How often do sinus infections occur before it’s considered abnormal. What are the signs of chronic sinusitis. When should you consult an ENT specialist for sinus problems. How long does a typical sinus infection last. What are severe symptoms of sinusitis that require immediate attention. Why might antibiotics fail to treat a sinus infection. How can you tell if your sinus condition is worsening over time.

Understanding Sinusitis: Types and Prevalence

Sinusitis, also known as a sinus infection or rhinosinusitis, is an inflammation or swelling of the tissue lining the sinuses. It’s one of the most common medical conditions in the United States, with Americans experiencing nearly 29 million sinus infections annually. But what exactly constitutes sinusitis, and when does it become a cause for concern?

There are several types of sinusitis, categorized based on duration and frequency:

• Acute sinusitis: Lasts less than 4 weeks
• Subacute sinusitis: Lasts between 4 and 12 weeks
• Chronic sinusitis: Lasts more than 12 weeks
• Recurrent acute sinusitis: Four or more acute infections within a year

While most people experience one or two sinus infections a year, frequent occurrences may indicate a more serious underlying condition. Understanding the difference between normal and abnormal sinus infection frequency is crucial for proper management and treatment.

Recognizing Symptoms: When Sinusitis Becomes Problematic

Sinus infections can present with a variety of symptoms, ranging from mild discomfort to severe pain. Common symptoms include:

• Nasal congestion
• Facial pressure or pain
• Headache
• Discolored nasal discharge
• Post-nasal drip
• Fever

While these symptoms are typical of most sinus infections, certain signs may indicate a more serious condition requiring specialized attention. How can you differentiate between a routine sinus infection and one that necessitates a visit to an ENT specialist?

Frequency of Symptoms

Experiencing sinusitis four or more times per year is considered more than usual. If you find yourself battling sinus infections frequently throughout the year, it may be time to consult a specialist. This is especially true if each infection requires antibiotics for treatment.

Persistent Symptoms

Most sinus infections resolve within 14 days. If your symptoms never fully go away, even after taking antibiotics, you may be dealing with chronic sinusitis. This long-term condition can persist for months or even years, significantly impacting your quality of life.

Severity of Symptoms

While sinus infections are uncomfortable, they shouldn’t be debilitating. If you find yourself taking significant time off work or requiring trips to urgent care due to severe symptoms, it’s a clear indicator that you need specialized help.

The Role of Antibiotics in Sinus Infection Treatment

Antibiotics are often prescribed for sinus infections, but they’re not always the answer. Why might antibiotics fail to treat a sinus infection? There are several reasons:

1. Viral cause: Most sinus infections are caused by viruses, which don’t respond to antibiotics.
2. Antibiotic resistance: Some bacteria may be resistant to certain antibiotics.
3. Underlying conditions: Chronic sinusitis or structural issues may require more than just antibiotics.

If you don’t improve after taking antibiotics, or if you require frequent courses of antibiotics, it’s time to consider seeing an ENT specialist. They can perform cultures to determine the exact cause of your infection and prescribe the most effective treatment.

When to Consult an ENT Specialist for Sinus Problems

Knowing when to transition from self-care or primary care to specialized treatment is crucial for managing sinus health effectively. Here are key indicators that it’s time to see an ENT specialist:

• Symptoms persist for more than 12 weeks
• You experience 4 or more sinus infections per year
• Antibiotics fail to resolve your symptoms
• You have severe symptoms that significantly impact your daily life
• You develop complications such as visual changes or severe headaches

An ENT specialist can offer advanced diagnostic tools and treatments that go beyond what’s available in primary care settings. These may include nasal endoscopy, CT scans, and specialized treatments like balloon sinuplasty or functional endoscopic sinus surgery (FESS).

Advanced Diagnostic Techniques for Chronic Sinusitis

Diagnosing chronic sinusitis often requires more than just a physical examination. ENT specialists employ various advanced techniques to get a clear picture of your sinus health:

Nasal Endoscopy

This procedure involves inserting a thin, flexible tube with a camera into the nasal passages. It allows the doctor to visualize the inside of your sinuses and identify any structural abnormalities or signs of chronic inflammation.

CT Scans

Computed tomography (CT) scans provide detailed images of your sinus cavities, helping to identify blockages, polyps, or other issues that may not be visible through endoscopy alone.

Allergy Testing

Since allergies can contribute to chronic sinusitis, your ENT may recommend allergy testing to identify potential triggers.

Sinus Cultures

In cases where antibiotics have been ineffective, a culture can help identify the specific bacteria causing the infection and determine the most appropriate antibiotic.

Treatment Options for Chronic and Recurrent Sinusitis

Once a proper diagnosis is made, your ENT specialist can recommend a tailored treatment plan. This may include:

• Targeted antibiotic therapy based on culture results
• Corticosteroid nasal sprays to reduce inflammation
• Saline nasal irrigation to clear mucus and allergens
• Immunotherapy for allergy-related sinusitis
• Minimally invasive procedures like balloon sinuplasty
• Endoscopic sinus surgery for severe cases

The goal of treatment is not just to alleviate current symptoms but to prevent future recurrences and improve overall sinus health.

Preventing Sinus Infections: Lifestyle and Environmental Factors

While some sinus infections are unavoidable, there are steps you can take to reduce your risk:

1. Practice good hand hygiene to prevent the spread of viruses
2. Use a humidifier to keep nasal passages moist
3. Avoid known allergens and irritants
4. Quit smoking and avoid secondhand smoke
5. Manage allergies with appropriate medications
6. Use saline nasal sprays or rinses regularly
7. Stay hydrated to thin mucus secretions

By incorporating these preventive measures into your daily routine, you can significantly reduce the frequency and severity of sinus infections.

The Impact of Chronic Sinusitis on Quality of Life

Chronic sinusitis can have far-reaching effects on your overall well-being. How does persistent sinus inflammation affect daily life? Consider the following:

• Sleep disturbances due to nasal congestion and post-nasal drip
• Reduced productivity at work or school
• Chronic fatigue from ongoing inflammation
• Mood changes, including irritability and depression
• Social isolation due to frequent illness
• Decreased sense of smell and taste

Given these potential impacts, seeking specialized care for chronic or recurrent sinusitis is not just about treating symptoms—it’s about reclaiming your quality of life.

The Psychological Toll of Chronic Sinusitis

The persistent nature of chronic sinusitis can take a significant toll on mental health. Patients often report feelings of frustration, helplessness, and anxiety related to their condition. Addressing these psychological aspects is an important part of comprehensive sinus care.

Impact on Sleep and Energy Levels

Chronic sinus issues can severely disrupt sleep patterns. Nasal congestion and post-nasal drip can lead to snoring, sleep apnea, and frequent nighttime awakenings. This sleep disturbance often results in daytime fatigue, decreased concentration, and reduced overall energy levels.

Emerging Treatments and Research in Sinus Care

The field of otolaryngology is constantly evolving, with new treatments and technologies emerging to improve sinus care. What are some of the latest advancements in sinus treatment?

Biologics for Chronic Sinusitis with Nasal Polyps

For patients with chronic sinusitis and nasal polyps, especially those with concurrent asthma, biologic drugs targeting specific inflammatory pathways are showing promising results. These medications can significantly reduce polyp size and improve symptoms in patients who haven’t responded well to traditional treatments.

Minimally Invasive Procedures

Advancements in minimally invasive techniques continue to improve patient outcomes. Procedures like balloon sinuplasty can now be performed in-office under local anesthesia, offering quicker recovery times and less discomfort compared to traditional sinus surgeries.

Nasal Microbiome Research

Growing research into the nasal microbiome—the community of microorganisms living in the nasal passages—is opening new avenues for treatment. Understanding the role of beneficial bacteria in maintaining sinus health could lead to novel probiotic therapies for chronic sinusitis.

Personalized Medicine Approaches

The future of sinus care is moving towards more personalized treatment plans. Genetic testing and biomarker analysis may soon allow doctors to tailor treatments to individual patients, improving efficacy and reducing side effects.

As research continues to advance our understanding of sinus health and disease, patients with chronic or recurrent sinusitis can look forward to more effective and personalized treatment options. Staying informed about these developments and maintaining open communication with your ENT specialist can help ensure you receive the most appropriate and up-to-date care for your sinus condition.

The Importance of Long-Term Sinus Health Management

Managing sinus health is not just about treating acute infections—it’s about developing a long-term strategy to maintain optimal sinus function. What steps can you take to ensure long-term sinus health?

Regular Follow-ups with Your ENT Specialist

Even after successful treatment of chronic or recurrent sinusitis, regular check-ups with your ENT specialist are crucial. These appointments allow for early detection of any recurring issues and adjustment of your treatment plan as needed.

Adherence to Maintenance Therapies

For many patients with chronic sinus issues, ongoing maintenance therapies are essential. This may include daily use of nasal corticosteroid sprays, saline rinses, or other prescribed medications. Consistent adherence to these regimens can significantly reduce the risk of symptom recurrence.

Lifestyle Modifications

Long-term sinus health often requires ongoing lifestyle adjustments. This may include:

• Maintaining proper indoor air quality
• Managing allergies through avoidance strategies and medications
• Practicing stress reduction techniques, as stress can exacerbate sinus symptoms
• Adopting a diet that supports overall immune health

Monitoring Environmental Factors

Being aware of environmental triggers that may affect your sinus health is crucial. This includes keeping track of pollen counts, air quality indices, and weather changes that might impact your sinuses.

Education and Self-Management

Empowering yourself with knowledge about your condition and learning to recognize early signs of sinus problems can lead to more proactive management. Many ENT practices offer patient education programs to support this self-management approach.

By adopting a comprehensive, long-term approach to sinus health management, you can significantly reduce the frequency and severity of sinus issues, improving your overall quality of life. Remember, your ENT specialist is your partner in this journey, providing expert guidance and support as you work towards optimal sinus health.

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
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.