How often should you experience sinus infections before seeking specialist care. What are the signs that your sinus problem requires advanced treatment. When do recurring sinus symptoms indicate a need for ENT consultation. How can you determine if your sinus issues are severe enough for specialist intervention.

Understanding Sinusitis: Prevalence and Impact

Sinusitis, a condition characterized by inflammation of the sinus cavities, is one of the most prevalent medical issues affecting adults in the United States. With approximately 29 million cases reported annually, it’s crucial to understand the nuances of this condition and when professional intervention becomes necessary.

Sinus infections typically manifest with a range of uncomfortable symptoms, including:

• Nasal congestion
• Fever
• Facial pain and pressure
• Headaches
• Discolored nasal discharge
• Post-nasal drip

While most individuals experience one or two upper respiratory or sinus infections per year, some cases may require more than over-the-counter remedies. In such instances, a primary care physician might prescribe antibiotics. However, there are specific circumstances when consulting an ENT (Ear, Nose, and Throat) specialist becomes imperative.

Frequency of Sinus Infections: When Is It Too Much?

How many sinus infections per year are considered abnormal? While it’s common to fall ill with an upper respiratory or sinus infection once or twice annually, experiencing sinusitis four or more times a year is cause for concern. This is particularly problematic if each episode necessitates antibiotic treatment.

Why is frequent antibiotic use a concern? Although antibiotics are generally safe and effective, their repeated use can lead to complications. Like all medications, antibiotics can have side effects, and overuse increases the risk of developing antibiotic-resistant bacteria.

The Risks of Antibiotic Overuse

Antibiotic resistance is a growing global health concern. When bacteria become resistant to antibiotics, it means that these medications become less effective in treating infections. This can lead to more severe, prolonged illnesses and, in some cases, untreatable infections.

Persistent Sinus Symptoms: A Red Flag for Chronic Sinusitis

Do your sinus symptoms never fully resolve? Most episodes of sinusitis clear up within 14 days. However, if you find that your symptoms linger even after completing a course of antibiotics, it could be a sign of chronic sinusitis.

Chronic sinusitis is defined as a long-term sinus infection that persists for months or even years. This condition often requires advanced treatment from an ENT specialist. But how can you distinguish between a prolonged acute infection and chronic sinusitis?

• Duration: Symptoms lasting more than 12 weeks
• Persistence: Feeling of incomplete recovery between infections
• Resistance to treatment: Symptoms not responding to standard therapies

Severity of Symptoms: When Sinus Problems Become Debilitating

How severe should sinus symptoms be before seeking specialist care? While being sick is uncomfortable and irritating, typical sinus infections are not usually debilitating. If you find yourself frequently missing work or requiring urgent care visits due to unbearable symptoms, it’s time to consult an ENT specialist.

Severe symptoms that may warrant specialist attention include:

1. Intense facial pain or pressure
2. Severe headaches unresponsive to over-the-counter pain relievers
3. High fever (above 101°F or 38.3°C) that persists
4. Vision changes or eye swelling
5. Difficulty breathing

Treatment Resistance: When Standard Therapies Fail

Are your sinus infections not responding to prescribed treatments? While it’s normal for antibiotics to take 2-3 days to show effects, a lack of improvement after completing the full course could indicate a more complex issue.

If your symptoms persist for more than two weeks and don’t improve with antibiotics, an ENT specialist evaluation may be necessary. Why? Some sinus infections are caused by antibiotic-resistant bacteria or may have underlying causes that require specialized treatment.

The Role of Sinus Cultures

In cases of treatment-resistant sinusitis, an ENT specialist may perform a sinus culture. This procedure involves collecting a sample of the sinus discharge to identify the specific pathogen causing the infection. With this information, your doctor can prescribe a more targeted antibiotic therapy.

Chronic Sinusitis: Beyond Medication

Can sinus problems sometimes require more than just medication? In some cases, yes. Chronic or recurrent sinusitis may be caused by structural issues in the nasal passages or sinuses, which can’t be resolved with medication alone.

Potential structural causes of chronic sinusitis include:

• Nasal polyps
• Deviated septum
• Narrow sinus openings
• Scar tissue from previous infections or surgeries

In these situations, an ENT specialist may recommend advanced diagnostic procedures such as CT scans or endoscopy to visualize the sinus structures. Based on the findings, they might suggest surgical interventions to correct the underlying issue and provide long-term relief.

The Gradual Nature of Sinus Conditions

Why can it be challenging to recognize when a sinus condition becomes serious? Sinus symptoms often evolve slowly over time, making it difficult for patients to perceive day-to-day changes. This gradual progression can obscure the line between a normal course of illness and a more serious condition requiring specialist intervention.

To help track the progression of your symptoms, consider keeping a symptom diary. Note the following:

• Daily severity of symptoms
• Duration of each episode
• Treatments tried and their effectiveness
• Impact on daily activities

This information can be invaluable when consulting with an ENT specialist, helping them understand the full picture of your sinus health.

Advanced Diagnostic Techniques in ENT Care

What diagnostic tools do ENT specialists use to evaluate chronic sinus problems? ENT specialists have access to advanced diagnostic techniques that can provide detailed information about your sinus condition. These may include:

1. Nasal endoscopy: A thin, flexible tube with a camera is inserted into the nasal passages to visualize the internal structures.
2. CT scan: This imaging technique provides detailed cross-sectional views of the sinuses, helping to identify structural abnormalities or blockages.
3. Allergy testing: If allergies are suspected to contribute to sinus problems, skin or blood tests may be performed to identify specific allergens.
4. Ciliary function tests: These assess the movement of the tiny hair-like structures in the sinuses responsible for mucus clearance.

These advanced diagnostic tools allow ENT specialists to develop a comprehensive understanding of your sinus condition, leading to more targeted and effective treatment plans.

The Role of Biofilms in Chronic Sinusitis

Recent research has highlighted the role of biofilms in chronic sinusitis. Biofilms are communities of bacteria that adhere to surfaces and are notoriously difficult to eradicate with standard antibiotic treatments. ENT specialists are equipped to identify and address biofilm-related infections, which may require specialized treatments such as topical therapies or surgical intervention.

Multidisciplinary Approach to Sinus Health

Is sinus health influenced by factors beyond the sinuses themselves? Absolutely. ENT specialists often take a holistic approach to sinus health, considering various factors that can contribute to recurrent or chronic sinusitis. This may involve collaboration with other medical specialists, including:

• Allergists: To manage underlying allergic conditions
• Immunologists: To address potential immune system deficiencies
• Pulmonologists: For patients with coexisting respiratory conditions like asthma
• Dentists: To rule out dental infections that can affect the sinuses

This multidisciplinary approach ensures that all potential contributing factors are addressed, leading to more comprehensive and effective treatment strategies.

Emerging Treatments in Sinus Care

What cutting-edge treatments are available for chronic sinus problems? ENT specialists are at the forefront of implementing new, minimally invasive treatments for chronic sinusitis. Some of these innovative approaches include:

1. Balloon sinuplasty: A procedure that uses a small balloon to dilate sinus openings, improving drainage without removing tissue.
2. Steroid-eluting stents: Tiny devices placed in the sinuses that slowly release anti-inflammatory medication over time.
3. Photodynamic therapy: A treatment that uses light-activated agents to target and eliminate harmful bacteria in the sinuses.
4. Biologics: Advanced medications that target specific inflammatory pathways involved in chronic sinusitis, particularly effective for patients with nasal polyps.

These innovative treatments offer new hope for patients with recalcitrant sinus conditions that haven’t responded to traditional therapies.

The Promise of Personalized Medicine in Sinus Care

The field of ENT is increasingly embracing personalized medicine approaches. By analyzing individual patient factors such as genetic predispositions, microbiome composition, and inflammatory profiles, ENT specialists can tailor treatments to each patient’s unique characteristics, potentially improving outcomes and reducing the risk of recurrence.

Long-Term Management of Sinus Health

How can patients maintain sinus health after treatment? Managing sinus health is often an ongoing process. ENT specialists can provide guidance on long-term strategies to maintain sinus health and prevent recurrences. These may include:

• Nasal irrigation techniques
• Environmental modifications to reduce allergen exposure
• Dietary recommendations to support overall immune function
• Stress management techniques, as stress can exacerbate sinus problems
• Regular follow-up appointments to monitor progress and adjust treatments as needed

By implementing these strategies and maintaining open communication with your ENT specialist, you can take an active role in managing your sinus health and improving your quality of life.

The Impact of Sinus Health on Overall Well-being

How does chronic sinusitis affect overall health and quality of life? The impact of chronic sinus problems extends far beyond nasal symptoms. Patients with chronic sinusitis often report:

1. Decreased productivity at work or school
2. Sleep disturbances leading to fatigue and mood changes
3. Reduced sense of smell and taste, affecting enjoyment of food
4. Social isolation due to persistent symptoms
5. Increased risk of other respiratory conditions

By addressing chronic sinus issues with the help of an ENT specialist, patients can experience significant improvements in their overall well-being and daily functioning.

The Economic Burden of Chronic Sinusitis

The economic impact of chronic sinusitis is substantial, both for individuals and healthcare systems. Direct costs include medical treatments, surgeries, and medications, while indirect costs encompass lost productivity and reduced quality of life. Early intervention by an ENT specialist can potentially reduce these long-term economic burdens by providing more effective and targeted treatments.

Patient Education and Empowerment in Sinus Care

How can patients take an active role in managing their sinus health? ENT specialists emphasize the importance of patient education and empowerment in managing chronic sinus conditions. This may involve:

• Providing detailed information about the nature of sinusitis and its causes
• Teaching proper techniques for nasal irrigation and medication administration
• Discussing lifestyle modifications that can support sinus health
• Encouraging patients to track their symptoms and triggers
• Involving patients in shared decision-making about treatment options

By fostering a collaborative relationship between patient and specialist, ENT care can achieve better outcomes and higher patient satisfaction.

The Future of Sinus Care: Research and Innovation

What advancements can we expect in the field of sinus care? The field of ENT is continuously evolving, with ongoing research aimed at improving our understanding and treatment of sinus conditions. Some areas of current research include:

1. Genetic factors influencing sinus disease susceptibility
2. The role of the microbiome in sinus health and disease
3. Novel drug delivery systems for more targeted treatments
4. Artificial intelligence applications in diagnosis and treatment planning
5. Tissue engineering approaches for sinus reconstruction

These research directions hold promise for even more effective and personalized treatments for chronic sinus conditions in the future.

The Role of Telemedicine in Sinus Care

The recent expansion of telemedicine has also impacted ENT care. While some aspects of sinus evaluation require in-person examination, telemedicine can play a valuable role in follow-up care, medication management, and patient education. This can improve access to specialist care, particularly for patients in remote areas or with mobility limitations.

In conclusion, understanding when to consult an ENT specialist for sinus problems is crucial for effective management of these common but potentially debilitating conditions. By recognizing the signs that indicate a need for specialized care, patients can access advanced diagnostic techniques and treatment options, leading to improved outcomes and quality of life. As research continues to advance our understanding of sinus health, we can look forward to even more innovative and effective approaches to managing these complex conditions.

When to See an ENT Specialist for Your Sinuses

Posted on November 30, 2020 by The Center for ENT

Article written by Dr. Samuel Ross Patton MD

Sinusitis is one of the most common medical conditions affecting adults in the United States. Americans experience nearly 29 million sinus infections per year. Stuffy nose, fever, facial pain, headache, discolored drainage and post-nasal drip can be all-too-familiar as most people get sick with an upper respiratory or sinus infection once or twice a year. Many of these infections can be successfully treated with over-the-counter medications. Some sinus infections, however, require a prescription from your primary care provider for antibiotics. So, when should you see an ENT/Sinus specialist? 

1.  You have symptoms frequently throughout the year.

It is normal to get sick with an upper respiratory or sinus infection a couple times per year.  We all get sick from time to time; unfortunately, it’s part of the human condition. Experiencing sinusitis four or more times per year is more than usual. This is especially a problem if each infection requires antibiotics to treat it. Although antibiotics are quite safe and effective, frequent use of antibiotics can lead to trouble. Antibiotics, like all medications, can have side effects and using too many antibiotics puts you at risk for developing resistant bacteria.  

2.  Your symptoms never fully go away.

Most episodes of sinusitis resolve within 14 days. The vast majority of these infections run their course and you get back to your old self. Occasionally, a sinus infection will never fully go away; even after taking antibiotics. Feeling like you never get all the way back to normal between sinus infections could be a sign of chronic sinusitis- a long term sinus infection that smolders for months or even years. Chronic sinusitis may require advanced treatment with an ENT/Sinus specialist.   

3. Your symptoms are very severe. 

Being sick is no fun. It’s uncomfortable, irritating, and sometimes downright miserable. Fortunately, for most sinus conditions the worst of it comes and goes over the period of a few days. Many adults are still able to motor through their normal routines without taking time off. Typical sinus infections, however, are not debilitating. Taking lots of time off work for sinus symptoms is a red flag for having a severe problem. Similarly, requiring trips to urgent care or the emergency room because your symptoms are unbearable is another good indicator you need help. 

4. You don’t improve with treatment.

Anyone who has taken antibiotics knows that they don’t work instantly. It usually takes two to three days for them to kick in. What happens if you don’t feel better after taking antibiotics? If you have been sick for less than 14 days, you may just have a virus—which won’t respond to any antibiotics.  If your symptoms last longer than two weeks and don’t get better with antibiotics, you may require evaluation by an ENT specialist. Some sinus infections are caused by bacteria that are resistant to certain antibiotics. Getting a culture from the sinuses helps your doctor know which antibiotic to use. In some circumstances, medication alone can’t get rid of a sinus problem. 

Sinus symptoms can evolve slowly over time. As a patient, it can be difficult to perceive the change from one day to the next. This may make it hard to tell when a sinus condition crosses the line between the expected course and going off the rails. With these guidelines you will know when to see an ENT/Sinus specialist and get the care you need.   

If you think it may be time to see an ENT/Sinus specialist, click here or call (713) 795-5343 to schedule an appointment today. 

Sinus Infection: Symptoms, Causes, and Treatment

Sinusitis can cause facial pressure, sinus headache, and other symptoms. Treatment may depend on the cause.

A sinus infection, also known as sinusitis or rhinosinusitis, occurs when your nasal cavities become infected, swollen, and inflamed. Fluid buildup in the sinuses can cause germs to grow, leading to a sinus infection.

Sinusitis is usually caused by a virus and often lasts even after other upper respiratory symptoms are gone. In some cases, bacteria — or, rarely, fungi — may cause a sinus infection.

The type of sinus infection you have depends on how long it lasts and how often you get it.

• Acute sinusitis: This type of sinus infection lasts less than 4 weeks, according to the American Academy of Otolaryngology. It’s usually part of a cold or other respiratory illness. It may also be caused by a bacterial infection (acute bacterial sinusitis).
• Subacute sinusitis: A subacute sinus infection lasts between 4 and 12 weeks.
• Recurrent acute sinusitis: An acute sinus infection is considered recurrent if the infection returns four or more times within a year, with each infection lasting 7 days or more.
• Chronic sinusitis: Chronic sinus infections last for more than 12 weeks or continue to recur.

What can be mistaken for a sinus infection?

Other conditions such as allergies, nasal polyps, and tooth infections can also cause sinus pain and symptoms.

Sinusitis symptoms can be similar to cold symptoms. But it may also cause:

• facial pain or pressure
• infected nasal discharge
• nasal congestion

Symptoms of acute infections last at least 10 days without improving or worsen within 10 days after seeming to improve. A general practitioner or an ear, nose, and throat doctor (ENT) can provide a treatment plan.

Pain or pressure in your sinuses

Your sinuses above and below your eyes and behind your nose can cause facial pain. You may feel pain in:

• your forehead
• on either side of your nose
• in your upper jaws and teeth
• between your eyes

This may lead to a sinus headache, a headache on the top of the head, or an earache.

Tenderness in the face

Your face may also be tender to the touch. This can occur:

• at the bridge of the nose
• under the eyes
• on the forehead and cheeks

Runny nose and postnasal drip

You may need to blow your nose often because of nasal discharge. It may appear:

• cloudy
• green
• yellow
• pink-tinged with blood, due to frequent blowing

Discharge may also drain down the back of your throat, causing postnasal drip. It can cause symptoms that include:

• coughing at night when you’re lying down to sleep
• coughing in the morning after getting up
• hoarseness
• tickle in your throat
• sore throat

Nasal congestion

You may have swelling in your sinuses and nasal passages that lead to a “blocked“ feeling.

Because of the nasal congestion, you probably won’t be able to smell or taste as well as normal. Your voice may also sound “stuffy.”

Sinus headaches

Persistent pressure and swelling in your sinuses can give you symptoms of a headache. It can be worse:

• after lying down
• when barometric pressure changes
• when changing the position of your head

Throat irritation and cough

Postnasal drip can cause irritation and may lead to a persistent cough. It can be worse when lying down to sleep or after getting up from bed. It can also make sleeping difficult.

Sore throat and hoarse voice

Mucus can irritate your throat as it drips, resulting in a sore throat and hoarse voice. Frequent coughing and throat clearing can make it worse.

Fever

While not common, a low grade fever, meaning 100.4 to 103°F (38 to 39.4°C), may also occur with sinusitis.

Bad breath (halitosis)

The mucus that’s produced by your infected sinuses can smell bad and drip down the throat into the mouth.

Treatment for sinus infections may vary depending on how severe the infection is and how long it lasts.

Over-the-counter (OTC) medications

Using a nasal decongestant spray, such as oxymetazoline, can help relieve sinus infection symptoms in the short term. But you should limit your use to no more than 3 days. Prolonged use can make your symptoms worse.

A steroid nasal spray such as fluticasone (Flonase) or triamcinolone can help with nasal congestion symptoms without the risk of rebound symptoms from prolonged use.

OTC antihistamines and decongestants can help with sinus infections, particularly if you also experience allergies. Options can include:

• Sudafed
• cetirizine (Zyrtec)
• fexofenadine (Allegra)
• loratadine (Claritin)

Decongestants are typically not recommended for people with:

• high blood pressure
• prostate issues
• glaucoma
• sleep difficulties

Consider talking with a doctor before taking any of these medications to make sure they are the best choice for your situation.

Nasal irrigation

Flushing out the nostrils may help people with chronic rhinosinusitis and other types of sinus infections.

Because using unfiltered tap water can lead to a fatal infection, according to the Centers for Disease Control and Prevention (CDC), experts recommend:

• if using tap water, boiling the water and allowing it to cool
• using a water filtration system
• buying distilled water
• using OTC premixed solutions

Learn how to do nasal irrigation with a Neti Pot.

Herbal treatments

Some studies (including a 2013 study of people with acute bronchitis and a 2017 study of children with acute sinusitis) suggest that herbal treatment may help treat acute and chronic sinusitis. These treatments include the product GeloMyrtol forte (sold as Myrtol 300 in the United States), an oral capsule of essential oils, and Sinupret, an oral mixture of herbs.

Additional research is needed to compare herbal treatments with other methods. If you’re considering herbal remedies, be sure to talk with a doctor about which treatment options are right for you.

Antibiotics

Antibiotics like amoxicillin treat acute sinusitis caused by a bacterial infection that has not resolved with other treatments.

Before prescribing antibiotics, a doctor may practice “watchful waiting,“ which involves monitoring a sinus infection to determine its cause before prescribing antibiotics. Antibiotics only treat bacterial sinus infections.

A doctor may prescribe antibiotics for a bacterial sinus infection that has lasted 10 days or more without symptoms improving, or if symptoms seem to improve but then get worse within 10 days.

Other remedies for symptom relief

You may be able to find relief with home remedies that include:

• staying hydrated
• drinking hot liquids like tea and broth
• breathing in moist air in the shower or with a humidifier
• resting your voice
• sleeping upright with your head elevated
• using sinus rinses
• using a warm compress

You may be able to prevent sinus infections or reduce their frequency. Steps can include:

• quitting smoking, if you smoke, which can make you especially prone to sinus infections
• avoiding pollutants, including second-hand smoke and chemicals
• washing your hands frequently, especially during cold and flu seasons
• diagnosing and treating allergies
• diagnosing and treating other health conditions such as gastroesophageal reflux disease (GERD) or enlarged adenoids, which tends to affect children and teens

If you’re allergic to something that causes persistent sinus symptoms, you will likely need to treat your allergies to relieve your sinus infection.

An allergy specialist can help determine the cause of the allergy. They may suggest:

• avoiding the allergen
• taking oral medications such as antihistamines
• doing allergic immunotherapy

A sinus infection may improve on its own. But in some cases, it may get worse.

While uncommon, if a sinus infection affects a sinus cavity close to the brain, it can spread to the space around the brain. Though rare, an infection can also pass into the eye socket and cause vision changes or blindness. These types of infections are more common in people with compromised immune systems.

While uncommon, a serious fungal sinus infection left untreated may pass into the bones.

Make an appointment with a doctor if you have severe symptoms, or if your symptoms last longer than 10 days or keep coming back.

Because the cause of your sinus infection can affect your treatment options, it’s important to see a doctor for a diagnosis. The Healthline FindCare tool can provide options in your area if you’re looking for a doctor.

If you may have chronic or recurring sinusitis, an otolaryngologist, also known as an ear, nose, and throat (ENT) specialist, may use imaging and other tests to determine the cause.

You could also have an underlying condition that causes chronic infections and needs special treatment.

Conditions that cause chronic infections may include:

• nasal polyps
• deviated septum
• allergies
• other medical conditions

When it’s an emergency

Rarely, symptoms like those of a sinus infection may occur with serious health conditions. You may need urgent medical care if you experience any symptoms of a more serious infection, such as:

• a fever over 103°F (39.4°C)
• confusion
• stiff neck
• changes in vision
• other related symptoms that are concerning or severe
• lethargy

Was this helpful?

It’s common for children to have allergies and to be prone to infections in the nose and ears.

Your child may have a sinus infection if they have the following symptoms:

• a cold that lasts over 7 days with a fever
• swelling around eyes
• thick, colored drainage from the nose
• postnasal drip, which can cause bad breath, coughing, nausea, or vomiting
• headaches
• earaches

A pediatrician can determine the best course of treatment for your child. Treatment can include:

• nasal sprays
• saline sprays
• pain relief medication

Do not give OTC cough or cold medicines or decongestants to your child if they’re under 2 years old.

Most children will fully recover from a sinus infection without antibiotics. Antibiotics are used for severe cases of sinusitis or in children who have other complications because of sinusitis.

If your child doesn’t respond to treatment or develops chronic sinusitis, a doctor may recommend that they see an ENT doctor. Enlarged adenoids may also cause sinusitis and similar symptoms.

Sinus infections often start to improve on their own after about 10 days. If your symptoms last longer without improving or worsening, a doctor may need to treat the underlying cause of the infection. Acute sinusitis usually goes away within 1 to 2 weeks with proper treatment.

Chronic sinusitis may require seeing a specialist or having long-term treatment to address the cause. An episode of chronic sinusitis can last longer than 12 weeks. Practicing good hygiene, keeping your sinuses moist and clear, and treating symptoms immediately can help shorten the course of the infection.

Sinus infections can cause uncomfortable symptoms like pressure and congestion. They may go away with home care but sometimes require medical treatment.

Sinus infections that occur often may be due to an underlying condition.

The problem with the maxillary sinuses – how can a dentist help?

Imagine the situation, the patient came to the dentist with a bad tooth, and he is sent to the ENT. Sometimes the opposite happens, the patient has a chronic runny nose, and the ENT sends him to treat his teeth. Where is the connection?

Dial-Dent Family Dental Center understands the relationship between processes in the body, and in particular, the relationship between dental diseases and problems in the sinuses. When contacting a patient who has problems with the upper teeth, a specialist can refer him to a CT scan of the sinuses. In order to properly plan the treatment of patients with problems of the upper teeth, a complete diagnosis is necessary, as a result of which the doctor will be able to refer the patient to the right specialist.

Commentary by the chief physician of Dial-Dent S.V. Zukora: “The whole organism is divided by medicine into organs, organ systems. Historically, each organ system, or sometimes even an individual organ, has been the responsibility of a physician with a specialty. For example, a cardiologist is responsible for the heart, etc. The modern World is faced with a problem: doctors cannot agree among themselves in the treatment of complex interdisciplinary problems. The quality of diagnosis and treatment is falling. In fact, all human problems are complex, interdisciplinary and non-systemic. There are very few teams of doctors who can unite their efforts for the benefit of the patient! I am glad that I was able to gather such a team at the Dial-Dent Family Dental Center!”

You can find out the condition of the teeth and maxillary sinuses by taking a panoramic picture of the teeth or x-ray of the maxillary sinuses. For a deeper diagnosis, Dial-Dent performs computed tomography of the sinuses. CT is performed on a modern Samsung cone beam tomograph.

Computed tomography of the sinuses reflects the condition of the upper teeth, surrounding bones, temporal joints and respiratory tract. All this is important for drawing up an optimal treatment plan in order to eliminate the cause of the problem and obtain a stable positive result of treatment. Andrey Arkhandeev, an ENT, who is a candidate of medical sciences, works at the Dial-Dent Family Dental Center. In complex cases (requiring complex surgery or hospital conditions), patients are referred to highly qualified specialists with whom Dial-Dent cooperates. Dentists refer the patient to the ENT if it is necessary to clarify the condition of the sinuses. In turn, the ENT refers patients for dental treatment if a dental source of the problem is identified. With such interaction of specialists, the patient receives the right treatment and does not waste too much time.

Conditions such as a maxillary sinus cyst, a foreign body in the maxillary sinus, some problems of the maxillary sinuses require the close attention of two specialists: both a dentist and an ENT familiar with dental issues. A foreign body can get into the maxillary sinus with improper filling of the roots of the teeth or with unsuccessful tooth extraction, and a dental implant can also protrude into the sinus with improperly planned implantation of the upper teeth. All this can lead to inflammation in the sinuses and the appearance of ENT symptoms. Such a patient goes to the ENT and unsuccessfully treats the inflammation, and the dental problems remain unresolved. A tooth cyst can also cause a change in the condition of the maxillary sinus and the ENT should refer this patient to the dentist. If the cyst in the maxillary sinus is not associated with the condition of the teeth, then it is treated exclusively by the ENT.

When the interaction between the ENT and the dentist is not established, the patient is driven back and forth, from one specialist to another, and everyone says that the problem is not in his competence. This does not happen in Dial-Dent, since the interdisciplinary knowledge of dentists is very high, and the ENT, to which the dentist referred the patient, knows that all dental issues are excluded.

A girl applied to the Dial-Dent Family Dental Center for dental treatment. Since during the consultation the doctor found out that the patient had a chronic runny nose and frequent headaches, the patient underwent computed tomography of the sinuses to clarify the diagnosis. According to the results of CT of the sinuses, an inflammatory process was detected in the left maxillary sinus (on CT, the sinus is not dark, as it should be in a normal state, but light).

The cause of the inflammation was the upper tooth, the roots of which developed inflammation due to poorly treated canals (shown by the arrow on the CT fragment):

Commentary by the chief physician of Dial-Dent S.V. Zukora: “Dental problems were part of the overall picture of the disease, in which the patient’s ENT system was also very badly affected. Due to the presence of interdisciplinary-minded doctors in Dial-Dent and the availability of an excellent computer tomograph, we did not focus only on solving dental problems, which in this case would not have been possible to solve without the closest interaction with the ENT doctor! One of the teeth of the upper jaw was in poor condition and led to inflammation in the maxillary sinus – sinusitis. It was necessary to develop a strategy for managing the patient jointly with the ENT doctor. Dentists from Dial-Dent, together with an ENT surgeon, were able to develop the right treatment strategy.”

Doctors have developed two treatment options.

First variant

Removal of the causative tooth – surgeon. Then the treatment of sinusitis is performed by the ENT. Then the installation of a dental implant and prosthetics – a surgeon and an orthopedic dentist.

Second variant

Saving a tooth by retreating the canals of the tooth with a microscope at Dial-Dent. Treatment of a tooth under a microscope will completely eliminate the source of infection that caused sinusitis. The tooth will be covered with a temporary crown. Then the ENT doctor will treat sinusitis. With a positive result, the tooth will be covered with a permanent ceramic crown for many years of service.

Behind each of the options were many hours of interdisciplinary discussions, disputes, the study of medical records and computed tomography data. Monthly “Round Tables” held in “Dial-Dent” are very helpful in solving non-standard, difficult cases.

In the end, the second option was chosen!

The dentist-endodontist carried out retreatment of the canals of the tooth under a microscope, carefully removed all the remnants of the infection in the dental canals using special endodontic instruments. The channels were treated with antimicrobials and ultrasound. Complete removal of infection in the canals of the teeth is achieved by temporary filling of the canals with special tools. After the infection in the canals was eliminated, they were hermetically sealed to prevent harmful bacteria from entering from the outside. The tooth is covered with a temporary filling. Root canal treatment under a microscope is an excellent alternative to tooth extraction. Inflammation at the roots stops, and the bone tissue around the roots of the tooth is restored. After proper canal treatment, the tooth serves for many years.

Root canal treatment was the first stage of interdisciplinary treatment aimed at restoring and maintaining the health of the patient.

Due to the fact that the Family Dental Center “Dial-Dent” works closely with the best specialists, the patient was referred to the Central Clinical Hospital of the Administration of the President of the Russian Federation to Ksenia Eldarovna Klimenko. Ksenia Eldarovna Candidate of Medical Sciences, otolaryngologist of the first category, member of the American Academy of Otorhinolaryngology of Head and Neck Surgery, official reviewer of the American printed publication “International Forum of Allergy and Rhinology”, has been successfully cooperating with our center for ENT problems for a long time. According to the CT scan of the sinuses, which was done at Dial-Dent, Ksenia Eldarovna diagnosed the patient with chronic bilateral maxillary ethmoiditis, deviated nasal septum, and chronic rhinitis. In a planned manner, endoscopic surgery was performed on the maxillary and ethmoid sinuses, as well as septoplasty (surgery to eliminate the curvature of the nasal septum in order to improve breathing) and submucosal vasotomy of the inferior turbinates (surgery on the vessels of the nasal mucosa to reduce swelling and restore physiological nasal breathing) .

After the operation was performed, the team of interclinical specialists waited the necessary time to find out that the operation was successful. Since the condition of the maxillary sinuses improved markedly, the tooth did not bother and the ENT symptoms disappeared, the dentists proceeded to the last stage of treatment – the tooth was closed with a ceramic crown for reliable restoration.

Six months after such a complex interdisciplinary treatment, a repeated CT scan of the sinuses was made (computed tomography of the sinuses was performed at Dial-Dent). Sinus ventilation and nasal breathing have fully recovered, the condition of the roots of the teeth is normal:

See other examples of the work of specialists of the Dial-Dent Family Dental Center here.

Sign up for a consultation by phone +7-499-110-18-04 or through the form on the website. You can ask questions about dental prosthetics to the head doctor of the clinic Sergey Vladimirovich Zukor on his page in
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Odontogenic sinusitis – diagnosis and treatment, stages of surgery

Odontogenic sinusitis – inflammation of the maxillary sinuses, which develops from infected teeth of the upper jaw. The penetration of the infection is also facilitated by dental manipulations in the area of ​​the maxillary sinuses – treatment and extraction of teeth, implantation and sinus lifting. Without identifying and eliminating the cause, standard treatment by an ENT doctor in a clinic does not bring results. Treatment of odontogenic infections should be comprehensive!

Doctor Levin has been specializing in the treatment of patients with combined ENT and dental pathologies for more than 20 years. Comprehensive rehabilitation programs are carried out by maxillofacial surgeons with otolaryngological training.

Causes of odontogenic sinusitis

The maxillary sinuses (maxillary sinuses) are separated from the oral cavity by a thin bone layer, in which the roots of the upper chewing teeth are located. Such close proximity carries the threat of infection of the sinuses. In 15% of cases, the root tips are anatomically located under the sinus mucosa, without a bone layer, which further increases the risk of developing odontogenic sinusitis.

Conventionally, the causes can be divided into 2 categories:

Untimely dental treatment

In case of pulpitis, periodontitis, the infection from the dental canals slowly but surely spreads to the surrounding bone tissues. Without treatment, the foci of infection grow, melt the bone septum, opening the “gate” for the penetration of pathogenic microflora. In neglected situations, cysts form on the roots of the teeth, and when the bone barrier is destroyed, they grow into the sinus.

Medical errors

As a result of dental errors, mechanical damage to the sinus floor (perforated form of the disease) is possible. As a result – the formation of a message with the sinus, the penetration of foreign bodies with a response of the body in the form of odontogenic sinusitis.

The most common treatment errors, after which patients turn to our Center:

How to avoid

There are only two ways to prevent the development of odontogenic sinusitis:

1. Timely treat teeth, prevent infection of the dental canals and the spread of inflammation beyond the apex of the tooth root.
2. Contact trusted clinics with experienced doctors, the ability to conduct a thorough diagnosis and provide for an emergency situation.

In our Center, not a single dental procedure, especially at the border with the maxillary sinuses, is performed without a thorough X-ray examination on a CT scanner.

The study is carried out on a high-precision device Sirona with a diagnostic software package Galileos

Based on the results of computed tomography, we determine the location of the roots, the size of the bone septa. This makes it possible to plan treatment in such a way as to avoid risks.

Dental extractions and other interventions in the area of ​​the maxillary sinuses in our Center are performed only by maxillofacial surgeons with ENT training . Deep knowledge of the anatomy of the maxillary region allows you to avoid mistakes that a regular dentist can make. But each case is individual, and even if something goes wrong, our doctors are always ready for any turn of events and to correct the situation.

Symptoms of odontogenic sinusitis

Inflammation from infected teeth develops gradually and is usually asymptomatic in the initial stages. If dental treatment was performed, the symptoms may also not appear immediately – it all depends on the body’s immune system, reactions to foreign bodies. There are times when sinusitis does not make itself felt for several years.

But sooner or later the infection will make itself known. Symptoms of odontogenic sinusitis practically do not differ from rhinogenic (when the infection enters through the nose as a result of a cold, flu or SARS):

An unsuspecting patient first of all turns to the ENT, and then to the dentist. However, there are moments that indicate the odontogenic origin of sinus inflammation:

• soreness of the chewing teeth of the upper jaw, especially when chewing
• there was a treatment or extraction of teeth on the border with the sinuses
• implants were installed or a sinus lift was performed

9000 2 The most main distinguishing feature – only one sinus bothers , which is associated with diseased teeth or dental treatment. In this case, first of all, you need to solve problems of a dental nature. As a rule, the symptoms of sinusitis disappear within two weeks after the source of inflammation has been eliminated.

What is the danger of the disease

Without proper treatment, a chronic inflammatory process develops in the sinus with pathogenic microflora that destroys the sinus mucosa and surrounding bone tissues. Since the maxillary sinuses are close to anatomically important structures, severe complications can occur:

Foci of infection provoked by the presence of a foreign body can cause a precancerous condition.

Why it is worth entrusting treatment to the ENT department of dentistry

ENT dentistry is a symbiosis of two medical directions, a multidisciplinary approach in the treatment of inflammation of the maxillary sinuses of odontogenic origin. Only an experienced maxillofacial surgeon with ENT training can make an accurate diagnosis and draw up an informed rehabilitation plan.

As a rule, odontogenic causes of sinusitis are simply ignored during a routine examination by an otolaryngologist. Treatment in a city clinic without high-quality diagnostics or in the absence of it at all turns into a serial series with monthly visits to an ENT doctor, drags on for many years, causing inconvenience and worsening the quality of life.

Unified drug therapy or traumatic sinus punctures are prescribed, which, if they bring relief, then for a short time. Inflammation from the acute stage becomes chronic with periodic exacerbations. A person runs from one doctor to another in vain, but odontogenic sinusitis cannot be cured without identifying and eliminating the cause !

Diagnosis

The odontogenic form of sinusitis often remains undiagnosed by ENT specialists due to the lack of high-precision diagnostics and the banal ignoring of the “dental” cause of the disease. Such gaps lead to the fact that even after medical and surgical treatment, a person continues to suffer.

Differential diagnosis is extremely important, which allows you to determine the form of sinusitis and select the appropriate treatment.

Computed tomography alone provides informative 3D images for visualization of bone and adjacent soft tissues, dental conditions, presence of foreign bodies and neoplasms in the sinus.

In our Center, CT is performed on a Sirona Gallileos dental tomograph with ENT-mode settings.

In some cases, a study of the microbial composition of the sinus membrane will be required to exclude a malignant process.

How to treat

Treatment tactics differ depending on the cause of sinusitis, but the goal is the same – to eliminate the source of infection

Maxillary sinus access protocol is selected according to the clinical situation:

We do not welcome punitive surgery!

Do not use saws, chisels or drills. We use gentle ultrasonic technology – the bone tissue is not broken out barbarously, but softened, the infected tissues are delicately removed. All operations on the sinuses in our Center only in sedation – without pain and nervous tension .

Levin Dmitry Valerievich

Chief Physician and Founder of Doctor Levin

Stages of treatment

We strive to carry out all activities in a comprehensive manner in one day, so as not to delay the patient

1. Sanitation of the oral cavity
   Preparation for maintaining sterility during the operation to avoid secondary infection – retreatment of compromised teeth, hygienic cleaning.
2. Operation
   Performed by an maxillofacial surgeon in a sterile operating unit of the ENT department – “in sleep”, according to the selected access protocol. A follow-up CT scan is required after surgery.
3. Prosthetics
   If the protocol provides for the extraction of teeth, we install temporary orthopedic structures to close the aesthetic defect so as not to leave the patient without teeth.

Recovery after surgery

Without hospitalization

Staying in the hospital for 2-3 days after surgery (as happens in city hospitals) is not required.

Gentle operation protocols, use of modern functional equipment and microscope allows for the most delicate treatment .

All surgeries are performed in a controlled drug-induced sleep – this is not general anesthesia ! The exit from the state is easy, without dizziness, memory loss or clouding of consciousness. The drugs are absolutely safe for the body, they are excreted naturally 40 minutes after the supply is stopped.

For patients with vascular and cardiological problems, day hospital is provided, where you can calmly recover and recover under the supervision of our anesthesiologist-resuscitator.

Accelerated rehabilitation

Recovery after the intervention takes place within a week. For those who want to speed up the process, our Center provides a set of procedures to reduce pain, resolve hematomas and edema – performed on the day of surgery.

Microcurrent Therapy

Low frequency currents act on the cellular level. They improve metabolism, relieve muscle spasm, remove swelling and bruising.

Facial biostimulation

Biomodulators have a lymphatic drainage and anti-inflammatory effect, tighten the contours of the face, reduce swelling.

Plasma therapy PRP

Enriched blood plasma improves tissue regeneration and metabolic processes. Relieves inflammation, eliminates puffiness, bruising.

Home care

Medications are prescribed – antibiotics, painkillers and decongestants. To prevent the patient from running around pharmacies in the postoperative state and to avoid purchasing counterfeit products “on the side”, the entire package of drugs is collected and dispensed free .

The package contains all the necessary preparations for taking and caring for the surgical area.

Please follow the recommendations and do not skip taking medications in order to avoid complications. The instructions are in the package with medicines.

If you suspect a worsening condition, contact the clinic immediately. The phone number of the 24-hour patient support service is indicated in the memo.

Frequently Asked Questions

Can odontogenic sinusitis be treated with antibiotics?

Without removing the source of the infection, antibiotic therapy is useless, and in some cases even dangerous.