Dr. Daniel Glass, a physician at ENT Associates of East Texas, leads this week’s Walk with a Doc event on Thursday and will discuss sinusitis. Walk With a Doc is a project of the Smith County Medical Society and is held at Rose Rudman Park at Copeland Road. Registration is at 5:45 p.m. with a brief health presentation at 6 p.m. followed by walking. For more information on Walk With a Doc, call the Smith County Medical Society office at 903-593-7058 or visit www.walkwithadoc.org/our-locations/tyler-tx/.

 

Q: What is sinusitis, and whom does it affect? How common is it?

A: Sinusitis can affect people of all ages. The sinuses are not fully developed until age 20, but pediatric patients can still be affected in the developing sinuses. Chronic sinusitis — defined as symptoms for 12 weeks — affects around 12 percent of the population. Acute sinusitis — defined as symptoms of less than four weeks — affects around 4 percent of the population per year. Direct health care related costs for sinusitis reach upward of $8 billion per year.

 

Q: How is sinusitis diagnosed?

A: Sinusitis diagnosis begins with a detailed patient history. There are major factors such as facial pain/pressure, nasal obstruction, nasal drainage/post nasal drip, decreased smell and fever; and minor factors such as headache, bad breath, dental pain, fatigue, cough and ear pain/pressure/fullness in the history that leads to diagnosis of sinusitis. Factors that contribute to the development of sinusitis include environmental factors, genetic factors and sinus structural factors. Examination is also important, including the use of sinus endoscopes to closely examine the sinuses for inflammation, drainage and polyps. Occasionally, CT scans are also used in chronic and complicated cases.

 

Q: How is it treated? How often is surgery recommended?

A: Treatment includes antibiotics, steroids (nasal steroid sprays, occasionally pills) to decrease swelling, decongestants. If there is underlying allergy, control with antihistamines is also important. Surgery is targeted at improving the drainage and ventilation of the sinuses through their natural drainage sites. Surgery is indicated for those patients who have failed maximal medical therapy of the above-mentioned treatments. Medical therapy remains important even in post surgical patients to continue to control inflammation, otherwise improvement seen with surgery can be short lived.

 

Q: Explain any implications of untreated sinusitis.

A: Complications of sinusitis can include spread of infection to the areas close to the sinuses, including the eyes (orbit), cerebral spinal fluid and brain, soft tissues and skin of the face.