Sinus problems – from the common cold to chronic and recurrent sinusitis, most of us have dealt with a runny nose or sinus congestion at some point. But for some people, sinus problems go far beyond the periodic inconvenience of getting the sniffles once a year.
Chronic sinus infections and other sinus problems can have a major impact on a person’s quality of life. When medications fail to provide the relief you need, the doctors of CornerStone Ear, Nose & Throat can help provide lasting relief for patients suffering from chronic or frequent sinus problems. We offer the most up-to-date minimally invasive techniques, including in-office procedures under local anesthesia, and more traditional outpatient endoscopic sinus surgery without packing.
The glands in your nose and throat produce up to two quarts of mucus a day. This is usually true even for a healthy person. Normally, this mucus is clear and thin and serves a useful role in keeping the mucus membranes clean and moist. Excessive secretions of mucus in response to inflammation or infection can cause a buildup of dried or thick mucus and create the feeling that mucus is dripping from the back of the nose into the throat. This sensation, called “post-nasal drip,” can be caused by these thick, draining mucus secretions or by other throat and swallowing conditions. Correct diagnosis is critical to developing a successful treatment plan.
Causes Of Mucus Secretions
- Viruses such as colds and flu
- Environmental airborne pollutants
- Environmental allergies
- Cold temperatures
- Bright lights
- Certain foods/spices
- Pregnancy, and other hormonal changes
- Various drugs (including birth control pills and some high blood pressure medications)
- Structural abnormalities (deviated or irregular nasal septum)
- Dryness due to climate or in heated buildings and homes
- Sinus infections
- Some food allergies or sensitivities (especially to dairy products)
Note: If thin mucus secretions become thick, and turn green or yellow, it may be an indication that a bacterial sinus infection is developing.
Swallowing And Throat Problems Related To Post-Nasal Drip
Excess mucus secretions can cause hoarseness or coughing when they spill into the voice box (larynx) and breathing passages (trachea and bronchi). The latter would typically happen only with the elderly or in individuals with laryngeal functional problems. However, viral infections, pollutants, and allergens that irritate the lining of the nose and throat can also irritate the lining of the trachea and bronchi in the lungs. This often causes mucus to form in the chest a few days after it starts in the nose and sinuses, giving the impression that mucus is “flowing” from the nose down into the chest. Post-nasal drip can also cause a sore throat due to local irritation, throat clearing, and mouth breathing when the nose is also congested. Even without a sinus infection, the tonsils and other tissues in the throat may swell and become irritated with excessive post-nasal drip, especially if a viral infection is present.
Inflammation of the lining of the nose from any cause generally results in swelling and increased thick mucus production. So post-nasal drip is often associated with nasal congestion (stuffy nose) that makes it difficult to breathe through the nose. This nasal stuffiness is caused by swelling in the lining (mucosa) of the nasal passages. Causes of both nasal congestion and post-nasal drip include:
- Infection (viral and bacterial)
- Structural abnormalities (deviated septum)
- Environmental allergies
- Nasal polyps
- Vasomotor rhinitis (swelling of the lining of the nose with increased clear mucus drainage caused by a reflexive trigger such as cold air or some chemicals/medications)
The swelling of the mucus membranes lining the sinuses can lead to a condition commonly referred to as a “sinus headache.” Patients typically experience pain under, between, or above the eyes, and in the upper teeth. This discomfort is a result of inflamed mucus membranes blocking normal sinus drainage passages and causing mucus to become trapped in the obstructed sinuses. Sinus headaches and facial pain are often a symptom of sinusitis.
Sinusitis (Aka Rhinosinusitis)
Post-nasal drip, congestion, and sinus headaches can all be symptoms of inflammation or infection of the sinuses, a condition also known as sinusitis. The body reacts to sinusitis by causing the lining of the sinuses to swell and secrete large amounts of thick mucus. This swelling does not allow mucus to drain properly, causing it to fill the nasal and sinus cavities.
Symptoms Of Sinusitis
- Nasal obstruction
- Yellow or green mucus
- Facial pain
- Bad breath
- Teeth pain
- Post-nasal drip
- Sore throat
Acute sinusitis is typically diagnosed when there has been four weeks or less of green or yellow nasal drainage, plus one or both of the following:
- Stuffy, congested nose
- Pain or pressure in the face or around the eyes
Symptoms of sinus infection lasting less than 10 days, with no history of recurring or chronic sinus problems, are most likely an indication of viral rhinosinusitis. Over-the-counter pain relievers, saltwater irrigation, and steroid nasal sprays are recommended treatments for this condition. Antibiotics are not usually needed. If the symptoms of a sinus infection last for more than 10 days without improvement, or the symptoms worsen after an initial phase of improvement, you most likely have acute bacterial sinusitis. While pain relievers, saltwater irrigation, and steroid nasal sprays can also help with this condition, antibiotic treatment may be needed. If productive cough, increasing fever, or chest pain develop and last more than one week, bronchitis and even pneumonia may be developing from the viral infection. Evaluation by a physician is definitely recommended in these instances, especially in children, the elderly, and those with immune system problems.
Chronic sinusitis is diagnosed when the symptoms of sinusitis last for 12 weeks or longer. Chronic sinusitis is more typically the result of prolonged inflammation due to environmental causes, rather than infection. While infection can also be a secondary factor in chronic sinusitis, it is not usually the original cause – three factors that lead to chronic nasal and sinus problems.
Medical treatments for chronic sinusitis include saltwater nasal irrigation and/or nasal steroid sprays. Antibiotics may be useful in selected cases. Other factors that can impact chronic sinusitis, which may require additional treatment, include environmental allergies, nasal polyps, prior trauma or surgery in the area, recent dental implant surgery, and asthma.
When symptoms of chronic sinusitis cannot be fully resolved with medications, surgical intervention may be the best option. Sinus surgery is drastically different and much more tolerable to patients now than it was decades ago. CornerStone Ear, Nose & Throat is proud to offer in-office, minimally invasive procedures that provide lasting relief of sinus symptoms with a very short recovery time. These procedures have proved to be highly effective and provide immediate relief for many of our patients.
CornerStone Ear, Nose & Throat was the first practice in the Charlotte region to offer in-office balloon sinuplasty. During this procedure, a small balloon is inserted into the sinus drainage passage (osium) and inflated to open the sinus passage and relieve obstruction. This allows subsequent daily topical medical therapy to treat the original cause of the chronic sinusitis and also for the natural secretions of the lining of the sinus to properly drain out of the sinus.
In-office balloon sinuplasty is not recommended for all patients, including those with a history of severe chronic sinusitis, extreme nasal septum deviation, or moderate or severe nasal polyposis. In those cases, a more traditional endoscopic, minimally invasive surgical procedure would be recommended to correct the anatomic obstruction and restore the normal flow of healthy mucus. This procedure should make breathing easier and allow patients to easily use topical medications to block the original source of inflammation. These procedures are typically performed on an outpatient basis and require no packing.
Sinus Problems – When to see an ENT
Sinus problems can be frustrating because they are so common and can have multiple causes. If you have prolonged sinus symptoms, it is important to be examined by an ear, nose, and throat specialist to determine the best course of treatment – request an appointment today.