Do you suffer from a sinus infection? It can be painful, uncomfortable and affect your quality of life.
When should you see a doctor? There are so many myths surrounding the sinuses such as if you have green discharge, it always means an infection.
Listen in as Howard Russell Semm, MD, discusses five myths you need to know about sinus infections and the solutions to help your sinus misery.
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Sinus Infections: 5 Things You Need to Know
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Learn more about Dr. Howard Russell Semm
Howard Russell Semm, MD, Ear Nose Throat Specialties
Dr. Howard Russell Semm is an otolaryngologist with Ear Nose and Throat Specialties.Learn more about Dr. Howard Russell Semm
Transcription:
Sinus Infections: 5 Things You Need to Know
Melanie Cole (Host): If you've ever had a sinus infection, you know the pain and discomfort it can cause. My guest today is Dr. Russell Semm. He's an otolaryngologist with a subspecialty in rhinology with ear, nose, and throat specialties. Welcome to the show, Dr. Semm. What is the first thing that you would like patients to know about sinus infection?
Dr. Russell Semm (Guest): I think the most important thing is that most acute sinus infections will actually clear without antibiotics, usually in a period of about two to three weeks. So, most people do not need to be treated for an isolated acute sinus infection.
Melanie: Wow. That's very interesting. What's the difference between chronic versus acute?
Dr. Semm: Acute sinus infections are usually caused by viral inflammation or viral infection and then progress into a bacterial infection, if there's a blockage within the sinuses. You can also have what's called a “recurrent acute sinus infection” and that would be somebody who gets sick and then gets over the infection two months or so later, winds up with another infection. Where “chronic sinusitis” is actually a chronic inflammatory disease process and that diagnosis is usually only made by an otolaryngologist. It's treated, not with antibiotics, but more with anti-inflammatories and potentially surgery.
Melanie: When do you tell patients it's time to see a doctor?
Dr. Semm: Typically, if they're experiencing symptoms from an acute sinus infection such as congestion, obstruction, pressure, or mid-face pain, headache, cough--especially a cough at night--or purulent rhinitis that persists longer that 10-14 days or seems to be getting worse as time goes on.
Melanie: So, what's the second most important thing that you would like people to know that you tell them every day about sinus infections?
Dr. Semm: The second misconception people always have is that purulent drainage or discolored drainage coming from their nose is a sign of a bacterial infection when, in fact, that really just means that there's an infiltration of neutrophils into the mucous that's being dispensed from the nose and doesn't necessarily mean it's a bacterial infection.
Melanie: Do you think people should be giving their sinus a shower, as it were? Give us some of the things you'd like people to do to keep a healthy sinus at home.
Dr. Semm: Well, the purpose of the sinuses is to cleanse the nose. The nose is the filter for the air we breathe. It's very efficient and it actually traps all of the bacteria, dirt, dust, pollens, viruses. The milliseconds that the air is within our nose, about 90-99% of that material is filtered out. The sinuses are actually there to wash out your nose, so your nose basically cleans itself two-to-three times per day. So, things that will help the mucous flow properly to cleanse the nose will help prevent people from getting recurring infections. One of the simplest things is probably seen in most all grocery stores and in pharmacies are the sinus rinse kits where you rinse your nose with distilled or sterile water and a solution of baking soda and salt. That's actually very physiologic and is actually very therapeutic for both preventing and curing acute sinus infections.
Melanie: That's nasal lavage, or Neti Pots, that you're talking about?
Dr. Semm: Yes. The Neti Pot is an older method. They also have the squeeze bottle ones. Most companies make both. The Neti Pot has been shown not to be as effective as the squeeze bottle sinus lavages are.
Melanie: What's the third most important thing you'd like people to know about sinus infection? You're giving such great information today.
Dr. Semm: Well, it's related to the lavaging and that is that the cause of an infection is actually when the mucous doesn't flow properly. As long as the mucous is flowing and doing its job of cleaning the nose, we don't get infected. So, anything that can block up our nose to prevent the mucous flow will lead to an infection. That can be anatomical things, like a deviated nasal septum. It can be allergies causing the structures inside of nose that are involved with filtration called the “turbinates” to swell too large and actually block things up.
Melanie: So, you've discussed sinus discharge and what that means, what about the congestion that goes with it? Because sometimes, at the same time that you're dealing with this drainage, you can have trouble breathing when you have a sinus infection, yes?
Dr. Semm: Yes. And that's usually due to swelling in the structures I talked about called the “turbinates” which are actually in the nose. They're not actually in the sinuses. The sinuses open in between the turbinates and we have three turbinates on each side. When those turbinates swell too much due to irritations, allergies, or viral inflammation, then that blocks the sinus up and then leads us to be more prone to developing a sinus infection.
Melanie: Does a cough signal a problem with your sinuses, in some cases?
Dr. Semm: A cough can be a symptom of an acute infection and it can also be a symptom of what we call “silent sinus syndrome” and that is that some people have mucous flow that is abnormal or there's a blockage in the sinus which can cause, in children, actually, a lack of development of the paranasal sinuses. They will oftentimes present with cough as the only symptom. If the cough is at night, then that is more indicative of a sinus problem than a cough that is throughout the day.
Melanie: And give us the fourth most important thing you like to tell people that's so important to know about sinuses and sinus infections.
Dr. Semm: The fourth thing is the misconception about headaches and that is that many patients are under the conception that their headaches are caused by their sinuses, when in fact, the vast majority of headaches are not actually sinus related. If you have a sinus headache, then that usually implies that there is a blockage problem of one of the paranasal sinuses. If the sinuses are not blocked, then it's unlikely that it would be causing a headache. Studies have shown that 80% of patients who are referred to seeing an otolaryngologist for their sinus headaches actually have vascular headaches such as cluster headaches and migraine headaches.
Melanie: And now, give us the fifth thing that you would like people most importantly to know about sinuses and sinus infections.
Dr. Semm: If you've tried the rinsing of the sinuses and your symptoms are getting worse, then usually around two weeks is when you should be going to see your doctor. If you've just come down with an illness, unless there are complicating factors of severe fever or other types of problems, you really don't need to see the physician right away. If you're worsening at about 10 days, that's when you probably should go to see your doctor.
Melanie: How do you know when it could just be allergies?
Dr. Semm: Allergies can be seasonal and can be year around but most of the time, allergies don't cause the severe pressure or pain in the teeth and congestion that you would get. You would also have, most of the time, other symptoms such as sneezing and itchy, watery eyes and stuff like that.
Melanie: Would this condition ever require surgery?
Dr. Semm: Usually, acute sinus infections do not require surgery unless there are complications that develop from the bacterial infections. That can be things such as infection around your eye, tear duct infections an abscess formation around your eye, or even brain abscesses. Under those circumstances, immediate surgery would be indicated. Chronic rhinosinusitis, on the other hand, is a condition of chronic inflammatory process that causes blockage of the sinuses and almost always requires surgery at some point. That surgery usually, however, is elective in its time.
Melanie: In just the last few minutes, give your best advice for people that have some of these pain, drainage, cough, headaches--everything you've described--and what you tell them, what you really want them to know about how to treat their sinus infections.
Dr. Semm: I think the sinus rinsing is the single best innovation that has come along that patients can do at home actually for control of their allergies and their sinuses, in my entire career, which has been 34 years. So, I think the sinus rinsing, as long as you're using sterile or distilled water and cleaning your rinse container frequently, is the single best thing that people can do to help prevent and get over a sinus infection. Then, I think other common sense things like taking vitamin C in moderate doses and then also using Zinc as an immune stimulant can help get most people over garden-variety sinus infections.
Melanie: Wow, what great information. Thank you so much Dr. Semm, for being with us today. You're listening to Bryan Health Radio. For more information, you can go to bryanhealth.org. That's bryanhealth.org. This is Melanie Cole. Thanks so much for listening.
Sinus Infections: 5 Things You Need to Know
Melanie Cole (Host): If you've ever had a sinus infection, you know the pain and discomfort it can cause. My guest today is Dr. Russell Semm. He's an otolaryngologist with a subspecialty in rhinology with ear, nose, and throat specialties. Welcome to the show, Dr. Semm. What is the first thing that you would like patients to know about sinus infection?
Dr. Russell Semm (Guest): I think the most important thing is that most acute sinus infections will actually clear without antibiotics, usually in a period of about two to three weeks. So, most people do not need to be treated for an isolated acute sinus infection.
Melanie: Wow. That's very interesting. What's the difference between chronic versus acute?
Dr. Semm: Acute sinus infections are usually caused by viral inflammation or viral infection and then progress into a bacterial infection, if there's a blockage within the sinuses. You can also have what's called a “recurrent acute sinus infection” and that would be somebody who gets sick and then gets over the infection two months or so later, winds up with another infection. Where “chronic sinusitis” is actually a chronic inflammatory disease process and that diagnosis is usually only made by an otolaryngologist. It's treated, not with antibiotics, but more with anti-inflammatories and potentially surgery.
Melanie: When do you tell patients it's time to see a doctor?
Dr. Semm: Typically, if they're experiencing symptoms from an acute sinus infection such as congestion, obstruction, pressure, or mid-face pain, headache, cough--especially a cough at night--or purulent rhinitis that persists longer that 10-14 days or seems to be getting worse as time goes on.
Melanie: So, what's the second most important thing that you would like people to know that you tell them every day about sinus infections?
Dr. Semm: The second misconception people always have is that purulent drainage or discolored drainage coming from their nose is a sign of a bacterial infection when, in fact, that really just means that there's an infiltration of neutrophils into the mucous that's being dispensed from the nose and doesn't necessarily mean it's a bacterial infection.
Melanie: Do you think people should be giving their sinus a shower, as it were? Give us some of the things you'd like people to do to keep a healthy sinus at home.
Dr. Semm: Well, the purpose of the sinuses is to cleanse the nose. The nose is the filter for the air we breathe. It's very efficient and it actually traps all of the bacteria, dirt, dust, pollens, viruses. The milliseconds that the air is within our nose, about 90-99% of that material is filtered out. The sinuses are actually there to wash out your nose, so your nose basically cleans itself two-to-three times per day. So, things that will help the mucous flow properly to cleanse the nose will help prevent people from getting recurring infections. One of the simplest things is probably seen in most all grocery stores and in pharmacies are the sinus rinse kits where you rinse your nose with distilled or sterile water and a solution of baking soda and salt. That's actually very physiologic and is actually very therapeutic for both preventing and curing acute sinus infections.
Melanie: That's nasal lavage, or Neti Pots, that you're talking about?
Dr. Semm: Yes. The Neti Pot is an older method. They also have the squeeze bottle ones. Most companies make both. The Neti Pot has been shown not to be as effective as the squeeze bottle sinus lavages are.
Melanie: What's the third most important thing you'd like people to know about sinus infection? You're giving such great information today.
Dr. Semm: Well, it's related to the lavaging and that is that the cause of an infection is actually when the mucous doesn't flow properly. As long as the mucous is flowing and doing its job of cleaning the nose, we don't get infected. So, anything that can block up our nose to prevent the mucous flow will lead to an infection. That can be anatomical things, like a deviated nasal septum. It can be allergies causing the structures inside of nose that are involved with filtration called the “turbinates” to swell too large and actually block things up.
Melanie: So, you've discussed sinus discharge and what that means, what about the congestion that goes with it? Because sometimes, at the same time that you're dealing with this drainage, you can have trouble breathing when you have a sinus infection, yes?
Dr. Semm: Yes. And that's usually due to swelling in the structures I talked about called the “turbinates” which are actually in the nose. They're not actually in the sinuses. The sinuses open in between the turbinates and we have three turbinates on each side. When those turbinates swell too much due to irritations, allergies, or viral inflammation, then that blocks the sinus up and then leads us to be more prone to developing a sinus infection.
Melanie: Does a cough signal a problem with your sinuses, in some cases?
Dr. Semm: A cough can be a symptom of an acute infection and it can also be a symptom of what we call “silent sinus syndrome” and that is that some people have mucous flow that is abnormal or there's a blockage in the sinus which can cause, in children, actually, a lack of development of the paranasal sinuses. They will oftentimes present with cough as the only symptom. If the cough is at night, then that is more indicative of a sinus problem than a cough that is throughout the day.
Melanie: And give us the fourth most important thing you like to tell people that's so important to know about sinuses and sinus infections.
Dr. Semm: The fourth thing is the misconception about headaches and that is that many patients are under the conception that their headaches are caused by their sinuses, when in fact, the vast majority of headaches are not actually sinus related. If you have a sinus headache, then that usually implies that there is a blockage problem of one of the paranasal sinuses. If the sinuses are not blocked, then it's unlikely that it would be causing a headache. Studies have shown that 80% of patients who are referred to seeing an otolaryngologist for their sinus headaches actually have vascular headaches such as cluster headaches and migraine headaches.
Melanie: And now, give us the fifth thing that you would like people most importantly to know about sinuses and sinus infections.
Dr. Semm: If you've tried the rinsing of the sinuses and your symptoms are getting worse, then usually around two weeks is when you should be going to see your doctor. If you've just come down with an illness, unless there are complicating factors of severe fever or other types of problems, you really don't need to see the physician right away. If you're worsening at about 10 days, that's when you probably should go to see your doctor.
Melanie: How do you know when it could just be allergies?
Dr. Semm: Allergies can be seasonal and can be year around but most of the time, allergies don't cause the severe pressure or pain in the teeth and congestion that you would get. You would also have, most of the time, other symptoms such as sneezing and itchy, watery eyes and stuff like that.
Melanie: Would this condition ever require surgery?
Dr. Semm: Usually, acute sinus infections do not require surgery unless there are complications that develop from the bacterial infections. That can be things such as infection around your eye, tear duct infections an abscess formation around your eye, or even brain abscesses. Under those circumstances, immediate surgery would be indicated. Chronic rhinosinusitis, on the other hand, is a condition of chronic inflammatory process that causes blockage of the sinuses and almost always requires surgery at some point. That surgery usually, however, is elective in its time.
Melanie: In just the last few minutes, give your best advice for people that have some of these pain, drainage, cough, headaches--everything you've described--and what you tell them, what you really want them to know about how to treat their sinus infections.
Dr. Semm: I think the sinus rinsing is the single best innovation that has come along that patients can do at home actually for control of their allergies and their sinuses, in my entire career, which has been 34 years. So, I think the sinus rinsing, as long as you're using sterile or distilled water and cleaning your rinse container frequently, is the single best thing that people can do to help prevent and get over a sinus infection. Then, I think other common sense things like taking vitamin C in moderate doses and then also using Zinc as an immune stimulant can help get most people over garden-variety sinus infections.
Melanie: Wow, what great information. Thank you so much Dr. Semm, for being with us today. You're listening to Bryan Health Radio. For more information, you can go to bryanhealth.org. That's bryanhealth.org. This is Melanie Cole. Thanks so much for listening.