sinus specialist Archives - Page 2 of 2 - The New York Otolaryngology Group

The New York Otolaryngology Groupsinus specialist
Q & A
If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

I have constant nasal pressure, difficulty breathing through my nose and a bad odor

Question: Why do I have a constant pressure from top to bottom of my nose? Also difficulty breathing sometimes with mouth closed.  I also think that there is odor from my sinus. Is this one of the symptoms of chronic sinusitis?

Answer:

Thanks for your question.  While it is impossible to say for sure from your description, it is quite likely that you have a sinus infection.  Sinuses are spaces around the nose that make mucous and drain into the nose.  If the sinus openings get blocked, the mucous cannot drain and one tends to get a secondary bacterial infection.  This can feel like a pressure sensation.   The swelling of the lining of the nose makes it difficult to breathe freely through the nasal passageways.  Bacteria growing in the closed environment of the blocked sinuses can make pus which will have a bad odor.

These are 3 of the cardinal signs of a sinus infection.

This is the section from our website www.nysinuscenter.com that describes the symptoms of a chronic sinus infection:

Symptoms of Chronic Sinusitis

Sinusitis usually causes nasal stuffiness and a feeling of pressure or pain in the face and head. It often causes a thick discolored nasal discharge, cough, even severe asthma, loss of ability to taste and smell, pain in the upper teeth, bad breath, a generalized feeling of fatigue and feeling sick. If you are experiencing any or all of these symptoms, a doctor’s evaluation can help determine the underlying cause. Contact us today for an appointment.

I would suggest you have a medical evaluation by a sinus specialist either here at the sinus center or near you if you’re not in the NY area.

I hope this clears things up.

Robert Pincus MD

C0-Director NY Sinus Center

Q & A
If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

Will balloon sinuplasty help my runny nose and deviated septum?

Question: I was diagnosed with a chronic runny nose due to having a small nasal opening for drainage and a deviated septum. Am I a Balloon Sinuplasty candidate?

Answer:   

Balloon sinuplasty is a wonderful new technique for opening the sinuses.  Sinuses are small air filled pockets around the nose that drain into the nose.  If blocked, we can get recurrent infections of the sinuses.  Balloon sinuplasty is a non-surgical technique in which we find the opening of the sinus, thread a small catheter into the opening, and then briefly inflate the balloon- widening the drainage site.  We then remove the balloon.  The results have been excellent with this procedure.  There is no down time and sinuplasty is done in the office with just a local anesthetic.

You can read more about this on our web site- below

http://www.nysinuscenter.com/2011/01/balloon-sinuplasty/#more-535

Unfortunately, to date, we have not been using balloons to straighten a twisted (or deviated) septum.  The septum is the center wall of the nose, and while it is never straight, a significant bending or twisting can block up the nasal passages or even make one more susceptible to sinus infections.

If the sinuses are sinuses are blocked, then sinuplasty may have a role in your care.

If you’re in the NY area, we’d be happy to evaluate you and determine if you are a good balloon sinuplasty candidate, here at the NY Sinus Center.

I hope this clears things up.

Robert Pincus MD
Co-Director NY Sinus Center

Q & A
If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

I have severe sinus headaches and my doctor is considering balloon sinuplasty

Question: I have been dealing with terrible headaches for a long time. I went to the emergency room roughly 9 months ago with an excruciating headache.  They did a CT Scan and found that I had chronic sinusitis and a small retention cyst in my right maxillary.  I followed up with an ENT who is trying to treat it with nasal sprays.  Months later I felt some numbness above my left eye and had another CT scan which still proved chronic sinusitis but nothing wrong with the brain.  It is now August and my symptoms: daily headaches, pain between eyes and top of the head and temples, still are present. It is truthfully affecting my life and I can’t stand the pain.  My ENT mentioned a balloon sinuplasty but is now telling me it would have to be proven for me to have the procedure. Please help because this pain is awful.

Answer: Thank you for your question.

Headaches are always a difficult problem.  While sinusitis may be the cause of headaches, there are many other types of headaches that can be excruciating and difficult to manage as well.  It would be important to see what your sinus CT shows.  Should there be significant or persistent inflammation in your frontal sinuses (the sinuses in the forehead), then balloon sinuplasties may be helpful for you.  In balloon sinuplasty,  the doctor places a thin wire into the opening of the sinus- then inflates a balloon for about 10 seconds.  This results in a wider drainage site for the sinuses- and should alleviate frontal sinus infection.   It is done in the office, with local anesthetic- and there is virtually no downtime.  We do this frequently here at the NY Sinus Center and you can read more about it on our site, nysinuscenter.com

However, as you can well imagine- this will not likely help you if your headaches are from migraines, muscle tension, cluster headaches- or other causes.

Sinus headaches will often respond temporarily to a course of antibiotics and nasal or oral steroids.  Migraines may present with visual changes (aura) or respond temporarily to a medication such as sumatriptan taken at the onset of a headache.

We’d be happy to see you here at the NY Sinus Center and help clear things up.

Robert Pincus MD

Co-Director NY Sinus Center

Associate Professor Otolaryngology

Q & A
If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

I think my sinus infections stem from a problem with my immune system

Question:

I had sinus surgery 8 months ago. Since then I have been on 5 courses of steriods and 8 courses of antibiotics for the 8 sinus infections I have had post surgery. As soon as I get off an antibiotic, within a few days, I get another infection. I also have been doing a nasal mist with three antibiotics (bethmethasone, tobramycin and mupirocin). I have become totally unresponsive to antibiotics. I am desperate and starting to loss hope. I am interested in IGG because I believe the problem is my immune system. Do you know of an resources in the DC area that could help me with this?

Answer:

Thanks for your question. There is a small group of people who have recurrent respiratory infections, in spite of treatment, because of a weaknesss in their immune system.  This is not related to AIDS. Generally these people have a “partial immune deficiency”- that is their white blood cells do not fight certain bacteria well. This causes them to be more susceptible to infections. Infections caused by immune deficiency can be treated successfully by supplementing one’s own immune cells with immunoglobulins given intravenously.

The best way to see if that is your problem is to be tested for this. It certainly makes sense at this point to do so.  This type of evaluation is usually done by an immunologist. (a subspecialty within Allergy-Immunology) I would ask your doctor, or your own allergist if you have one, who is best for this –  Should that not be the case, immunoglobulins would not likely be of help.   I would look to  for other, untreated causes of your problems- either at the NY Sinus Center or nearer to home.

I hope this clears things up.

Robert Pincus MD

NY Sinus Center

Q & A
If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

Is Post Nasal Drip Curable?

Question: Is there a post nasal drip cure? Can you get antibiotics for it? Aside from sinus infections, what are the other causes for it?

Answer:

The short answer is yes, post nasal drip is curable once one finds the cause. Post nasal drip is one of the more common symptoms people complain about to their Ear Nose and Throat doctor. Much of the time doctors consider this a diagnosis. It is not a diagnosis, but a symptom with many causes. The actual post nasal drip cure starts with understanding the sinuses and the causes of post nasal drip.

We make mucous in the nose and sinus cavities, about a quart a day. It serves as a lubricant, think motor oil, that traps particles in the nose- dust, virus, contaminants, bacteria- and is swept back by cilia into the back of the nose and then down the throat into the stomach. The stomach acid then destroys or inactivates these contaminants. The mucous is usually a thin lubricating layer.

However, sometimes we make the wrong consistency of mucous- think thick old motor oil- and there are multiple causes that should be able to be diagnosed by your ENT or sinus doctor.

One of the more common causes of post nasal drip is gastric reflux. If acid comes up as high as the nose or throat, the membranes make extra mucous, trying to delicate nasal lining tissues from the acid. Patients often feel the need to clear the throat with this.

A sinus infection can cause post nasal drip. In this case the examiner can see pus coming out of the sinus openings, being swept down the throat.

Allergies can cause post nasal drip by making “the wrong kind of mucous”. Typically with allergic nasal conditions one may make excess watery- or at other times overly thick- mucous that one feels in the throat.

Mucous can become thick from drying and cause a post nasal drip. This can occur with dry air- such as heated air in cold weather or often from drying medication such as a diuretic (water pill).

Any individual can have one or more of these problems simultaneously. Appropriate treatment, when aimed at the cause or causes, should be able to help alleviate your post nasal drip.

Robert Pincus MD
NY Sinus Center

Q & A
If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

Health Benefits of Nasal Washes Are Limited

The Wall Street Journal looks at the value of nasal washing and the benefits daily use brings. While there are many different techniques, SaltAire is featured for its ease of use and effectiveness for airline passengers trying to fight off colds caused by germ-filled cabin air. Regular nasal washing can relieve congestion and other symptoms associated with chronic sinus problems and reduce the need for medication and natural brands (with only salt water), such as SaltAire are shown to be as effective as those with added active ingredients, such as xylitol.

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