How Is Sinus Infection Diagnosed
Diagnosis depends on symptoms and requires an examination of the throat, nose and sinuses. Your allergist will look for:
- Discolored nasal discharge
If your sinus infection lasts longer than eight weeks, or if standard antibiotic treatment is not working, a sinus CT scan may help your allergist diagnose the problem. Your allergist may examine your nose or sinus openings. The exam uses a long, thin, flexible tube with a tiny camera and a light at one end that is inserted through the nose. It is not painful. Your allergist may give you a light anesthetic nasal spray to make you more comfortable.
Mucus cultures: If your sinus infection is chronic or has not improved after several rounds of antibiotics, a mucus culture may help to determine what is causing the infection. Most mucus samples are taken from the nose. However, it is sometimes necessary to get mucus directly from the sinuses.
Knowing what kind of bacteria is causing the infection can lead to more effective antibiotic therapy. A fungus could also cause your sinus infection. Confirming the presence of fungus is important. Fungal sinus infection needs to be treated with antifungal agents, rather than antibiotics. In addition, some forms of fungal sinus infection allergic fungal sinus infection, for example do not respond to antifungal agents and often require the use of oral steroids.
Complications Of Nasal Polyps
Nasal polyps can block your airflow and keep fluids like mucus from draining properly. They also cause lots of irritation and inflammation while they’re forming. All of those things can bring complications, including:
- Sinus infections
- Asthma flare-ups
- Obstructive sleep apnea, a potentially serious condition where you stop and start breathing while you sleep
Related Conditions And Causes Of Sinus Infections
Colds, allergies, and sinus infections can cause similar symptoms, including stuffiness and headache. What’s more, both colds and allergies can cause sinus inflammation. So how can you tell the difference between these illnesses?
The truth is, even doctors can sometimes have difficulty differentiating among colds, allergies, and sinus infections. But the illnesses do present differently.
A hallmark sign that you have a sinus infection is that the illness is, as you’d expect, severely affecting your sinuses. Both colds and allergies can cause congestion and runny nose, but sinus infections typically cause an aching sensation and pressure in the face, including in the ears and teeth.
Additionally, postnasal drop, reduced sense of smell, and halitosis are typically associated with sinus infections.
The mucus associated with a sinus infection is usually green or yellow, though color alone isn’t enough to determine the cause of your nasal distress, as there are many reasons your nasal discharge may not be clear.
Both allergies and colds can cause sneezing, a symptom not typically seen in sinus infections. Allergies never cause fever, which is seen in both colds and sinus infections.
And if your symptoms last more than 10 days, you most likely don’t have a cold.
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Acute Or Chronic: Which Do You Have
When sinus infections get better within a week or two, called an acute infection, they are more likely to be caused by a bacteria or virus, like the common cold.
People with an acute bacterial sinus infection typically notice an improvement of their symptoms after about one week, followed by a sudden worsening of symptoms such as pressure in the face combined with a stuffy and runny nose, Dr. Roxbury says.
These types of infections often get better on their own but may be treated with antibiotics.
But when they last for 12 weeks or longer, sinus infections become chronic. In these cases, nasal polyps may be to blame because, unlike a bacteria or virus, they dont go away without treatment.
Long-term problems arent the only sign of nasal polyps.
Treatment For Nasal Polyps
Medications: If you need treatment, youâll probably start with a nasal corticosteroid spray. In many cases, that can shrink or even get rid of nasal polyps. But some people need to take corticosteroids such as prednisone by mouth for a week. If that doesn’t work, your doctor may give you a shot of a medicine called dupilumab .
Unfortunately, nasal polyps tend to come back if the irritation, allergy, or infection continues. So you may need to keep using a corticosteroid spray and get checkups with a nasal endoscope every now and then.
In general, medications such as antihistamines and arenât great at managing nasal polyps. But you may need antihistamines, to control allergies, or antibiotics, if you have an infection, before you start on steroids.
Surgery: Sometimes, nasal polyps are so large that medications donât work. In such cases, surgery may be an option.
The doctor would likely use a small nasal telescope that removes nasal polyps. You can go home the same day as the surgery.
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How To Stay Safe
The following tips can help to reduce your risk of getting COVID-19:
- Wash your hands frequently.
- Wear a mask that covers your mouth and nose when you go out in public.
- Avoid crowded spaces.
- Stay away from people who are sick.
- Keep a distance of at least six feet from people you don’t live with.
- To keep your immune system healthy, get plenty of sleep and exercise and eat a balanced diet.
Are Some People More Prone To Developing Nasal Polyps
Cystic fibrosis is one of the conditions that may predispose a person to developing nasal polyps. Other conditions include asthma and sensitivity to aspirin that, together with nasal polyps, form Samters Triad, also known as aspirin exacerbated respiratory disease. People who have Samters Triad suffer from severe asthma accompanied by nasal polyps. They also frequently develop an allergy-like reaction to aspirin and other nonsteroidal anti-inflammatory drugs.
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Types Of Chronic Sinusitis Or Chronic Sinus Infections
While acute sinusitis often involves an infection, chronic sinusitis does not. Sometimes, the long-term illness is caused by an infection that hasnt cleared up properly, but most often the exact cause of chronic sinusitis isnt known.
But clinicians may categorize chronic sinusitis into one of three types depending on the features present.
The most common type of the illness, chronic sinusitis without nasal polyposis, involves swelling and inflammation of the mucous membranes by various non-polyp factors, such as allergies or irritation and infections.
Chronic sinusitis with nasal polyposis, on the other hand, involves nasal polyps that are large enough to clog the sinus. Its not always clear why some people develop these polyps and others dont.
In chronic sinusitis with fungal allergy, people experience a strong allergic reaction to fungi in the air, which causes their mucous membranes to produce a thick, dense mucus.
Complications Of Sinus Infection
Sinus inflammation can spread to the bones and soft tissues of the face and eyes. This can cause:
- Cellulitis of the face or around the eyes
- Abscesses of the eyes
Left intreated, sinus infections can also lead to serious intracranial complications, including blood clots within the cavernous sinus, pus between the skulls and dura mater , and meningitis.
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Loss Of Taste And Smell
If you lose your taste and smell due to nasal polyps, there is a chance that it will never come back.
The other potential complications from nasal polyps would be a result of having them surgically removed. In that situation, complications can include:
- The possibility of the nasal polyps coming back in the future
However, in some situations, nasal polyps can lead to other health problems. The most common of these is sinusitis , which may require antibiotics if it is caused by a bacterial infection.
Other potential, though more serious and less common, complications of nasal polyps may include:
- Meningitis: Infection of the tissue around the brain and spinal cord
- Orbital cellulitis: Infection around the tissue around the eye
- Osteitis: Infection of the sinus bones
- Obstructive sleep apnea: When large nasal polyps can block nasal passageway during sleep
Can Nasal Polyps Cause Sinus Infection
Nasal polyps can cause a sinus infection by blocking how mucus flows between your sinuses and your throat.
This can cause mucus to become trapped in your sinuses, which allows germs to grow and can lead to infection.
Your doctor will diagnose nasal polyps through testing, which may include:
- a nasal endoscopy
- imaging tests like a CT scan
- allergy and immune testing
They may also recommend a full medical workup to look for other health conditions that often occur with nasal polyps.
Treatment for CRwNP is focused on decreasing inflammation in your sinuses and nasal passages to reduce your symptoms. Some treatments can help shrink nasal polyps to prevent further obstruction of your nasal cavity.
Ask your doctor about the following treatment options:
If you have a severe case of CRwNP that doesnt respond to standard steroid therapies, talk with your doctor about:
- Leukotriene modifiers. A 2013 review suggests these medications may reduce CRwNP symptoms and polyp size. The allergy medication montelukast in particular may help people who have CRwNP along with asthma.
- Biologics. Dupilumab and omalizumab are two other allergy and asthma medications approved by the Food and Drug Administration to treat CRwNP. According to a 2020 review, studies suggest that dupilumab reduces polyp size, alleviates nasal congestion, and reduces the need for surgery. Other 2020 research has found that omalizumab significantly improves symptoms and quality of life compared with a placebo.
The Importance Of Treatment
Nasal polyps can result in irritation and other health complications. They may also indicate an underlying medical condition, such as allergies. That is why it is important to seek professional diagnosis and treatment for nasal polyps.
Ear, nose and throat doctorslike the physicians at Sierra Nevada ENTspecialize in managing symptoms and reducing or eliminating nasal polyps. Common treatment options include:
- Corticosteroids: Prescribing a corticosteroid is often the first step to treating nasal polyps. This anti-inflammatory drug works to reduce swelling and irritation, resulting in diminished polyps. Typically, corticosteroids take the form of a nasal spray, though oral or injectable corticosteroids may be an option in more extreme cases.
- Antihistamines or allergy shots: If the nasal polyps are the result of allergic rhinitis, it is important to manage the underlying allergy by identifying and avoiding the irritant. If avoidance is not possible, a regimen including antihistamines, decongestants or allergy shots may be necessary.
- Antibiotics: If the nasal polyps are the result of a sinus infection, antibiotics will be prescribed to fight the underlying bacterial infection.
Saline sprays, nasal rinses and humidifiers may also be used to keep nasal passages moist and reduce inflammation.
These treatment options are safe and highly effective ways to slow the growth or shrink nasal polyps. In some cases, however, surgery may be necessary to fully remove the growth.
Diagnosis Of Sinus Infection
To diagnose if you have a sinus infection, your doctor will ask about your symptoms and their timeframe, and give you a physical exam.
This exam may include looking in the nose for signs of polyps, conducting a transillumination test to identify inflammation, and tapping the sinus area to detect infections.
If you have a chronic sinus infection, your doctor may conduct additional tests, including:
- Rhinoscopy or nasal endoscopy to inspect your sinuses and see if your membranes are inflamed
- Mucus cultures to determine what is specifically causing your infection
- Allergy tests to determine what allergens may be triggering your chronic or recurrent infections
- CT scan to identify sinus abnormalities, such as polyps or a deviated septum
- MRI scan to see if you have a nasal tumor or fungal infection
If you have a serious fungal sinus infection, your doctor may order a bone biopsy to see if the infection has penetrated your bones.
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Nasal Polyp Treatments And Covid
Medications that affect the immune response are frequently used in the treatment of nasal polyps. These include corticosteroids and biologic medications such as dupilumab.
Some people have hypothesized that since corticosteroids are known to suppress your immune response, it is logical to assume that using these medications would increase your risk of catching COVID-19 or affect your body’s ability to fight off COVID-19. However, science isn’t exactly bearing this theory out.
A case report of COVID-19 in a patient who was taking dupilumab for nasal polyps showed a very mild case of COVID-19, but this is hardly evidence for all individuals who might be using this medication.
A study conducted on chronic obstructive pulmonary disease and asthma patients using inhaled corticosteroids seemed to suggest a slightly increased risk of death of COVID-19 that correlated with higher doses of inhaled corticosteroids.
Ultimately, however, the study authors could not be certain that this was directly caused by the medication and not the underlying illness since higher doses of corticosteroids were mainly used in patients with more severe respiratory disease.
Interestingly, one inhaled steroid used to treat asthma and allergic rhinitis , ciclesonide, has been shown in some studies to inhibit the replication of coronaviruses.
There have also been a few case reports of COVID-19-related pneumonia being successfully treated using this medication. More research is needed.
What Are The Possible Causes Of Nasal Polyps
Nasal polyps can form when the mucous membranes that line the nasal passageways and sinus cavities become inflamed repeatedly or over a long period. Infections and allergic reactions are to blame, as these incidents cause inflammation, redness, and fluid build-up in the passageways.
Inflammation can then lead to the formation of small, fluid-filled growths, which develop into nasal polyps. Some people develop nasal polyps at random, but most of the time, there is a triggering mechanism.
The common triggers for nasal polyps include the following:
- Corticosteroid sprays
- Medicines to help decrease inflammation
- Saline rinses and steroid nasal sprays must be used daily and do not always provide relief because the medicine is difficult to reach the polyps
- Aspirin desensitization therapy, if appropriate
Drops and tablets are typically steroid-based, which means theyre a great short-term fix, but the long-term side effects may not be worth it.
- A doctor may also prescribe a one-week tapered course of oral corticosteroids, such as prednisone, in some cases.
Some common non-surgical options professionals may use to treat and remove nasal polyps include:
When considering how to remove nasal polyps, there are times when nonsurgical treatment is ineffective and surgery becomes a viable option.
Nasal polyps treatment and surgery
There are two surgical options for nasal polyp removal:
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Chronic Sinus Infection Treatment
Chronic sinus infections typically have a more mysterious cause than acute infections people with chronic sinus infections often require life-long treatment to keep symptoms at bay.
In addition to the options above, treatment for chronic sinus infections may include:
- Lifestyle changes, such as quitting smoking and changing home or work conditions to reduce exposure to environmental toxins and allergens, such as dust mites, pet dander, or cockroaches
- Leukotriene modifiers, which reduce inflammation through a different mechanism than steroids
- Surgery to reopen sinuses affected by issues like nasal polyps and deviated septum
Recent research suggests other treatment options may also exist for chronic sinus infections, including:
- Nasal probiotics of the beneficial bacteria lactobacilli
- The drug dupilumab, derived from a human antibody, which the Food and Drug Administration approved to treat chronic sinus infections with nasal polyps in 2019
- A regime combining oral and intranasal corticosteroid irrigations
How To Prevent Nasal Polyps
While the exact cause of nasal polyps is unknown, they often develop in adulthood in people in their 30s and 40s.
A few ways to prevent or reduce the frequency of nasal polyps include:
- Avoiding allergy triggers: Avoiding allergens and airborne triggers that can lead to inflammation may help prevent nasal polyps.
- Allergy and asthma medications: If you have medications for asthma and allergies, taking them regularly may help reduce inflammation in the sinus and nasal passages.
- Saline nasal spray: Using a saline nasal wash with distilled water regularly can help keep sinus and nasal passages clean and reduce the chances of inflammation and infection.
- Humidifiers: These can help moisten the nasal passages and make it easier to breathe.
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Diagnosis Of Nasal Polyps In Dogs
In order to diagnose a benign nasal tumor, the dog will typically need to be anesthetized so that the vet is able to inspect the nasal passage. Polyps are glistening red, pink, or gray growths in the nasopharynx. In addition to a physical examination, advanced imaging may be required to determine further information about the nature of the growth.
The veterinarian may use a rhinoscope to inspect the nasal passage. Like tumor manifestations in humans, the veterinarian may try to obtain a sample of the growth in order to complete a biopsy of the tumor. Once the results are determined, further decisions regarding diagnosis and treatment can be made.
Surgical Interventions And Implants
Endoscopic surgery is performed to remove your nasal polyps. Your provider uses a special tool that has a camera and lighting at the end and inserts it into your nostrils. They then locate and remove your polyps using specially designed tools.
Sometimes your Jacksonville ENT Surgery provider may recommend inserting PROPEL®, a meshlike implant that keeps your nasal passage open while you heal, following your endoscopic surgery.
PROPEL also contains slow-release steroid medication, which reduces inflammation and helps you heal faster. Plus theres no need to come back for removal the device gradually dissolves over time.
Another implant your provider may recommend is SINUVA®, which is designed to shrink your polyps so you can avoid surgery. Your provider inserts the SINUVA implant, and it releases medications that shrink your polyps, helping your symptoms improve.
If you suspect you have nasal polyps, dont wait to schedule an appointment with a specialist at Jacksonville ENT Surgery in Lake City, Florida. Call one of our three Jacksonville offices to schedule or use our online booking tool now.
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