"Ask the Doctor": Sinus Problems

March 28, 2000

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Kclyn`: What can be done about sinus headache?

Dr Harold Reuter: First, a definite diagnosis of sinusitis must be made. If it is a documented sinus infection, then it needs to be treated with an antibiotic and a decongestant, which sometimes will have a mucus-thinning agent in it. When there is allergic involvement, an antihistamine is necessary. Nose sprays are helpful; most of these are decongestants, including the long-acting, 12-hour sprays - Afrin is one, there are many others that contain the same medication, such as 12-hour Neosenephrin, 12-hour Dristan, and Duration. Most of the generic decongestant nose-sprays are the same medication, which is oxymetazoline. There are a number of local-acting steroid sprays that are helpful in short and long-term treatment. These include such sprays as Flonase, Nasocort, Nasonext, Rhinocort, Beconase, and Vancinase. Analagesics are certainly very helpful, such as ibuprofen, Tylenol, and Alleve -- which is not ibuprofen.

Pepsigirl: Will my chances of contracting sinusitis be decreased if I take allergy medicine like Claritin?

Dr Harold Reuter: If there's a question of diagnosis a definitive way of making sure it's sinusitis is getting an x-ray. A plain x-ray has the disadvantage of everything in the head being compressed into one thin plane. So, more often, we will have a CT scan made. The CT scan is a much better study for diagnosing sinusitis than an MRI. We can discuss definitive treatment such as surgery later. Usually, a sinus infection will begin as an upper-respiratory infection, such as a cold. However, allergies can present a problem and make more swelling around the sinus openings and make you more susceptible to infections. In this case, medications such as Claritin or Claritin D, are helpful to decrease inflammation around the sinus openings in the nose and within the membranes within the sinuses.

Dolphins-Dream: Why is sinusitis increasing?

Dr Harold Reuter: Sinusitis is not actually increasing, except in areas where there is more pollution in the air. It is usually worse during the winter, when more people have upper-respiratory infections which then become sinus infections. But there is no actual increase in the cases of sinusitis in the last few years.

Daisygirley: It seems like every stuffed nose is blamed on sinuses. Is the problem as widespread as it seems?

Dr Harold Reuter: Sinus infection can be a product of a stuffy nose, when the membranes in the sinus openings are swollen and obstruct the free flow of air into the sinus. Since sinus cavities are air-containing, when the openings are blocked and there are bacterial organisms present in the nose that can cause sinusitis. Nasal stuffiness can be caused by many things, including allergies, upper-respiratory infections or colds, or contact with irritants such as dust or chemicals. This does not necessarily lead to sinusitis, but can in susceptible individuals.

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