Sinus and Allergy

Have you ever experienced an aching head? If you have, you're in good company. Sinusitis is one of the most common diseases occurring in the United States with nearly 36 million cases diagnosed every year. While that's a lot of aching heads, it also leads to a lot of aching pocketbooks with over 200 million dollars worth of prescriptions prescribed in addition to more than 2 billion dollars spent for over-the-counter medications.

The Sinus and Allergy Center at UNC ENT is here to help you with your sinus and allergy concerns. Our physicians Drs. Senior and Pillsbury, along with our nurses, Libby and Judy provide a complete range of services for management of sinus and allergy conditions. These services include the latest medicines, immunotherapy (allergy shots), and surgeries. The surgeries performed are the latest and most modern techniques of "minimally invasive surgery" including "Functional Endoscopic Sinus Surgery" (FESS). While all of our surgeons are highly skilled in these techniques, we also offer the extra advantage of the latest in surgical equipment for FESS including "Powered Instrumentation" and "Computer Image Guided Surgery" allowing for more complete surgeries while at the same time offering significant safety advantages over more traditional approaches.

 "Doctor, Help Me! Is it a cold, is it allergy, or is it an infection?"

Sinusitis literally means "inflammation of the sinuses," specifically resulting from a bacterial infection of the sinuses. The sinuses are air-containing spaces in the face that surround the nose and eyes extending into the forehead. The purpose of the sinuses is unknown but we do know that they lighten the weight of the skull (otherwise we would all be forced to walk around with our heads hanging to the ground!) and provide some protection to the brain in accidents.

Sinusitis typically occurs following a cold and individuals with allergy or nasal polyps may be prone to it. Symptoms of sinusitis include nasal congestion or stuffiness, facial pressure or pain, drainage from the nose, and a diminished sense of smell. Some will also experience fevers, fatigue and cough. All these symptoms are remarkably similar to those of a common cold or allergy attack, but it is important to distinguish between them for appropriate treatment.

Allergy causes stuffiness and congestion of the nose and occasionally headache or facial pain; but it's usually also accompanied by itchiness of the eyes, nose, or even the roof of the mouth. Drainage in allergy tends to be thin and watery. Symptoms of allergy typically occur when exposed to something in the environment to which you are sensitive, for example, Aunt Bea's new Himalayan cat, or ragweed in the schoolyard. Symptoms tend to clear-up once the environmental culprit has been removed. While avoidance is key to treatment, over-the-counter and prescription allergy medications may work very well to ameliorate the symptoms. For some, allergy testing and shots may be needed to resolve the problems.

Colds are viral infections that usually occur after exposure to someone else who is sick. They can be transmitted through the air with sneezing or coughing (cover your face!) or by direct contact on the hands (wash your hands!). The symptoms, while similar to sinusitis, last only about a week. Over-the-counter decongestant medications help relieve the stuffiness, while antihistamines may help stop the dripping nose. Most important, however, is doing what mom always told you to do: get plenty of rest, drink plenty of liquids, and, of course, get plenty of TLC ("tender-loving care"). Antibiotics have no role in treating common colds.

Sinusitis differs from cold or allergy by being a bacterial infection causing swelling, congestion, and drainage from the nose and sinuses. It typically arises after a cold and manifests itself by symptoms of the cold that simply don't get any better. So rather than the headache and congestion going away after a week as with a cold, they drag on and on and on. It's this duration of symptoms that signal it's time to see a physician to get treatment.

Treatment

The Division of Otolaryngology-Head and Neck Surgery (ENT) at the University of North Carolina provides comprehensive Sinus and Allergy care. In addition to discussing your symptoms and performing a careful exam, your UNC ENT doctor may wish to obtain x-rays to confirm the presence of sinusitis. Mainstay of treatment is antibiotics, usually given for about 10 days. While the experience in some European countries has suggested that many sinus infections will clear on their own without antibiotics, most physicians in the United States will recommend antibiotics to aid in clearing the infection. In addition to being shown to reduce the duration of symptoms, antibiotics probably also help to prevent rare, serious complications of sinusitis. These complications may include the infection spreading to critical areas around the sinuses, specifically, the eye and the brain.

Additional treatments that may be beneficial for sinusitis include decongestants to decrease the congestion in the nose and improve breathing, saltwater sprays to moisturize the nose, and over-the-counter pain medications such as aspirin or acetaminophen to relieve discomfort.

Antihistamines provide little in management of sinusitis and should probably not be used unless allergy is suspected as the root of the problem. When symptoms persist despite antibiotics, or when complications arise, more advanced care by your UNC Ear, Nose, and Throat surgeon (Otolaryngologist) may be required including surgery. The UNC Sinus and Allergy Center offers the latest and most modern techniques of "minimally invasive surgery" including "Functional Endoscopic Sinus Surgery" (FESS). While all of our surgeons are highly skilled in these techniques, we also offer the extra advantage of the latest in surgical equipment for FESS including "Powered Instrumentation" and "Computer Image Guided Surgery" allowing for more complete surgeries while at the same time offering significant safety advantages over more traditional approaches.

So take heart, relief for your nose is on the way! Make an appointment today with your University of North Carolina Ear, Nose, and Throat Surgeon for the best in Sinus and Allergy care. And before you know it, with proper treatment, that running nose will stop running you down.