Doctor, is it sinus or allergy or what?
"Sinus" - or more properly sinusitis - is irritation of the delicate mucous producing membrane lining the sinus cavities around the nose. The same membranes line the nose, mouth, throat, air passages in the lungs, surface of the eye and the narrow Eustachian tubes from the nose to behind the eardrums. Irritation can be caused by viruses such as in colds and flu, or by bacteria. Often it is caused by allergy or similar conditions. True allergy is an abnormal response by the body's immune system to living things (called allergens) in the air. Hay fever is allergy to pollens. But allergy can also be caused by dust, molds, animal hair or dander (dead skin) and feather or down bedding. Similar reactions can be produced by chemicals such as smog, tobacco smoke, perfumes, new paint or carpet, common cleaners, etc. Patients with indigestion, reflux (GERD) or hiatal hernia can also have the same complaints. Another non-allergic source of the same symptoms is sensitivity to climate - either hot/cold or humid / dryness.
Additionally, nasal stuffiness can be caused by a variety of anatomic problems including deviation of the septum that divides the right and left sides of the nose, and by the growth of 'polyps' which are an excessive swelling of the tissues, as well as blockage by other growths.
Obviously, effective treatment will depend on the cause. Antihistamines help with itching and sneezing. Decongestants are for stuffiness. Many medications are combinations of both. Nasal steroid sprays often help shrink swollen irritated tissue and polyps. As opposed to steroid pills, the sprays do not get into the circulation to affect the body and some are even approved for children to use daily for years without any problem. Over-the-counter decongestant sprays/drops are to be avoided as much as possible since the rebound effect in the membranes can cause people to be essentially addicted in as little as 3 days. Saline (salt water) sprays can be used as often as necessary. Each of these types of medicine have potential side effects and (other than saline) potential reactions with other medications, even non-prescription ones. Therefore, they should not be used for prolonged periods without consulting a physician.
Allergy shots help the body to be less sensitive to the true allergens in the environment. First, simple skin tests are done to determine both the identity and degree of sensitivity to specific allergens. Then a customized solution is prepared for each patient. This often allows the patient to significantly reduce or even eliminate the regular use of medications.
Of course the best way to handle any medical problem is by prevention or avoidance. Some simple things you can do for yourself are:
- Take your antihistamine at least 1 hour before doing cleaning or yard work and wear a pollen mask and long-sleeve clothing that you put in the wash when you are done.
- Also shower after exposure to allergens.
- Vacuum well, including under furniture, or use a dust-collecting cloth. Don't just "dust" which spreads more allergens into the air.
- Do not allow pets indoors, or at least not into the bedroom.
- Keep all scents in a drawer rather than sitting out. No smoking in the house (preferably not at all).
- Do not use down or feather bedding and enclose pillows, mattress and box springs in a plastic barrier.
- Keep windows and doors closed during heavy pollen season and when smog levels are high.
- Change heating and air conditioning filters regularly - monthly if necessary. Also
consider a humidifier when the weather is dry but be alert for mold growth in the
humidifier. Air purifiers (especially with HEPA filters) can also be very helpful. Notice if your symptoms are worse in a particular room at home or work and
check to determine what the source of irritation may be - dust, mildew from indoor plants or other sources, animal hair or dander, perfume, chemicals for cleaning or hobbies, etc. - Similarly, if you can pinpoint when your symptoms first began, try remembering what may have changed in your environment about that time.
Why see an otolaryngic allergist?
We are specialists in head and neck medicine and surgery. In addition to expertise in treating allergies of the ears, nose/sinuses, and throat, we are also trained to diagnose and treat the anatomic problems often confused with allergy symptoms. As a member of the American Academy of Otolaryngic Allergy, a Board Certified Otolaryngologist and Assistant Clinical Professor on the faculty at UCLA, I remain current in all the latest techniques. This is in addition to experience since 1981. I provide on site skin testing, the latest diagnostic fiberoptic scopes with video documentation, radiofrequency (Somnus) surgery for persistent nasal congestion or snoring, CT X-rays of the sinuses in the office and we have a microbiologist in the office to perform cultures for infection.
Please see me if you have any of the following problems: Recurrent sneezing, stuffy/runny nose, stuffy ears, itchy/watery eyes Frequent or lingering colds, cough or difficulty breathing Frequent or persistent sinus infection Frequent or persistent hoarseness, throat pain or swelling Frequent ear infections
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Pillar Procedure
FDA approved for snoring and mild to moderate sleep apnea, the Pillar Procedure involves the placement of 3 to 5 tiny implants in the soft palate to help reduce the vibration that causes snoring and the ability of the soft palate to obstruct the airway. Once in place, the implants add structural support to the soft palate.
The procedure takes approximately 15 minutes to perform in our office under a local anesthetic. Most patients resume their normal activities and diet that same day with minimal discomfort. The implants are designed to be invisible and do not interfere with speech or swallowing.
For more information on the Pillar Procedure, please visit www.pillarimplant.com