Are your sinuses bothering you? You’re not alone.
Some 31 million people in the United States suffer from sinus infections, or sinusitis.[1] Sinus infections aren’t life-threatening, but they do represent a major health problem in the United States. Sinusitis leads to more than 16 million outpatient doctor visits a year and some $150 million in prescription medication costs.[2] And if you’ve ever had one, you know that a sinus infection can make you miss work and feel miserable for days.
While there are different types of sinus disorders, sinusitis is the most common. Symptoms of sinusitis include postnasal drip, a runny nose with discolored (greenish) nasal discharge, nasal stuffiness or congestion which causes difficulty breathing, headaches or tenderness of the face (particularly under the eyes or at the bridge of the nose), pain in the teeth, coughing, fever, fatigue, and bad breath.[3]
“Here in the Dallas-Fort Worth area, one of the most common chronic conditions affecting adults are issues with their sinuses, with allergies and with persistent pain or infections,” said Dr. Michael Kubala, an ear, nose and throat (ENT) surgeon on the medical staff at Texas Health Center for Diagnostics and Surgery in Plano, Texas. 
The sinuses are cavities near the nasal passages and are lined with mucous membranes. There are four types of sinuses, located inside the face, near the bridge of the nose, around the cheeks, in the forehead and behind the nose.[4]
Many patients with sinusitis will initially visit their primary care physician or an urgent care clinic, who can help with the first line of defense: medications such as anti-inflammatory nasal sprays, decongestants, oral inflammatory inhibitors and systemic steroid medications. In most cases, medications will clear up the symptoms within a week or two. [5]
However, sinusitis may be acute or chronic. Chronic sinusitis is diagnosed when symptoms persist for more than 12 weeks.[6] Similarly, recurrent sinusitis occurs with four episodes of sinusitis within one year.[7] When over the counter medicine and antibiotics don’t lead to lasting relief, patients turn to specialists like Dr. Kubala.
“Many of our patients have tried over-the-counter medications—such as nasal sprays (like Flonase) or antihistamines (like Allegra or Zyrtec)—and prescription medications such as antibiotics,” said Dr. Kubala. “If the symptoms persist, they come to see us.”
The best course of treatment for chronic sinusitis is not always obvious. Sinusitis may be initially triggered or exacerbated by allergic rhinitis (hay fever) or an upper respiratory tract infection (a cold).[8] However, the root cause could be an underlying sinus condition. People with asthma, structural blockages in the nose or sinuses, or with weak immune systems are at greater risk.[9] Injuries, such as nasal fractures, can also increase a patient’s susceptibility to sinusitis.[10]
For patients with persistent sinus problems, Dr. Kubala examines the patient’s nose thoroughly using an endoscope, a thin, flexible tube equipped with a camera. Patients typically report the procedure is a little uncomfortable but painless.
“We look to see if the patient has polyps, inflammation or mucus production that’s causing the recurrent symptoms,” he said.
Nasal and sinus polyps are benign growths inside the nose or sinuses.[11] They can affect anyone but are most common in adults.[12] Not all polyps are symptomatic, but larger ones can block the airway, inhibit mucus drainage, cause symptoms such as post-nasal drip or trouble breathing and lead to frequent infections.[13] Medications can often shrink nasal polyps, but sometimes surgery is required to remove them. Even after successful treatment, nasal polyps often return.[14]
If needed, Dr. Kubala may also order a CT scan to look for obstructions or other structural issues, such as a deviated septum or enlarged turbinates (bony structures inside the nose that act as built-in air filters; if enlarged, they can cause nasal blockage).[15]
“We always look to see if allergies are playing a role, because in the Dallas area, allergies are definitely a part of the environment,” Dr. Kubala said. Dallas often makes the Asthma and Allergy Foundation of America’s annual list of “Allergy Capitals” – the most challenging places to live with allergies in the United States. In 2022, Dallas ranked 28th.[16]
Treatment options for managing chronic sinusitis may involve allergy testing and treatment, or a surgical procedure such as endoscopic sinus surgery, septoplasty (correcting a deviated septum), turbinate reductions, or other surgery to minimize inflammation or remove obstructions. Endoscopic sinus surgery is minimally invasive and does not require any external incisions. [17]
About Texas Health Center for Diagnostics and Surgery
If you’re struggling with a sinus infection that won’t go away, make an appointment with one of the physicians on the medical staff at Texas Health Center for Diagnostics & Surgery (THCDS). The physicians on the medical staff provide non-surgical and surgical care for ear, nose and throat (ENT) disorders in infants, children and adults. Many of these conditions can be treated using minimally invasive techniques, including endoscopic surgery, which may reduce recovery time. Ear, Nose, and Throat physicians on the medical staff treat a range of issues stemming from conditions with the ears, nose, throat and neck. Physicians on the medical staff also treat common ear, nose, and throat (ENT) conditions in children, including ear infections. Dr. Kubala and other specialists on the medical staff at THCDS can help you identify underlying causes, find the right treatment and get relief.
FAQs
What are common symptoms of sinus problems?
Common symptoms of sinus problems include:
*Nasal inflammation
*A runny nose with thick, discolored discharge
*Postnasal drip -- drainage down the back of the throat
*Stuffy nose causing difficulty breathing through your nose.[18]
What are 4 types of sinuses?
The sinuses near the nose are named after the bones that contain them: frontal (the lower forehead), maxillary (cheekbones), ethmoid (beside the upper nose), and sphenoid (behind the nose).