Causes and current treatments of sinusitis

June 6, 2000

Dr. Ron Moses of St. Luke’s Episcopal Hospital chats about the causes and current treatments of sinusitis.

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HoustonChronicle: Welcome to Ask the Doctor! The purpose of the Ask The Doctor chats is to provide general information and is in no way intended to be construed as medical advice for any visitor's specific disease or condition. The intent is to increase a participant's knowledge about a general disease or condition. For treatment of your specific condition, please see your personal physician. This forum is not intended to be used in emergency situations. If you are uncertain of the urgency of your problem or condition, contact your personal physician or the nearest hospital for assistance. Welcome to Ask the Doctor! HoustonChronicle.com, St. Luke's Episcopal Hospital - Houston and the Talk City Network are proud to present our special guest for today, Dr. Ron Moses of St. Luke's Episcopal Hospital. Welcome Dr. Moses.

Dr. Moses: Hello, welcome back everyone if you're coming for a repeat visit. Or if you're a new participant, please feel free to ask any questions.

Sallyq: What is sinusitis?

Dr. Moses: Sinusitis is inflammation in the sinuses. While that sounds like a very basic definition, it is the most accurate. Sinusitis, by itself, does not necessarily mean an active infection, although it might. Often sinusitis can be a short-term problem, or a long-term or chronic problem. All of these fall within the broad outlines of sinusitis.

Blueyes: How can a person distinguish between an allergic reaction and sinusitis before seeing a doctor?

Dr. Moses: Allergies and sinusitis are one of the most commonly debated terms in my field. Allergies and sinusitis are not mutually exclusive--in fact, it is difficult to know when one started and the other began. Allergies can, in fact, lead to classic sinusitis; however, many other factors can also lead to sinusitis. The classic symptoms of sinusitis include facial pain, nasal congestion, a runny nose, headaches, and occasionally halitosis. As most of the listeners may agree, these may be the same symptoms that an allergy sufferer may have, so it is very difficult at times to know the difference. Allergies will tend to be seasonal, and most patients know when their "allergy season" is. They also tend to last a shorter time period, generally seven to ten days, whereas a chronic sinusitis patient will have problems that may last months. Additional symptoms that are classic of allergy, but not necessarily of sinusitis, include sneezing, burning eyes, and runny eyes.

Oplen: When should surgery be considered?

Dr. Moses: This is the question most commonly asked of me. Most patients have already seen their internists for months, and sometimes years, to treat a chronic sinusitis. Finally, when all of the various medicines do not seem to work, or there is a defined anatomic problem identified in a CAT scan or visualized in the nose, then a patient seeks surgical treatment. Basically, the definition of an indication for surgery includes those patients who have failed an aggressive medical treatment. Also, those with other underlying problems, including those with anatomic problems and those with immunologic problems. This would include patients with chronic steroid use, diabetics, and HIV, and these patients are at higher risk for complications if not treated aggressively.

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