Sinuses are air-filled cavities in the head that are lined by mucous membranes that lead through small openings into the nasal cavity.
When the mucous membranes become swollen and inflamed from infectious or allergic sources, the sinus openings into the nasal cavity become blocked.
When this occurs, sinusitis develops resulting in more blockage and infection.
There are two main categories of sinusitis: acute and chronic.
Sinusitis is usually preceded by a cold, allergy attack or irritation from environmental pollutants.
Often, the resulting symptoms, such as nasal pressure, nasal congestion, a "runny nose," and fever, run their course in a few days.
However, if symptoms persist, a bacterial infection or acute sinusitis may develop. If sinusitis occurs frequently or lasts three months or longer, it may be chronic sinusitis.
Dr Lisa Wilson is here to discuss your sinuses and give suggestions for how to keep a healthy sinus.
Selected Podcast
Keeping a Healthy Sinus
Featured Speaker:
Learn more about Dr. Wilson
Lisa Wilson, MD
Dr. Wilson grew up in Pennsylvania and attended college at the University of Pennsylvania where she graduated with a Bachelor of Arts in Biological Basis of Behavior and a Minor in Chemistry. She received her medical degree from New York Medical College in Valhalla, New York. Dr. Wilson then completed her surgical internship at Beth Israel Hospital in New York, New York and her residency in Otolaryngology from the New York Eye and Ear Infirmary. She went on to then study under the guidance of Dr. David Ellis at the University of Toronto in Ontario, Canada, a highly competitive one year fellowship position, one of 43 in North America offered by the American Academy of Facial Plastic and Reconstructive Surgery. Dr. Wilson is double board certified through the American Board of Otolaryngology and American Board of Facial Plastic and Reconstructive surgery. She is on staff at Beth Israel - Plymouth, UMass Memorial Medical Center, Saint Vincent Hospital, and Massachusetts Eye and Ear Infirmary.Learn more about Dr. Wilson
Transcription:
Keeping a Healthy Sinus
Melanie Cole (Host): You’re sneezing, you have a stuffy nose or sinus pressure. Sinus problems can often be prevented with some simple steps for sinus health. My guest today is Dr. Lisa Wilson. She is an ENT and facial plastic and reconstructive surgeon with BID Plymouth. Welcome to the show, Dr. Wilson. Tell us about the sinuses a little. What are they intended to do and how come they get clogged up so easily?
Dr. Lisa Wilson (Guest): Thanks for having me, Melanie. I want to just start off by letting people know about their sinuses and that we actually have multiple sinuses within our head region. Most people point to the ones that are directly in their cheeks and under their eye, but we actually have ones in our forehead which are called the “frontal sinuses.” The ones in our cheeks are the maxillary sinuses. We have the ethmoid sinuses within our nose and then even ones that further back called the “sphenoid sinuses”. Why we need our sinuses is that the lining of them, as well as the lining inside of our nose help with a number of different functions. First and foremost, people probably already know that our nose and our nasal cavities help with our sense of smell. Two, the other very important function is that it helps with respiration. It humidifies the air that we breathe and it traps particles in that way as well as it makes for easier gas exchange when the air finally reaches down into our lungs.
Melanie: At this time of the year, people have colds; there are still people with allergies or asthma, any of these things. What do you tell people, Dr. Wilson, when they come to you and say their sinuses feel so much pressure or their sinuses hurt? What is your first best piece of advice that you tell people all the time?
Dr. Wilson: I think the most important thing is to try to keep the nose clean and clear. As I just mentioned, our nose does a lot of filtering and so is the first line of defense for us in the air that we breathe. There could be bacteria in there; there could be viruses in there; there can be allergens or dust that are aggravating on the tissues inside our nose. What it will cause then, is swelling. That swelling inside the nose will block off the nasal cavities and it makes it difficult for us to breathe and smell and it relates to this pressure that people feel. Oftentimes, something as simple as nasal saline will help to open up the passageways and there are also other medicated nasal sprays that we can talk about as well.
Melanie: Let’s talk about some of these because people hear in the media that they shouldn’t be using certain over the counter medications and nasal sprays because you can become addicted or they could be making your sinuses more congested after using them. Is this a myth?
Dr. Wilson: No, it isn’t. That is absolutely correct. The safest thing to use, like I mentioned, is nasal saline which is just a wash for the nose. There is a spray bottle that people can use or there can be an irrigation which is a low pressure but high volume wash for people that do have chronic sinus issues. People often mistake just using just a nasal spray such as saline and end up inadvertently picking up a nasal decongestant. Of the nasal decongestants, the most common one on the market the name is “oxymetazoline”. Other people know it by its brand name such as Afrin. What this medication does – it’s very powerful – the warning signs are on the box to not use it more than three days because it can cause what we call “rebound congestion”. Even somebody that is just walking around and has no sinus complaints, if they use a nasal decongestant such as Afrin inside the nose, they will feel that they can breathe even better but that is not necessarily physiologically normal. It sets off a cycle where people tend to get addicted to use of the nasal spray because they feel that they can’t breathe without it. I advise my patients when they are going to use a nasal decongestant to do so for a very short period. Say, when they are in the worst days of their cold. They can just get a little bit of air through and they can get on with their day and with their activities.
Melanie: What about antihistamine medications? These are more systemic. You take them orally, for the most part. What are those doing for us? Is that something that you recommend often or not so much?
Dr. Wilson: To be honest, not so much. I believe that antihistamines should be used for patients that actually have allergies. Some people know what they are allergic to based on exposure but others sometimes aren’t 100% sure. There are allergy tests that can be done. The antihistamines themselves could work against some people with chronic sinus problems. If you have an acute sinus infection and you’re using an antihistamine, sometimes it can dry out your nasal secretions too much if that’s the only thing that you are using to treat your infection. It is a good way, in terms of keeping the inflammation down inside your nose to help prevent, if you have documented allergies.
Melanie: When we look at some of the more complimentary type treatments, you mentioned keeping your nose clean. What do you think of nasal lavage or neti pots and those kinds of things? They are not that comfortable but they do a good job.
Dr. Wilson: Absolutely. There is a little bit of a learning curve in terms of using them. My preference is to use a nasal lavage for patients with chronic sinus pressure to try to keep passage ways open and to wash any mucus that is within the sinuses causing that fullness. My preference for bottles is to use one that is a high volume. So, a lot of liquid – probably about 240 milliliters or cc’s--and it’s going to be low pressure, meaning that you control it yourself. Oftentimes, it is a squeeze bottle that patients can use and even if you don’t have a specifically formulated bottle people can do this with just having just a large syringe. Often times the lavage that people use is recommended to be hypertonic, ,meaning that it is a little bit saltier of a solution so that it can draw out the mucus from your sinuses. Tricks that I give my patients in terms of using it is to bend over; to hold the nozzle in one nostril and irrigate it just enough so that you can have the irrigation fluid come out your other nostril. That leaning forward just helps prevent any of that irrigation fluid from going down the back of your throat and swallowing.
Melanie: What about things like humidifiers and air purifiers? Do they help to keep our sinuses from having to filter so much stuff?
Dr. Wilson: Yes, I believe that they do help a number of patients, especially in these winter months, too, as well. The air purifiers help to remove any dust or allergens that are in the room. Oftentimes, dust particles like to stay on things like drapes and bedding and sheets. Often, it is helpful for patients to have that in their bedroom. At the same time, the coolness humidifier in the bedroom at night will help to keep the air nice and moisturized so that our nose and our nasal passages don’t have to work as hard in filtering the air that we breathe in.
Melanie: Dr. Wilson – more myth busting here. People hear that mucus can be created by dairy products that can cause it to thicken up. Do beverages or hydration have anything to do with our sinuses?
Dr. Wilson: Yes, I often recommend to our patients to keep well-hydrated. To drink six to eight glasses of water a day as it helps with a number of other physiologic functions in our body. We want to keep our mucus thin so that it can come out of our nose if we need to blow. Oftentimes, when people have a sinus problem or an infection it isn’t uncommon for patients to find that Mucinex is helpful to thin out those secretions. In terms of dairy, I think that we’re still going to find people in both camps. There are some patients that are very sensitive to dairy and that it causes them to produce increased mucus. Dairy in kids has even been linked with infections, whether it is of the sinuses or the ears. But, it is not something that applies to everybody. I think it is very specific in terms of allergens that one person can be affected more than another. I do not routinely recommend that people cut out dairy completely.
Melanie: Dr. Wilson, if everybody has tried the usual techniques for dealing with their sinus issues when does it come to using steroids or intranasal steroids?
Dr. Wilson: Intranasal steroids is something that we have been using for many, many years now. Recently, it has been available over the counter. Intranasal steroids are wonderful because they do treat inflammation inside the nose. When people have cleared their nose and they are still inflamed, the nasal steroids will help decrease that to help with breathing. A few concerns that we have about steroids is that even though it is something that is safe to use on a long-term basis, there are some application techniques that are important like placing it towards the outside corner of the eye and not pointing the medication at a certain spot. Pointing at a certain area towards the septum, which is the middle partition of the nose, people can cause a lot of problems with bleeding and crusting from over application at that site. It can even progress to something more severe such as a perforation or a hole in the septum. I often recommend to my patients that if they find nasal steroids helpful and useful, it is certainly safe to use them but they should get their nose checked probably once a year by somebody who is really going to evaluate the nose to make sure that we don’t find any of the beginnings of these problems.
Melanie: In just the last few minutes, Dr. Wilson, please give your best advice for keeping healthy sinuses this time of the year and all year round and what you like to tell people every day doing what you do.
Dr. Wilson: I think my best piece of advice would be that if you experience any stuffiness inside your nose or beginnings of pressure is to start on washing your nose out and getting all the allergens out as quickly as possible. What I find is that if people let something fester and brew, it can actually progress to an acute bacterial infection that you may then need antibiotics for. Staying on top of your sinuses, being in tune with your body, knowing that you’re feeling a little bit different, I think, will go a long way.
Melanie: Thank you so much. It’s great information. You’re listening to BID Plymouth Wellness Radio. For more information you can go to BIDPlymouth.org. That’s BIDPlymouth.org. This is Melanie Cole. Thanks so much for listening.
Keeping a Healthy Sinus
Melanie Cole (Host): You’re sneezing, you have a stuffy nose or sinus pressure. Sinus problems can often be prevented with some simple steps for sinus health. My guest today is Dr. Lisa Wilson. She is an ENT and facial plastic and reconstructive surgeon with BID Plymouth. Welcome to the show, Dr. Wilson. Tell us about the sinuses a little. What are they intended to do and how come they get clogged up so easily?
Dr. Lisa Wilson (Guest): Thanks for having me, Melanie. I want to just start off by letting people know about their sinuses and that we actually have multiple sinuses within our head region. Most people point to the ones that are directly in their cheeks and under their eye, but we actually have ones in our forehead which are called the “frontal sinuses.” The ones in our cheeks are the maxillary sinuses. We have the ethmoid sinuses within our nose and then even ones that further back called the “sphenoid sinuses”. Why we need our sinuses is that the lining of them, as well as the lining inside of our nose help with a number of different functions. First and foremost, people probably already know that our nose and our nasal cavities help with our sense of smell. Two, the other very important function is that it helps with respiration. It humidifies the air that we breathe and it traps particles in that way as well as it makes for easier gas exchange when the air finally reaches down into our lungs.
Melanie: At this time of the year, people have colds; there are still people with allergies or asthma, any of these things. What do you tell people, Dr. Wilson, when they come to you and say their sinuses feel so much pressure or their sinuses hurt? What is your first best piece of advice that you tell people all the time?
Dr. Wilson: I think the most important thing is to try to keep the nose clean and clear. As I just mentioned, our nose does a lot of filtering and so is the first line of defense for us in the air that we breathe. There could be bacteria in there; there could be viruses in there; there can be allergens or dust that are aggravating on the tissues inside our nose. What it will cause then, is swelling. That swelling inside the nose will block off the nasal cavities and it makes it difficult for us to breathe and smell and it relates to this pressure that people feel. Oftentimes, something as simple as nasal saline will help to open up the passageways and there are also other medicated nasal sprays that we can talk about as well.
Melanie: Let’s talk about some of these because people hear in the media that they shouldn’t be using certain over the counter medications and nasal sprays because you can become addicted or they could be making your sinuses more congested after using them. Is this a myth?
Dr. Wilson: No, it isn’t. That is absolutely correct. The safest thing to use, like I mentioned, is nasal saline which is just a wash for the nose. There is a spray bottle that people can use or there can be an irrigation which is a low pressure but high volume wash for people that do have chronic sinus issues. People often mistake just using just a nasal spray such as saline and end up inadvertently picking up a nasal decongestant. Of the nasal decongestants, the most common one on the market the name is “oxymetazoline”. Other people know it by its brand name such as Afrin. What this medication does – it’s very powerful – the warning signs are on the box to not use it more than three days because it can cause what we call “rebound congestion”. Even somebody that is just walking around and has no sinus complaints, if they use a nasal decongestant such as Afrin inside the nose, they will feel that they can breathe even better but that is not necessarily physiologically normal. It sets off a cycle where people tend to get addicted to use of the nasal spray because they feel that they can’t breathe without it. I advise my patients when they are going to use a nasal decongestant to do so for a very short period. Say, when they are in the worst days of their cold. They can just get a little bit of air through and they can get on with their day and with their activities.
Melanie: What about antihistamine medications? These are more systemic. You take them orally, for the most part. What are those doing for us? Is that something that you recommend often or not so much?
Dr. Wilson: To be honest, not so much. I believe that antihistamines should be used for patients that actually have allergies. Some people know what they are allergic to based on exposure but others sometimes aren’t 100% sure. There are allergy tests that can be done. The antihistamines themselves could work against some people with chronic sinus problems. If you have an acute sinus infection and you’re using an antihistamine, sometimes it can dry out your nasal secretions too much if that’s the only thing that you are using to treat your infection. It is a good way, in terms of keeping the inflammation down inside your nose to help prevent, if you have documented allergies.
Melanie: When we look at some of the more complimentary type treatments, you mentioned keeping your nose clean. What do you think of nasal lavage or neti pots and those kinds of things? They are not that comfortable but they do a good job.
Dr. Wilson: Absolutely. There is a little bit of a learning curve in terms of using them. My preference is to use a nasal lavage for patients with chronic sinus pressure to try to keep passage ways open and to wash any mucus that is within the sinuses causing that fullness. My preference for bottles is to use one that is a high volume. So, a lot of liquid – probably about 240 milliliters or cc’s--and it’s going to be low pressure, meaning that you control it yourself. Oftentimes, it is a squeeze bottle that patients can use and even if you don’t have a specifically formulated bottle people can do this with just having just a large syringe. Often times the lavage that people use is recommended to be hypertonic, ,meaning that it is a little bit saltier of a solution so that it can draw out the mucus from your sinuses. Tricks that I give my patients in terms of using it is to bend over; to hold the nozzle in one nostril and irrigate it just enough so that you can have the irrigation fluid come out your other nostril. That leaning forward just helps prevent any of that irrigation fluid from going down the back of your throat and swallowing.
Melanie: What about things like humidifiers and air purifiers? Do they help to keep our sinuses from having to filter so much stuff?
Dr. Wilson: Yes, I believe that they do help a number of patients, especially in these winter months, too, as well. The air purifiers help to remove any dust or allergens that are in the room. Oftentimes, dust particles like to stay on things like drapes and bedding and sheets. Often, it is helpful for patients to have that in their bedroom. At the same time, the coolness humidifier in the bedroom at night will help to keep the air nice and moisturized so that our nose and our nasal passages don’t have to work as hard in filtering the air that we breathe in.
Melanie: Dr. Wilson – more myth busting here. People hear that mucus can be created by dairy products that can cause it to thicken up. Do beverages or hydration have anything to do with our sinuses?
Dr. Wilson: Yes, I often recommend to our patients to keep well-hydrated. To drink six to eight glasses of water a day as it helps with a number of other physiologic functions in our body. We want to keep our mucus thin so that it can come out of our nose if we need to blow. Oftentimes, when people have a sinus problem or an infection it isn’t uncommon for patients to find that Mucinex is helpful to thin out those secretions. In terms of dairy, I think that we’re still going to find people in both camps. There are some patients that are very sensitive to dairy and that it causes them to produce increased mucus. Dairy in kids has even been linked with infections, whether it is of the sinuses or the ears. But, it is not something that applies to everybody. I think it is very specific in terms of allergens that one person can be affected more than another. I do not routinely recommend that people cut out dairy completely.
Melanie: Dr. Wilson, if everybody has tried the usual techniques for dealing with their sinus issues when does it come to using steroids or intranasal steroids?
Dr. Wilson: Intranasal steroids is something that we have been using for many, many years now. Recently, it has been available over the counter. Intranasal steroids are wonderful because they do treat inflammation inside the nose. When people have cleared their nose and they are still inflamed, the nasal steroids will help decrease that to help with breathing. A few concerns that we have about steroids is that even though it is something that is safe to use on a long-term basis, there are some application techniques that are important like placing it towards the outside corner of the eye and not pointing the medication at a certain spot. Pointing at a certain area towards the septum, which is the middle partition of the nose, people can cause a lot of problems with bleeding and crusting from over application at that site. It can even progress to something more severe such as a perforation or a hole in the septum. I often recommend to my patients that if they find nasal steroids helpful and useful, it is certainly safe to use them but they should get their nose checked probably once a year by somebody who is really going to evaluate the nose to make sure that we don’t find any of the beginnings of these problems.
Melanie: In just the last few minutes, Dr. Wilson, please give your best advice for keeping healthy sinuses this time of the year and all year round and what you like to tell people every day doing what you do.
Dr. Wilson: I think my best piece of advice would be that if you experience any stuffiness inside your nose or beginnings of pressure is to start on washing your nose out and getting all the allergens out as quickly as possible. What I find is that if people let something fester and brew, it can actually progress to an acute bacterial infection that you may then need antibiotics for. Staying on top of your sinuses, being in tune with your body, knowing that you’re feeling a little bit different, I think, will go a long way.
Melanie: Thank you so much. It’s great information. You’re listening to BID Plymouth Wellness Radio. For more information you can go to BIDPlymouth.org. That’s BIDPlymouth.org. This is Melanie Cole. Thanks so much for listening.