Subdural abscess gives rise to signs and symptoms that resemble meningitis, along with changes in mental status, such as confusion and irritability. The condition progresses rapidly and calls for prompt diagnosis, treatment, and often surgical drainage to stave off coma and death from the rapidly rising pressure within your brain.

9. Frontal bone osteomyelitis

The frontal bone is a bone of your skull that occupies the forehead region. Osteomyelitis is an infection of a bone. Frontal bone osteomyelitis (aka Pott’s puffy tumor) is a potential local complication of a sinus infection of the paired frontal sinuses, located in the frontal bones above your eyebrows.

When infection from your frontal sinuses extend to the bones in which they lie, signs and symptoms that mimic meningitis arise. However, it’s imperative to distinguish between the two conditions, as lumbar puncture cannot be done with frontal bone infection due to the growing pressure within your brain.

Thanks to the antibiotic era, owing to which we rarely see cases of frontal bone osteomyelitis today. The key is timely diagnosis and treatment.

10. Brain abscess

A brain abscess is a localized collection of pus within your brain substance. It occurs because of the direct spread of infection from your paranasal sinuses.

As is obvious, brain abscess is a potentially lethal condition that can lead to coma and death if not addressed right away.

Seek Consultation

Untreated sinus infection can take a heavy toll on your wellbeing. The good news is that with advancements in medical and surgical treatments today, almost all complications of sinusitis are preventable.

Hence, our experts at the Ear, Nose, Throat & Allergy Specialist, recommend seeking treatment if you have symptoms of sinusitis lasting longer than ten days, or symptoms that keep coming back. These symptoms include fever, runny or blocked nose, congestion, facial pain, and tenderness.

A plethora of medical and lifestyle options are available to help address a sinus infection. Moreover, if conventional measures don’t help, our experts at the ENT & Allergy Specialist are also adept at performing a cutting-edge procedure to widen blocked sinuses, known as balloon sinuplasty.  

Balloon Sinuplasty

The steps of this procedure are as follows:

•   You’ll be given medicine to relax.
•   We first insert a thin, flexible tube known as an endoscope into your nose. This tube has a camera and light on its end, which is used to visualize the sinus cavity.
•   Another small tube termed as a catheter with a balloon at its end is next advanced over the guiding endoscope.
•   Our specialists then open up the inflamed sinuses by inflating the balloon.
•   The balloon is finally deflated and taken out.  

The success rates of a balloon sinuplasty are well over 90%. Most patients report a long-term, significant improvement in their sinus symptoms.

Balloon sinuplasty is minimally invasive (doesn’t involve any cutting) and doesn’t require placing a packing inside after the surgery. Thus, the recovery from the procedure is also relatively easy and quick.

Balloon sinuplasty has minimal to no risks, and in the majority of cases, this procedure helps you get off all your anti-allergy and steroid medicines as well as antibiotics that you might be taking for very long.

If you’re experiencing a sinusitis flare-up or are having symptoms of a chronic sinus infection, get one-on-one consultation by booking an appointment with one of our experts at the Ear, Nose, Throat & Allergy Specialist.

Sinus infection is a common problem that can affect any age group. It represents the fifth most common condition that requires an antibiotic prescription.

Sinuses are four paired air-filled spaces in your skull and face bones surrounding your nose. Their main function is to produce mucus that forms a layer inside the sinuses to humidify inhaled air and keep the interior of your nose moisturized. This mucus layer can trap dust particles, other pollutants, or bad germs and brush them out through your nose. Each sinus drains into your nose through small openings to keep these passages clear of excess mucus and the trapped particles.

However, sometimes, such as when the weather changes and you catch a cold, it can turn into a sinus infection. This causes inflammation of your sinuses, known as sinusitis. Usually, sinusitis should go away in a few days or a week. But sometimes that sinus infection can stick around for a long time.

What is Chronic Sinus Infection?

Chronic sinusitis is a long-standing inflammation of your sinuses that lasts for 12 weeks or longer at a time. Sinusitis is also known as rhinosinusitis (rhino means nose). So, we use the two terms interchangeably. When inflamed, nasal passages and sinuses become swollen and blocked. Chronic sinusitis interferes with the normal drainage of the mucus. Too much mucus builds up in your nose and sinuses, making them stuffy.

What Causes Chronic Sinus Infection?

Multiple factors acting together usually contribute to chronic sinusitis.

People with allergies are more prone to develop chronic sinusitis. About one in five people with chronic sinusitis also have asthma. This is because the linings of your nose and sinuses are in continuation with the linings of your lungs. These people are also likely to have nasal polyps (benign growths in your nose containing mucus).

A bacterial or viral infection can also trigger the condition. The infection is often low grade. The bacteria confine themselves in stubborn “biofilms,” making it difficult for your immune system or antibiotics to find and attack them.

An overlap of additional factors such as smoking, environmental pollutants, and deviated septum, further complicate the picture of chronic sinusitis.

It would be more appropriate to say that if you’re already prone to allergies and nasal polyps, it becomes easier for harmful bugs, especially fungi (molds) to penetrate your sinuses. Likewise, a weak immune system makes you more susceptible to catch bacterial, viral, or fungal sinus infection.

A sinus that is inflamed and swollen can no longer sweep away the excess mucus and harmful agents due to the blockage of tiny hairs that facilitate this function.

What are the Signs and Symptoms of Chronic Sinus Infection?

Chronic sinusitis emerges more insidiously than acute sinusitis. At times, however, the symptoms start suddenly and may resemble that of the common cold or acute sinusitis that just won’t go away.

Chronic sinusitis is most likely if you have two or more of the following symptoms:

• Nasal congestion or stuffy nose
• Mucus and pus-like discharge (yellow fluid draining out of your nose)
• Postnasal drip (mucus dripping at the back of your throat)
• Facial pain, pressure around your eyes and nose, or fullness
• Partial or complete loss of your sense of smell

Chronic cough, sore throat, and fatigue may also be seen in a chronic sinus infection. That said, these symptoms are not required for the diagnosis of chronic rhinosinusitis.

How do you Diagnose Chronic Sinusitis?

The presence of two or more of the listed symptoms for at least three months raises the suspicion of a chronic sinus infection.

In such cases, we will evaluate you to confirm the diagnosis. This involves applying pressure on your sinuses to elicit tenderness. If the tenderness is positive, your sinuses are likely to be inflamed. We will then take a peek into your nose using a small flexible scope, and check for nasal polyps, pus-filled discharge, and deviated septum.

We may also recommend nasal endoscopy. This is an office procedure that enables us to view the interior of your nose and sinus passages. It’s done with an instrument called an endoscope, which is a thin, flexible tube with a tiny camera and a light. We will pass this scope into your nose and sinuses to look inside. Nasal endoscopy allows us to detect any swelling and polyps, as well as collect discharge from the infected area. This can help spot the cause of your infection and what’s the best way to treat it.

If need be, we may also perform imaging in the form of a computed tomography (CT) to look for further problems.

Allergy skin tests look for allergic causes and to check for problems within your immune system may also be done.

What is the Treatment for Chronic Sinus Infection?

When it comes to treating chronic sinusitis, there’s no one-size-fits-all solution. While several treatment options are available, what works for one person may not be appropriate for the other. Hence, we tailor the treatment to each individual’s’ needs, symptoms, and whether or not other conditions (such as allergies or asthma) are also at play.

The goals of treating chronic sinusitis are to address the allergic causes, minimize inflammation, promote free sinus drainage, and eradicate the infection (if there’s any).

Here are a few potential treatment options for chronic sinusitis. We will likely try out a combination of two or more of these options to see what works best for you.

Medical treatment

Saline Nasal Washes

Irrigating your nasal passages with salt water (saline) adds moisture to dry secretions, helps thin the trapped mucus, curbs postnasal drip, and thereby flush out mucus and allergens. It also helps control inflammation.

Glucocorticoid (aka steroid) nasal sprays, washes, and drops

Steroids are highly effective at limiting inflammation. They reduce mucus production and help shrink any polyps. When you use glucocorticoids in the form of nasal sprays or drops, the medicine works right where it is needed.

Nasal steroid sprays do not travel higher up into your sinuses. Instead, they stay and work inside your nose to limit swelling, thus easing sinus drainage into your nasal passages.

If the nasal spray doesn’t work well, we may suggest you adding a nasal steroid solution to the saline nasal wash. This mixture of saline nasal wash and steroid solution pushes the steroid solution higher up into your sinuses to relieve inflammation and ease sinus drainage.

Glucocorticoid pills

Sometimes, we may recommend taking glucocorticoids (steroids) by mouth (orally). These medications, unlike sprays and rinses, reach your circulation and can effectively address inflammation. Despite the dramatic improvement in symptoms with oral steroids, we only prescribe them when it’s necessary. This is because taking steroids by mouth carries some risks, such as suppressing your natural immune system.

Antibiotics

Chronic rhinosinusitis is usually caused by inflammation rather than infection. Bacterial infections may still contribute to sinusitis in some cases. Therefore, some people need to take antibiotics. An adequate antibiotic trial in chronic sinus infection entails a minimum of 3-4 weeks of treatment, preferably culture-guided.

Leukotriene modifiers

We may occasionally prescribe a group of medications called leukotriene modifiers to reduce symptoms of chronic sinusitis. These medications include montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo). They also work by curtailing inflammation but in a different way than steroids.

Immunotherapy shots

If we suspect allergies to be a trigger for your sinusitis, an allergist will also be involved in your treatment strategy. In such cases, we give allergy shots (immunotherapy) that help suppress your body’s immune response to specific allergens (triggers).

Surgical Treatment for Chronic Sinusitis

Although medical therapy and lifestyle tweaks are the first-line treatment for chronic rhinosinusitis, some people may fail to respond to optimal therapy. In such cases, Ear, Nose Throat and Allergy Specialist performs a surgery to widen up the blocked sinuses and remove any trapped mucus or polyps.

Other situations in which surgery could be considered include:

• When chronic sinusitis symptoms do not respond to the medical treatments listed above, and CT scan of your sinuses reveals complete blockage of one or more sinuses.
• When nasal polyps fail to shrink enough with steroids.
• When a severe deviation of the septum completely blocks your nose or hinders sinus drainage.
• When there’s a suspicion of allergic fungal sinusitis. The sinuses in allergic fungal sinusitis get clogged with thick, dense mucus that is hard to remove in any way other than surgery.

Balloon Sinuplasty

Our surgeons prefer balloon sinuplasty instead of the traditional endoscopic surgery due to its safety profile, less invasive nature, and faster recovery. However, not all patients are good candidates for balloon sinuplasty. This type of surgery is not a suitable option in patients with nasal polyps or those with severe damage to their sinus openings.

A balloon sinuplasty is an in-office procedure that uses a thin, small, flexible catheter (tube) with an inflatable balloon at its end to reopen blocked sinuses. After passing a balloon catheter, we will slowly inflate it to widen out the sinus opening. We will then wash out all the mucus and pus from your sinus cavity with a saline solution. The balloon is then deflated and removed. This helps reform and widen out the sinuses while maintaining the natural structure of the sinus lining.

It works the same way as balloon angioplasty, in which heart surgeons open up blocked blood vessels.

Most patients can resume their regular activities within a day or two after balloon sinuplasty.

Are you located in the North Georgia area and have a sinus infection that just won’t go away? Contact our office today to schedule an appointment.

It is back to school time again. That wonderful time of year that our kids start sharing germs that lead to illness. One of the most common complaints of school-age kids is a sore throat or tonsillitis. Tonsillitis can be caused by several things including postnasal drainage, allergic rhinitis, and viral or bacterial infections.

ENT evaluation is recommended if episodes of tonsillitis become recurrent. If your child begins to snore or have difficulty sleeping ENT evaluation is also important. Recurrent tonsillitis (6+ times per year) or obstructive sleep apnea combined with enlarged tonsils warrant a discussion about tonsillectomy.

A tonsillectomy is a surgical procedure to remove the tonsils. This procedure will likely improve sleep quality and eliminate the recurrence of strep throat. The recovery time for tonsillectomy varies from 10-14 days.

– Crystal Rice, MSN, FNP-C