How often do sinus infections occur. What are the symptoms of chronic sinusitis. When should you see an ENT specialist for sinus problems. What treatments are available for recurrent sinus infections. How can you prevent sinus infections.

Understanding Sinusitis: Causes and Prevalence

Sinusitis, a common medical condition affecting millions of Americans annually, occurs when the nasal cavities become infected, swollen, and inflamed. This condition can be caused by various factors, including viruses, bacteria, and in rare cases, fungi. The prevalence of sinusitis in the United States is staggering, with approximately 29 million cases reported each year.

What exactly causes sinusitis. The primary culprits are:

• Viral infections (most common)
• Bacterial infections
• Allergies
• Structural issues in the nasal passages
• Environmental irritants

Understanding the root cause of your sinus problems is crucial for effective treatment and management. While most cases of sinusitis are viral and resolve on their own, some may require medical intervention, especially if they become chronic or recurrent.

Recognizing the Signs: When Sinus Problems Become Serious

While it’s normal to experience occasional sinus infections, certain signs indicate that your condition may require specialized attention. How can you tell if your sinus problems are more serious than a typical infection.

Frequency of Symptoms

If you find yourself battling sinus infections four or more times per year, it’s a red flag that shouldn’t be ignored. This frequency suggests a recurring issue that may need more advanced treatment than over-the-counter medications or standard antibiotics can provide.

Persistence of Symptoms

Most sinus infections clear up within 14 days. However, if your symptoms linger beyond this period or never fully resolve between infections, you may be dealing with chronic sinusitis. This condition can persist for months or even years if left untreated.

Severity of Symptoms

While sinus infections are uncomfortable, they shouldn’t be debilitating. If your symptoms are so severe that they significantly impact your daily life, causing you to miss work or require emergency medical attention, it’s time to consult a specialist.

Resistance to Treatment

Have you found that antibiotics or other treatments aren’t providing relief. This could indicate a more complex issue, such as antibiotic-resistant bacteria or structural problems in your nasal passages that require specialized care.

The Role of an ENT Specialist in Sinus Care

An Ear, Nose, and Throat (ENT) specialist, also known as an otolaryngologist, is uniquely qualified to diagnose and treat complex sinus conditions. These medical professionals have extensive training in the intricate anatomy of the sinuses and can offer advanced diagnostic tools and treatment options not available through primary care.

What can you expect when visiting an ENT specialist for sinus problems.

• Comprehensive evaluation of your sinus anatomy
• Advanced imaging techniques like CT scans
• Endoscopic examinations
• Allergy testing
• Customized treatment plans

ENT specialists can also perform minimally invasive procedures when necessary, such as balloon sinuplasty or endoscopic sinus surgery, to address structural issues contributing to chronic sinusitis.

Advanced Diagnostic Techniques for Sinus Problems

Accurate diagnosis is crucial for effective treatment of sinus conditions. ENT specialists employ a range of sophisticated diagnostic tools to pinpoint the exact nature of your sinus problems.

Nasal Endoscopy

This procedure involves inserting a thin, flexible tube with a camera into the nasal passages, allowing the specialist to visualize the sinuses and identify any abnormalities or blockages.

CT Scans

Computed tomography (CT) scans provide detailed images of the sinus cavities, helping to reveal structural issues or chronic inflammation that may not be visible through other means.

Allergy Testing

Since allergies can contribute to chronic sinus problems, ENT specialists often perform allergy tests to identify potential triggers and develop a comprehensive treatment plan.

Sinus Cultures

In cases of recurrent or antibiotic-resistant infections, a culture may be taken to identify the specific bacteria causing the problem and determine the most effective antibiotic treatment.

Treatment Options for Chronic and Recurrent Sinusitis

ENT specialists have a wide array of treatment options at their disposal for managing chronic and recurrent sinusitis. The choice of treatment depends on the underlying cause and severity of your condition.

Medical Management

This may include:

• Targeted antibiotic therapy based on culture results
• Corticosteroid nasal sprays to reduce inflammation
• Oral corticosteroids for severe cases
• Antihistamines and decongestants
• Saline nasal irrigation

Immunotherapy

For patients with allergies contributing to their sinus problems, immunotherapy (allergy shots) can help desensitize the immune system and reduce allergic reactions.

Minimally Invasive Procedures

When medical management isn’t sufficient, ENT specialists may recommend minimally invasive procedures such as:

• Balloon sinuplasty: A procedure that uses a small balloon to dilate the sinus openings
• Endoscopic sinus surgery: A technique to remove blockages and improve sinus drainage

Structural Corrections

In some cases, structural issues like a deviated septum may need to be surgically corrected to alleviate chronic sinus problems.

Preventing Sinus Infections: Proactive Measures

While not all sinus infections can be prevented, there are steps you can take to reduce your risk and manage your sinus health effectively.

Maintain Good Hygiene

Frequent handwashing and avoiding touching your face can help prevent the spread of viruses that often lead to sinus infections.

Manage Allergies

If you have allergies, work with your doctor to develop an effective management plan. This may include avoiding triggers, using air purifiers, and taking appropriate medications.

Use a Humidifier

Keeping the air in your home moist can help prevent the nasal passages from drying out, which can make you more susceptible to infections.

Practice Nasal Irrigation

Regular use of a neti pot or other nasal irrigation device can help flush out irritants and keep your nasal passages clear.

Quit Smoking

Smoking irritates the nasal passages and can increase your risk of sinus infections. If you smoke, quitting can significantly improve your sinus health.

Long-Term Management of Chronic Sinus Conditions

For those with chronic sinus problems, long-term management is key to maintaining quality of life and preventing complications. What strategies can help in the ongoing management of chronic sinusitis.

Regular Follow-ups

Maintaining regular appointments with your ENT specialist allows for ongoing monitoring and adjustment of your treatment plan as needed.

Lifestyle Modifications

Identifying and avoiding triggers, such as certain foods or environmental factors, can help reduce the frequency and severity of sinus symptoms.

Adherence to Treatment Plans

Consistently following your prescribed treatment regimen, whether it involves medications, nasal sprays, or other therapies, is crucial for managing chronic sinus conditions.

Stress Management

Stress can exacerbate sinus problems. Incorporating stress-reduction techniques like meditation or yoga into your routine may help improve overall sinus health.

Ongoing Education

Staying informed about the latest developments in sinus care and working closely with your ENT specialist can help you make informed decisions about your treatment options.

By understanding when to seek specialized care and taking proactive steps to manage your sinus health, you can significantly improve your quality of life and reduce the impact of chronic sinus problems. Remember, while occasional sinus infections are common, recurrent or severe symptoms warrant professional evaluation. Don’t hesitate to consult an ENT specialist if you’re concerned about your sinus health – early intervention can make a significant difference in managing these challenging 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

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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
VK.

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.