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.

Peppermint tea causes me to have a sinus headache after sinus surgery

Question: I had several procedures done with sinus surgery (turbinoplasty, FESS) 4 weeks ago. I followed a doctor’s instructions as far as diet, and activity during the recovery period. It all went very well, minimal pain, until this week when I started drinking peppermint tea daily. I didn’t make any connection between the two, but my sinuses start hurting right after the tea. As a matter of fact, one day I had two cups of the tea and the pain was really bad. Can you get a sinus headache from peppermint tea? I thought peppermint was good to treat sinus problems. Thank you.

Answer: This really is rather interesting. We have found and reported in the medical literature that acid reflux (either known or “silent”) is a frequent cause of chronic sinusitis. In our study, eight of eleven patients with sinusitis who failed regular medical care, had significant reflux of stomach acid as high as the sinuses. Patients were studied over a 24 hour period with pH (acid monitors) in the back of the nose. In these patients, reflux was the likely cause of their recurrent infections. Most had no or few other symptoms of reflux and found that their sinus problems improved or resolved when their reflux was treated (diet -with or without medications). Surgery can often be avoided with such treatment.

One of the more common agents worsening reflux is peppermint. So yes, you can get a sinus headache from peppermint tea. Please see the page below for some more information

http://www.nysinuscenter.com/treatment/

While there may be some other, unexplained etiology, acid reflux is by far the most likely cause of these symptoms- and may have been part of the cause of your sinus problems that necessitated surgery.

I would ask your surgeon to evaluate whether you do in fact have reflux which may be worsening your symptoms. If so, treatment will likely lead to a better long-term outcome from your surgery.

Clinical evaluation may be enough, but at times we do 24 hour pH testing in the nasopharynx. This accurately measures whether acid is in fact coming up to your sinuses, when it happens and what exacerbates the problem.

We would be happy to evaluate you here at the sinus center if you are in the NY area.

I hope this clears things up.

Robert Pincus MD

Co-Director NY Sinus Center

Associate Professor Otolaryngology

Q & A

My 15 year old has 6-8 colds a year. Could she have sinusitis?

Question: My teenage daughter (15) has been challenged with recurrent colds since she was at least 3 years old. At this time she still gets 6-8 colds a year, very heavy, sometimes turning into a sinus infection. Enlarged adenoids were removed in 2012 with no improvement. No OTC meds (pain or cold) have any impact, even prescription strength pain meds offer no relief. Excessive absences from school – feels too ill to go. Very heavy mucous production. CT scan in 2011 shows focus of mucosal thickening in the right maxillary sinus. Undulation of the nasal septum. No one has suggested chronic sinusitis. Are there cases of chronic sinusitis in teenagers? Our school is looking for a medical condition for the cause of her recurrent colds and seemingly continuos sinus infection. I’m looking to improve my daughter’s health.

Answer: Thank you for your question. One would not expect a healthy 15 year old to still get 6-8 colds a year. Chronic sinusitis in teenagers is rare. While upper respiratory tract infections are quite common in children, they tend to get less frequent as they enter the teen years. If she has continous sinus infections, I would suggest looking into other factors that could be causing these .

Among the possibilities (not all mutually exclusive) are: sinus infections or a chronic low grade infection with exacerbations, allergies, or least likely a partial weakness in her immune system.

Sinusitis can certainly cause her recurrent infections. Her CT scan sounds like it showed a sinus infection. The most common cause of recurrent sinus infections in children is chronic infections in the adenoids- and this seems like it was addressed. Sometimes, though, adenoids can regrow and get re-infected. I would ask your pediatrician to have her get an ENT evaluation.

She could also have allergies- either causing what seems like recurrent colds- or as a factor causing recurrent sinusitis.

Less likely is a selective immune deficiency. Some children may have a weakness in their ability to fight off colds because they have a diminished antibody response to certain viruses. This is not in any way related to AIDs- but can cause a child to have an increased number of these URIs.

If you are in the NY area- we would be happy to see your daughter here at the NY Sinus Center…

I hope this helps clears things up

Robert Pincus MD

Co-Director NY Sinus Center

Q & A

I have a deviated septum and a crooked nose. My surgery did not help. Is it safe to perform surgery again?

Question: I have deviated nasal septum besides a crooked nose with a minor sinus infection and had septoplasty to correct it. Nothing changed after I had treatment for a crooked nose, and sinus infection got worse from then. Will a septorhinoplasty help solve my problem? Is it safe to perform surgery again?

Answer:

Thanks for your question.

First of all, while revision surgery is quite common and may solve your problem, one should try to find out why the surgery didn’t help in the first place before having another procedure.

The septum is a dividing wall that separates the nasal airway into to separate passageways. While the septum is never completely straight, the septum can be “deviated” or twisted enough to block the flow of air through one – (if the septum is over to one side)- or through both passages (if the septum has a shape like the letter S). Straightening the septum should be expected to improve breathing through the nose, but sinus infections usually will need to be further treated – either through opening the sinuses wider, or finding out the cause of the infections and treating them medically. Fixing a crooked nose requires breaking the bones of the nose- or rhinoplasty- and is a cosmetic procedure to improve the appearance of the nose. This can be done at the time of septoplasty and/or sinus surgery- or sometimes alone. I am not sure what problems you were having before and are continuing to have.

But, we frequently are called on to treat patients who have had nasal or sinus surgery before that did not fix their problem. Usually, that is because the problem causing the symptoms was not accurately identified, and less common because the surgical results were not as successful as we’d like.

Before I would say to have the procedure repeated, I would suggest having another opinion- certainly something we do a lot of here at the NY Sinus Center.

If revision sinus or rhinoplastic surgery is needed, we have significant experience in helping.

Robert Pincus MD
Co-Director NY Sinus Center
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Q & A

Pain while swallowing and turning my head after dental infection

Question: I have pain while swallowing and turning my head, what could it be? I had an abscessed wisdom tooth that caused my lymph nodes to swell and cause dysphagia several times within the last year and a half; it has always gone completely away leaving me asymptomatic. Feb of 2013 I became ill and the dysphagia began again. I was given antibiotics for suspected strep throat and pharyngitis. 2 weeks later I had my wisdom teeth extracted and developed necrosis of the bone and was subsequently put on a total of 5 weeks of antibiotics. The pain while swollowing has not gone away as of today. I have had a Laryngoscopy, Esophogram, Endoscopy, CT of the neck checking for an abscess and was diagnosed with a hetial hernia, gastritis and dyskinesia of the esophagus. My Gastroenterologist and PCP both have urged me to get a second opinion with another ENT saying the dysphagia is a separate problem. I was also sent for a Esophageal Motility Study that I was not able to tolerate. I was not able to swallow any saline without vomitting. What could be wrong for so long? I am very desperate, any info would be greatly appreciated. Thank you

Answer: Dental infections may often lead to infections elsewhere in the head and neck. Dental infections in the upper jaw (maxilla) may cause sinus infections, head and neck abscesses (pus pockets) and rarely even brain abscesses. Infections of the lower teeth can spread to the floor of the mouth- causing a potentially dangerous infection known as Ludwig’s Angina, or swollen infected lymph nodes or even potentially life threatening abscesses in the neck.

While I cannot say for sure, it seems likely that the infection of the lymph nodes you developed has resolved- or at least to your doctors’ best ability to determine. A CT scan with contrast should be able to detect any persistent infected lymph node.

The other findings that you have- a hiatal hernia with reflux, gastritis and finally dysknesia (incoordination) of your esophagus all are causes of dysphagia (difficulty swallowing). Pain while swallowing and turning the head is not uncommon when acid reflux from the stomach comes up as high as the throat- and may well be the cause of your symptoms. This can be usually be found on an ENT exam, or by testing to see if acid from the stomach does in fact come up to the throat (pH testing).

I wish I could tell you more precisely, but if you’re in the NY area, would be happy to see you here and try to better clear things up. If you make an appointment, please try to bring the results of the studies done so far and any scans.

Robert Pincus MD
Associate Professor Otolaryngology
NY Otolaryngology Group

Our office number is 212-889-8575- or you can email for an appointment request

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Q & A

Question: I have a strep infection and when I blow my nose, mucus comes out of my eyes.

Question:
I have cultured positive for strep in throat. The next day, my sinuses became inflamed and when I blew my nose, I had snot coming out of eyes and it also burned my eyes. Is this normal?

Answer:
While this is not what one would consider “normal”, it certainly can happen with a sinus infection (sinusitis).

Strep can not only cause a throat infection, but is a common bacteria causing sinusitis. When you get a sinus infection it is because the lining of the nose gets so swollen that the sinuses can’t drain. Typically the musus from sinusitis drains through the nose.

However, there are other “tubes” that drain into the nose, which can also get blocked in the same way. The eustachian tube drains the middle ear fluid into the back of the nose. If this gets blocked from swelling or congestion in the nose, fluid builds up in the space behind the ear drum and you can get a middle ear infection. (acute otitis media) This is quite common in children, because their eustachian tubes are shorter, more horizontal and often also blocked partially by adenoids (lymph tissue in the back of the nose). Adults can get this, of course, also.

The tear ducts are another set of tubes that drain into the nose. If they get blocked, we often tend to feel that we are making excess tears- as our normal tears can’t drain. If you blow your nose and the nose is congested- or hold the nose too tightly when you blow- mucus from the nose can go the other way- through the tear ducts and around the eye. This is likely what is going on in your case. Be careful not to blow the nose too forcefully while your nose is congested as the mucus from sinusitis can cause you to get conjunctivitis (pink eye).

I hope this clears things up.

Robert L Pincus MD

Co-Director NY Sinus Center

Q & A

How To Treat Puffy Eyes From Sinusitis

Congestion, a sore throat and a headache might plague you when you’re fighting a sinus infection. But your appearance can reveal your health problems, too. Puffy, swollen eyes can accompany sinusitis – and when you’re trying to fight the impression that you’ve been crying all night, there are a few simple swollen eye treatment remedies to get your eyes back in shape.

Swelling from Sinusitis

Why does a sinus infection lead to eye swelling? The sinuses, positioned just beneath the eyes, become inflamed and infected during a sinusitis attack. As a result, you might notice extra pressure and puffiness in the eye area.

When you’re fighting sinus-related eye swelling, consider these swollen eye treatment for relief.

Take a decongestant. An over-the-counter medication can fight mucus buildup in the sinuses – and help reduce eye puffiness in the process.
Drink extra water. Staying properly hydrated can prevent your body from hording extra liquids in all the wrong places.
Try a simple massage. With your eyes closed, gently move your ring finger in a half-circle from the inside to outside corner of your eye area. Complete the motion 10 to 15 times and repeat on the other side.
Turn to tea bags. Steep two tea bags in hot water for about five minutes, then let the bags cool until they’re comfortable to touch. While lying down with your eyes closed, place one tea bag over each eye area, and lay a soft cloth on top. Black or green tea can help constrict blood vessels, and herbal teas can sooth inflammation and redness. Take your pick!

Whether you’re fighting eye swelling or another symptom of sinusitis, a doctor’s help can make your trouble seem more bearable. Especially when sinusitis becomes a chronic problem, longer-term medical solutions can help you cope.

For a consultation or advice specific to your symptoms, please contact us anytime. And as always, check with a doctor to be sure these (and any) at-home solutions are right for you.

sinusitis Archives - Page 2 of 2 - The New York Otolaryngology Group

Peppermint tea causes me to have a sinus headache after sinus surgery

My 15 year old has 6-8 colds a year. Could she have sinusitis?

I have a deviated septum and a crooked nose. My surgery did not help. Is it safe to perform surgery again?

Pain while swallowing and turning my head after dental infection

Question: I have a strep infection and when I blow my nose, mucus comes out of my eyes.

How To Treat Puffy Eyes From Sinusitis

Swelling from Sinusitis