Nov. 6, 2019

This paid piece is sponsored by Sanford Health.

Whether it’s fatigue during the day, interruptions during sleep or aching pressure and swelling, a sinus infection can make life miserable. But what is a sinus infection, and when should you seek help?

Dr. Sean Johnson, an ear, nose and throat, or ENT, surgeon at Sanford Health, explains what is going on in the body to cause a sinus infection and when you should see a specialist. 

How sinusitis works

“The sinuses are hollow cavities filled with air located on either side of your nose. They have small openings, which connect with your nasal passage,” Johnson said. “Their primary purpose is to make mucus, which with your nose, helps humidify and adjust the temperature of the air you breathe.”

During a sinus infection, or sinusitis, the tissue in your nose and sinuses becomes inflamed and swollen, he added.

“This swelling can block the sinus openings, causing mucus to get trapped and build up.”

For most people, symptoms are the worst part of a sinus infection, which can have a huge impact on quality of life. Common symptoms include thick nasal drainage, reduced sense of smell, nasal congestion, facial pressure, facial pain and dental pain.

Many symptoms that occur are not because of the infection but rather related to the immune system fighting off and removing the infection. This battle within your body is what leaves you congested, often unable to smell and feeling tired, groggy and in pain.

When to see a doctor

A sinus infection is typically caused by a virus, such as the common cold, but it can turn into a bacterial infection. Bacterial sinus infections frequently start out as viral infections; however, with a bacterial infection, the symptoms may not improve or may get worse after 10 days. In this case, your primary care physician may recommend starting an antibiotic.

“Because many sinus infections are viral, antibiotics can be ineffective,” Johnson said. “Symptoms usually get better on their own after seven to 10 days. Many over-the-counter medications, such as nasal saline (saltwater) sprays, nasal steroid sprays and decongestants, can be effective at reducing symptoms of viral sinus infections.”

Some patients, however, have complications of sinusitis, have symptoms that never seem to go away after several weeks despite multiple courses of medications or even experience multiple infections a year.

“These patients could benefit from an evaluation by an ENT surgeon,” Johnson said.

What a specialist offers

ENT surgeons provide care for difficult cases of sinusitis where conventional methods have failed. An evaluation is done to identify the underlying problem and tackle it. Medication and other options are always first before resorting to surgery. During the initial evaluation, the ENT may use:

• Nasal endoscopy. Placing a small camera into the nose allows the ENT to see if there is a structural reason for the symptoms. For those who have had sinus surgery, it is sometimes possible to see into the sinuses themselves.
• Computed tomography, or CT, scan. This special type of X-ray imaging technique helps the doctor see into the sinuses, even in patients who have not had surgery.

“There are two main surgical options,” Johnson said. “Functional endoscopic sinus surgery, or FESS, uses tiny cameras and instruments in the nose. A more recent addition to the sinus surgery world is balloon sinuplasty. A balloon is inflated within a blocked sinus opening. This technique may be done alone or in conjunction with FESS.”

Because of advancements in health care and technology, nasal surgery is more convenient than ever. Sinus surgery is generally a same-day procedure where you can go home after recovering from the anesthesia. Plus, you often are able to return to a normal routine within a few days. Furthermore, because surgery is done through the nostrils, there typically is no outward sign of surgery.

Sanford Health ENT specialists care for a variety of conditions affecting hearing, sleep, speech and more, including:

• Cleft lip and palate
• Head and neck cancer
• Hearing and balance concerns
• Hearing aids and fittings
• Hemangiomas/birthmarks
• Pediatrics: ear tubes/tonsils and adenoids problems
• Sinus and allergy problems
• Sleep problems and snoring
• Voice and speech concerns