Sinus

How To Breathe easier...Treating Sinusitis and Allergy Disorders


At Boulder Valley Ear, Nose & Throat, we want you to take time to smell the roses...without itchy eyes or a runny nose. Leading-edge allergy and sinus care can ensure an accurate diagnosis of your allergies or other sinus difficulties for fast relief, so you can breathe easy.

Whether it's large or small, button-like or beak-like, your nose is important to your health. It filters the air you breathe, removing dust, germs and irritants. It warms and moistens the air to keep your lungs and tubes that lead to them from drying out. Your nose also contains the nerve cells that help your sense of smell. When there is a problem with your nose, your whole body can suffer. For example, the stuffy nose of the common cold can make it hard for you to breathe, sleep or get comfortable.

Many problems besides the common cold can affect the nose. They include:

  • Deviated septum - a shifting of the wall that divides the nasal cavity into halves
  • Nasal polyps - soft growths that develop on the lining of your nose or sinuses
  • Nosebleeds
  • Rhinitis - inflammation of the nose and sinuses sometimes caused by allergies. The main symptom is a runny nose

Deviated Septum

Deviated Septum is frequently caused by facial trauma such as a blow to the face. It can also be congenital disorders.

In most cases a deviated septum can be corrected with a minor surgical procedure known as a septoplasty, in which the surgeon enters through the nostrils and cuts away the obtruding matter. It is normal for the patient to take anywhere from two days to four weeks to heal completely.

Nasal Fracture

Nasal Fracture is the result of a fracture of the cartilage or bone of the nose. Categorized as either open or closed, a broken nose will often be accompanied by a nose bleed, swelling and even "black eyes". If you've sustained an injury to your nose, it is important that you visit your Ear Nose & Throat doctor within two weeks (if the patient is a child, one week) of the injury. If it's been longer than two weeks, it may be necessary to wait for two to three months for the swelling to reduce and the bones to heal.

Depending on the extent of injury, treatment can involve doing nothing (other than rest and caution not to bump your nose), stabilization, repositioning or surgery under general anesthesia.

Epistaxis

The nose has a high concentration of blood vessels combined with vulnerable nasal membranes. Common causes of nose bleeds; dry climates, injury, medications that thin the blood, infections, Hypertension, Alcohol abuse, and Allergic and non-allergic rhinitis.

You should go to the doctor or emergency room if:

  • You experience heavy bleeding or significant blood loss.
  • You experience a headache, or a fever while having a nose bleed.
  • You faint or feel week from blood loss.
  • Your baby has a nose bleed contact your pediatrician.
  • You have any concerns

Treatment of nose bleeds can involve electrocautery, chemical swab, local application of blood clotting medicine, and in some cases nasal packs for persistent bleeds. Though somewhat rare, severe cases are occasionally admitted to the hospital for further intervention.

Sinusitis (Acute, Sub-acute, and Chronic)

The sinuses are located behind the cheeks, eyes, forehead, and nasal bones consisting of an air filled space lined with mucus membranes.

Sinusitis is the inflammation of sinus tissue due to infection. The source of infection can be bacterial, fungal or viral. Healthy sinuses circulate air and allow mucus to drain. When the sinus is blocked, germs and bacteria can grow causing: Acute sinusitis (symptoms lasting up to 4 weeks), Sub-acute sinusitis (symptoms lasting 4 to 12 weeks) and Chronic sinusitis (symptoms lasting over 12 weeks).

Allergic Rhinitis

Allergic Rhinitis occurs when the body's immune system over-responds to specific, non-infectious particles such as plant pollens, molds, dust mites, animal hair, industrial chemicals (including tobacco smoke), foods, medicines, and insect venom. During an allergic attack, antibodies, primarily immunoglobin E (IgE), attach to mast cells (cells that release histamine) in the lungs, skin, and mucous membranes. Once IgE connects with the mast cells, a number of chemicals are released. One of the chemicals, histamine, opens the blood vessels and causes skin redness and swollen membranes. When this occurs in the nose, sneezing and congestion are the result.

Seasonal allergic rhinitis or hay fever occurs in late summer or spring. Hypersensitivity to ragweed, not hay, is the primary cause of seasonal allergic rhinitis in 75 percent of all Americans who suffer from this seasonal disorder. People with sensitivity to tree pollen have symptoms in late March or early April; an allergic reaction to mold spores occurs in October and November as a consequence of falling leaves. 

Perennial allergic rhinitis occurs year-round and can result from sensitivity to pet hair, mold on wallpaper, houseplants, carpeting, and upholstery. Some studies suggest that air pollution such as automobile engine emissions can aggravate allergic rhinitis. Although bacteria is not the cause of allergic rhinitis, one medical study found a significant number of the bacteria Staphylococcus aureus in the nasal passages of patients with year-round allergic rhinitis, concluding that the allergic condition may lead to higher bacterial levels, thereby creating a condition that worsens the allergies.

Patients who suffer from recurring bouts of allergic rhinitis should observe their symptoms on a continuous basis. If facial pain or a greenish-yellow nasal discharge occurs, a qualified ear, nose, and throat specialist can provide appropriate sinusitis treatment.

Non-Allergic Rhinitis does not depend on the presence of IgE and is not due to an allergic reaction. The symptoms can be triggered by cigarette smoke and other pollutants as well as strong odors, alcoholic beverages, and cold. Other causes may include blockages in the nose, a deviated septum, infections, and over-use of medications such as decongestants.

Rhinosinusitis: Clarifying the Relationship between the Sinuses and Rhinitis

Recent studies by otolaryngologist-head and neck surgeons have better defined the association between rhinitis and sinusitis. They have concluded that sinusitis is often preceded by rhinitis and rarely occurs without concurrent rhinitis. The symptoms, nasal obstruction/discharge and loss of smell, occur in both disorders. Most importantly, computed tomography (CT scan) findings have established that the mucosal linings of the nose and sinuses are simultaneously involved in the common cold (previously, thought to affect only the nasal passages). Otolaryngologists, acknowledging the inter-relationship between the nasal and sinus passages, now refer to sinusitis as rhinosinusitis. The catalyst relating the two disorders is thought to involve nasal sinus overflow obstruction, followed by bacterial colonization and infection leading to acute, recurrent, or chronic sinusitis. Likewise, chronic inflammation due to allergies can lead to obstruction and subsequent sinusitis. Other medical research has supported the close relationship between allergic rhinitis and sinusitis. In a retrospective study on sinus abnormalities in 1,120 patients (from two to 87 years of age), thickening of the sinus mucosa was more commonly found in sinusitis patients during July, August, September, and December, months in which pollen, mold, and viral epidemics are prominent. A review of patients (four to 83 years of age) who had surgery to treat their chronic sinus conditions revealed that those with seasonal allergy and nasal polyps are more likely to experience a recurrence of their sinusitis.