A New York City ENT doctor deals with a variety of different conditions from performing sinus surgeries to diagnosing ear, nose & throat problems.
Posts tagged sinus infection treatment
Wintertime Sinuses
3 years ago
Most people are aware that sinus infections and sinus inflammations occur frequently during the springtime and the summer when pollen counts are on the rampage, and seasonal allergies are in full force. However, many people who persistently suffer from allergies can tell you that symptoms don’t always go away when the first freeze of the season hits, and pollen count theoretically takes a nosedive.
It can still happen that even during wintertime, sinus symptoms such as congestion, postnasal drip, coughing, runny noses, sinus pressure, and troublesome headaches occur with practically the same regularity as they might during spring or summer.
There are a number of reasons why this can happen, even in the absence of one of the biggest contributors to allergy symptoms, which is pollen from various plants. Here are some of the reasons why allergy sufferers may be just as miserable during the wintertime.
Mold and Various Kinds of Fragrance
Although they are seemingly innocent sources, holiday decorations such as plants, wreaths, and even Christmas trees and ornaments can trigger allergies, and all the associated symptoms, because of the dust which settles on them, and the mold which may be growing on them.
When decorations are stored for an entire year in the basement or somewhere else, it’s very easy for dust to accumulate on them, or for mold to begin growing on them. To prevent this, decorations should be stored in airtight containers, so that when they’re reopened at holiday time, you aren’t introducing fresh allergens into the household.
When you bring a Christmas tree into the household, make sure that it has been thoroughly shaken down, so it doesn’t have dried leaves or other material in the branches because these might contain mold.
Also, since windows and doors are generally tightly shut during the wintertime, it can intensify the fragrances from decorations and specially scented candles, which can act as irritants for your sinuses. It’s probably best to avoid using scented candles like this during the wintertime when doors and windows keep all those irritants inside.
Cold and Influenza
Extra mucus is generally produced when you have a cold or influenza, and it can also cause swelling inside the nasal passages. All this contributes to unusually difficult drainage, which promotes the buildup of mucus. When that happens, bacteria development is sure to follow, and a sinus infection may not be far behind.
The best way to avoid getting colds or flu is to conscientiously observe good hygiene throughout the entire wintertime, especially as it relates to washing your hands. You should also make a point of getting plenty of rest to help out your immune system, and when it’s available, you should always get a flu shot to protect yourself against the particular strain which is most prevalent this year.
Excessively dry Air
There is always considerably less humidity in the air during wintertime, than there is during summer, and as a result, the air in homes and in offices also becomes much drier. When the breathable air inside a building is that dry, it will have the effect of irritating nasal linings and the lining of the throat, which in turn will also trigger irritation in the sinuses.
To avoid the predominately dry air of wintertime, remember to use a humidifier to increase the moisture level in breathing air throughout the home. A good rule of thumb is to set your humidifier for about 50% humidity, so that dryness doesn’t bother your sinuses and trigger symptoms which are going to make you miserable through the holidays.
Pet Dander, Allergens, and Dust
It happens quite frequently that pet dander, dust, and other allergens become trapped indoors during the winter time, due to the fact that doors and windows are routinely kept tightly shut to keep the cold out. While it can be a bit of an undertaking to ensure that all these allergens are removed or suppressed, it will be worth it, in terms of your ability to enjoy the holiday season.
In the case of pet dander, you should make a point of bathing your cat or dog at least weekly, because allergens will naturally be attracted to fur, and they’ll stay there until removed. If you allow your pet to go outdoors regularly, you may want to perform the bathing routine even more frequently, because every time your pet goes outside, it will be a magnet for whatever’s floating through the air.
To eliminate, or at least reduce allergens elsewhere in the home, you can take such steps as vacuuming the carpets thoroughly, especially using a vacuum with a HEPA filter, that can pick up even the smallest allergens. You should also vacuum furniture and draperies to remove allergens which may have built up on those surfaces.
It’s a good idea to dust all around the home every few days, but when you do this, it should be with a damp cloth that retains the allergens, rather than using a feather duster which will simply relocate any allergies present.
Lastly, by changing your own clothes whenever you’ve come inside from the outdoors, you can be relatively sure you aren’t tracking in a number of allergens, which will be lying in wait to torment you during the wintertime.
Home Remedies for a Sinus Infection
5 years ago
Which home remedies can help you with a sinus infection?
Is it a cold, the flu, or a sinus infection? Sometimes it can be hard to tell. Situations, where you end up sick, can occur at any time. And sometimes you can’t get to a doctor right away. So, what do you do in the meantime? Well, until you can see your physician, we suggest using these home remedies to help you ease your symptoms.
Saline Sprays and Washes
Designed to wash out your sinus cavities and nose, saline sprays and washes are your first defense against sinusitis. They provide quick relief and eliminate the nasty bacteria and other materials that cause infection. And if you are experiencing dryness, they are especially useful. They provide moisture within the nasal passageways, which prevents headaches, bleeding, and inflammation.
Stay Hydrated
You should always stay hydrated. It is especially important when you are dealing with a sickness. Like we said before, the sinuses must remain moist. A lot of water or healthy fluids will keep your body adequately hydrated and your sinus healthy.
Keeping the Air Moist
If you have noticed by now, these home remedies are all following a theme. Moisture in the sinuses means relief from pain and congestion. Another way to keep the sinus moist is to either take a steam shower or buy a humidifier. Breathing in the moist air will help you breathe easy and reduce the swelling of the sinuses.
Clean Your Home
Your symptoms can also be a result of allergies. Allergy symptoms usually don’t go away until the all the allergens in your home are gone. There are a few steps you can take to remedy this. For example, having someone clean your home for you will avoid upsetting your allergy symptoms. You can also use dust covers and run the air conditioner to prevent allergens from affecting you.
Confirm if You Have a Sinus Infection
While these home remedies will provide temporary relief, your condition can persist. It is important to know exactly what you’re dealing with. An otolaryngologist can confirm if you do indeed have a common cold or a sinus infection. Reach out to one for help.
Gestational Sleep Apnea: The Risk to Pregnant Women
6 years ago
by Social Media Team
in sleep apnea
As doctors ignore gestational sleep apnea in pregnant patients, they are at risk for complications.
According to new research, one of every four pregnant women suffer from obstructive sleep apnea (OSA). Unfortunately, pregnant women with OSA are more likely to be left untreated because it is not seen as a danger to either the mother or child. However, this new research suggest that OSA can be the cause of several symptoms in pregnant women. Now, researchers are recommending that doctors diagnose this condition as gestational sleep apnea.
Doctors Ignore OSA in Pregnant Women
Doctors are ignoring OSA in pregnant women because they attribute difficulty breathing during sleep, as well as daytime fatigue, to their pregnancy. Doctors are usually unwilling to refer pregnant patients to an ENT specialist, believing that symptoms will subside after their child is born. Some researchers believe that this thinking is a misstep in helping pregnant women with gestational sleep apnea.
Prof. Yehuda Ginosar, director of the Mother and Child Anesthesia Unit at the Hebrew University, and co-author of the study, states that “Currently there is a lack of uniform criteria to diagnose, treat and classify OSA in the pregnant population, which in turn complicates efforts to determine the risk factors for, and complications of, gestational sleep apnea.”
The Risk of Gestational Sleep Apnea
Without proper diagnosis and treatment of Gestational Sleep Apnea, pregnant women are left at risk. Not only do they suffer from both difficulty breathing during sleep and daytime fatigue, but the disorder is known to cause several complications in their condition, including high blood pressure, high blood sugar, and heart disease.
When non-pregnant adults are diagnosed with OSA, they are treated with continuous positive airway pressure (PAP machine) to relieve their symptoms. Researchers stress the importance of diagnosing pregnant women so that they might receive the same treatment. Without proper action, women and their babies are at risk.
Dr. Suzanne Karan, co-author of the study and Associate Professor of Anesthesiology and Director of the Anesthesiology Respiratory Physiology Laboratory at the University of Rochester School of Medicine, sends out a call to action for doctors, stating, “The time has come for our profession to wake up to the diagnosis of Gestational Sleep Apnea. This will allow us to research obstructive sleep apnea in pregnant women more effectively, and to develop and implement more effective treatments.”
CPAP and Type 2 Diabetes: Studies Debate Results
6 years ago
by Social Media Team
in sleep apnea
Obstructive sleep apnea (OSA) and type 2 diabetes have been linked together for a long time. Research into the link indicates that OSA may cause or worsen type 2 diabetes. This relationship has led many scientists to believe that treatment of OSA might improve the symptoms of patients with both disorders. However, this idea is an on-going debate. One treatment of OSA, known as continuous positive airway pressure (CPAP), has had conflicting reports.
What are CPAP Treatments?
Continuous positive airway pressure, otherwise known as CPAP, is a ventilator typically used by people who have problems breathing during their sleep time. The machine applies mild air pressure on a continuous basis in order to always keep airways open. CPAP treatments are most effective on patients who have obstructive sleep apnea.
The Two Studies
In a recent study conducted by the Autonama University of Madrid, CPAP treatments appeared to have had a positive effect on glycemic control in patients with OSA and type 2 diabetes. The study tested 50 people who have OSA, and whose type 2 diabetes was not well controlled. They found that after 6 months, there seemed to be an improvement in glycemic control.
Conversely, results from another study suggest that CPAP use may not have any effect on type 2 diabetes. Researchers randomly assigned a group of 298 patients who have OSA and well-controlled type 2 diabetes, to either receive CPAP or regular care. Their results showed that glycated hemoglobin levels in patients using CPAP did not show any more change than those using regular care.
Both studies were published in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine. Atul Malhotra, MD, President of the American Thoracic Society and a sleep expert, was not a part of either study.
Dr. Malhotra suggest that the “Differences in race and ethnicity and changes in diet, exercise and metabolism that may occur with CPAP, may have also contributed to the different findings.” She also noted that the “differences in glucose control at baseline and the relatively small size of the studies” may have contributed to the difference results as well. In the end, Dr. Malhotra believes more research is needed.
Sleep Apnea and High Blood Pressure
6 years ago
What is the connection between sleep apnea and high blood pressure?
The connection between sleep apnea and heart disease is a complicated one. The causal connection is not clear, but we do know that those with sleep apnea today have a high chance of developing hypertension in the future. In fact, people with cardiovascular problems—especially high blood pressure, heart failure, and stroke—have a higher prevalence of sleep apnea.
This fact makes sense because those with obstructive sleep apnea put their bodies under more stress because the condition prevents proper rest to occur on a daily basis. Obstructive sleep apnea (OSA) is when the upper throat closes, and the patient stops breathing numerous times during the night, putting them at risk for developing vascular disease that causes a specific type of treatment-resistant form of high blood pressure.
One of the problems with defining the connection between OSA and heart disease is that people with the former condition often have other complicating diseases as well.
When treating people with high blood pressure and sleep apnea, or heart failure and sleep apnea, the measures of blood pressure or heart failure are significantly improved. This suggests there is a cause-and-effect relationship between hypertension and sleep apnea.
Nancy Kanagy, PhD, a professor in the University of New Mexico (UNM) Department of Cell Biology and Physiology, is researching to understand how the connection occurs.
Insight is on the horizon
Just how sleep apnea heightens blood pressure demands further research, but we do know that up to one in five people may suffer from it. Recently, the National Institutes of Health issued a call for proposals on sleep apnea research on the connection several years ago. Kanagy realized UNM’s experience in conducting vascular studies could provide much needed insight here.
“Most researchers were looking at the sympathetic nervous system,” Kanagy says in a release. “We thought, ‘Why not develop a model to investigate vascular changes and contributions to the elevated blood pressure?”
Kanagy’s discovered a key connection when her team developed a rat model of sleep apnea and discovered that after 14 days of repeated exposure to hypoxia during sleep increases blood pressure, even during waking hours. Hypoxia is a condition when the body or a region of the body is deprived of an adequate supply of oxygen. The researchers found that hypoxia increases production of an artery-constricting peptide called endothelin, and this peptide elevates blood pressure. Further studies are investigating exactly how that happens.
Her team is further investigating how hydrogen sulfide molecules (H2S) play a crucial role in controlling blood pressure. In the study, they found that sleep apnea patients show significantly lower H2S levels compared with normal sleepers. This molecule appears to limit inflammation and open arteries, which leads to relieving the cardiac and vascular systems from constriction.
“Long-term, we are hoping that a better understanding of these mechanisms will lead to new and more effective therapies to treat cardiovascular disease in sleep apnea patients,” Kanagy says.
Azithromycin and Chronic Sinusitis
6 years ago
A new study shows treatment with long-term low-dose azithromycin in combination with the conventional therapy can reduce the recurrence rate of chronic sinusitis symptoms after functional endoscopic sinus surgery, but there was no sufficient evidence to support clinical significance of azithromycin at the investigated dose.
The aim of clinical trial was to evaluate the efficacy of long–term consumption of low–dose azithromycin after a successful endoscopic sinus surgery.
Chronic sinusitis is recognized as a common disease that imposes a huge burden on the healthcare system worldwide. About 37 million Americans suffer from at least one episode of sinusitis each year. Besides the burden on the healthcare system, there is a huge burden on the individual due to missed workdays and reduced productivity that the condition causes. This study is needed because when it comes to conventional therapies, other less invasive surgeries should be considered such as balloon sinuplasty.
Method of Research
Sixty-six patients were randomly divided into intervention and control groups. The subjects received the standard conventional treatment (fluticasone nasal spray plus normal saline solution irrigation) or the conventional treatment plus 250 mg of azithromycin on a daily basis for 3 months. Evaluation was made based on the 22-item Sino-Nasal Outcome Test (SNOT-22) immediately before surgery and 3 months after surgery.
Results
The intervention group showed a significant improvement in SNOT-22 scores after the treatment and a higher percentage change after 3 months of therapy compared to the control group. Also the researchers found a significant correlation between the percentage change of SNOT-22 scores and smoking in the placebo group.
Conclusion in relation to chronic sinusitis
Treatment with long-term low-dose azithromycin in combination with the conventional therapy could statistically reduce the recurrence rate of chronic sinusitis symptoms after functional endoscopic sinus surgery. However, more evidence is needed to support clinically significant conclusion of azithromycin at the investigated dose. Thus a larger scale trial and a longer follow-up period are warranted to evaluate the effectiveness of the therapy.
Take the Taste Test: To Aid in Sinusitis Surgery Treatment Selection
6 years ago
A new study proves that your taste buds may predict post-surgery results for sinusitis surgery patients, according to a Penn study.
Taste buds pickup what is called biomarkers, that is, the existence of a certain biological state or condition, such as bitter or salt. The researchers from Penn Medicine and the Monell Chemical Senses Center reported their findings in International Forum of Allergy & Rhinology.
It might sound strange but the team discovered that a genetic biomarker—the receptor for bitter taste—could better predict post-surgery results for patients who underwent surgery for chronic sinusitis. Remember that this seasonal-related condition afflicts around 37 million Americans each year. The condition reduces daily productivity in lost worktime, and is associated with a lower quality of life. In the US, sinus infections cost more than $13 billion in lost productivity each year.
The study found people sensitive to a certain bitter compound reported breathing more easily through their nose, having fewer subsequent infections, and sleeping with ease six months after surgery than those less sensitive to the bitter compound.
Bitter taste receptors are proteins that are found in taste cells of the tongue, where they protect against the ingestion of toxic plant and bacterial products. The collaborative Penn Medicine/Monell team had earlier identified these cells lining the passages of the nose and sinuses and contributing to the natural defenses against certain bacteria.
For the study, patients were asked to taste a specific bitter chemical and report their sensations. Those more sensitive to the bitter chemical than those who were not proved to better fight off certain types of respiratory infections. This specific genetic difference correlates to how much one group is able to combat infection following surgery. Thus, the study suggests those more sensitive to certain bitter tastes fight off upper respiratory infections better, and if they do get sick enough to require surgery, they improve more than people with less sensitive systems.
The researchers warn that there is still much research to do because of the diverse functions of taste receptors, but for now, once an easy test kit is produced, ENT specialists will be better able inform and chose a treatment for their patients.
This is welcome news for otolaryngologists who can correlate surgical outcomes to bitter taste tests in order to forecast postoperative complications and results, and thus choose the best sinusitis surgery options.
Citations
Other Penn authors are Douglas Farquhar; James N. Palmer, MD; David W. Kennedy, MD; Laurel Doghramji, RN; Shane A. Morris; David Owens; and Robert J. Lee, PhD.
Other authors are Corrine Mansfield, Anna Lysenko; Beverly J. Cowart PhD; and Danielle R. Reed, PhD, all from the Monell Chemical Senses Center in Philadelphia.
Some Over-the-Counter Drugs May Be As Effective as Surgery for Chronic Sinusitis Treatment
6 years ago
A new study offers some surprising answers to offering chronic sinusitis treatment. According to the study, those with this condition may find great relief in quality of life with nasal sprays and other nonsurgical treatments. For those with chronic sinusitis, this is great news because surgery may not be the best way to treat this infection. The general rule is: the less invasive treatment is the best response to most conditions.
Chronic sinusitis treatments can include nasal sprays and antihistamines may be as effective as surgery in helping some patients achieve a better quality of life, the small study found.
The study was funded by the U.S. National Institutes of Health and published online Oct. 29 in the journal JAMA Otolaryngology-Head & Neck Surgery. Dr. Jordan Josephson, a sinus specialist at Lenox Hill Hospital in New York City, said, “Chronic sinusitis is the number one cause for chronic fatigue and is closely associated with snoring and sleep apnea.
Thirty-eight patients with chronic sinus infections were given medical therapy rather than having surgery. “Patients who have relatively minimally reduced productivity at work and minimally reduced quality of life from their underlying chronic sinusitis can avoid getting worse by continuing with medical
therapy,” said lead researcher Dr. Luke Rudmik, a clinical associate professor of endoscopic sinus and skull base surgery at the University of Calgary in Canada.
The decision to choose medical therapy versus surgery for chronic sinusitis should be based on patient preference, and the decision for each treatment should involve an honest conversation between the doctor and patient so that the patient understands the expected outcomes and potential risks.
Surgery, however, can be a good option too for people with severe sinus infections. Surgery is just an aide to the necessary long-term medical plan that is required to improve the quality of these patients’ lives. Surgery can be minimally invasive, performed with local anesthesia. During surgery, the doctor uses probes and a laser to remove tissue and bone and polyps that have developed during the infection and are narrowing the nasal passages.
With newer surgical techniques, these procedures allow most patients to be free of black-and-blue marks, with most going home the same day. After surgery, patients still need their medical treatment because the procedure doesn’t stop the running nose. The best chronic sinusitis treatment is designed for each patient.
The best news here is that traditional treatments, alternative treatments, and surgical techniques that have failed patients in the past have been renewed and improved so that for them new medical and surgical treatments may offer significant improvements for their quality of life.
DIY Diagnosis of a Sinus Infection
6 years ago
Anyone who’s had a sinus infections will attest to the misery they suffer during allergy season. So it should come as no surprise that those who are hardest hit want—even need—relief now and thus they call their doctor complaining of the pain. Yet the nation’s ear, nose and throat doctors say that is not a good idea for most cases.
Most people who get sinusitis feel better within a week–your doctor will assure you of this–because many of those infections are caused by viruses. So even if you did get antibiotics, they are not going to help. Truth be told, this is how it is. You can only blow to your heart’s content and resist antibiotics for a typical sinus infection.
But should you be more sure about whether you’ve got a viral or bacterial sinus infection? Today, ENTs (Ear, Nose and Throat specialist) are becoming more and more involved with patients on figuring out what’s causing the infection, partly because patients should learn how antibiotics don’t work and can even harm the patient. And part of getting the patients to understand this is by their self-diagnosing the infection.
“For the first time we’ve really made it crystal clear how to self-diagnose your own bacterial sinus infections without going to the doctor, with a high degree of accuracy,” says Dr. Richard Rosenfeld, lead author of the practice guidelines published Wednesday by the American Academy of Otolaryngology-Head and Neck Surgery Foundation.
How can you tell if it’s bacterial or viral?
It’s rather simple: If you’ve been ill for fewer than 10 days and your symptoms remain the same, it’s most likely viral. If your symptom become worse within 10 days or if they get worse in that 10 days after having improved a bit, bacteria could be to blame. The premise here for waiting it out in the DIY approach is that it’s OK to wait and see what happens, rather than rushing off for antibiotics.
Even if it is bacterial, antibiotics help very little Rossefeld says, and adds that “most of what’s going on is your body fighting off the infection yourself with maybe a little boost from antibiotics.”
So what can I do for some relief?
ENTs highly approve of nasal saline washes, as well as over-the-counter pain medications. The saline washes out mucus and reduces stuffiness, and refreshes and –re-invigorates the membranes, Rosenfeld says.
Steroid nose sprays may help with inflammation, the guidelines say, especially for people with chronic sinusitis, which lasts more than three months.
Chronic sinusitis shouldn’t be diagnosed just on symptoms, the guidelines say. A doctor needs to document inflammation of the nose and sinuses, which is usually done by inspecting the nose with special scopes.
You can diagnose acute sinusitis from the comfort of your home remember, but not chronic sinusitis. For that you need a doctor.
Nasal Passage Infections: Bacteria in the Throat, Changing Forms to Better Adapt
6 years ago
That nasal passage infections have been an important area of research for ENT specialists is no secret. Research in morphology and bacteria have recently yielded some crucial research in infections that originate in the nasal passage ways. Some animals are physically shaped by their environment in whole, not just in part. For example, earthworms are entirely slender so that they can weave in and out of narrow spaces in the ground. Evolution plays a key role in such benefits. But does that hold for all things big and microscopic? Interestingly, bacteria come in two shapes: there’s the spherical bacterium (coccus) and the stick-shaped (bacillus)?
Biologists and morphologists wonder if there’s a reason behind why one is spherical and the other slender-shaped. After analyzing pathogenic bacteria living in the nasopharynx, the upper part of the nose, questions of shape have been answered. These bacteria have changed over time, evolving from bacillus to coccus. In an article published in the journal PLOS Genetics, Professor Frédéric Veyrier, of INRS-Institut Armand-Frappier Research Centre, along with his colleagues, demonstrated that the change may have occurred to allow bacteria to pass through the defenses of their host’s immune system.
Respiratory infections are the number three cause of death worldwide. So understanding how these bacteria, or pathogens, make it into the upper respiratory passage way is critical. These pathogens are highly evolved, some so well that bacteria like Neisseria meningitidis and Moraxella catharralis can sometimes cause severe infections in humans. Genetic analysis of the ancestors of these bacteria pinpointed a key gene: yacF. The absence of this gene makes it possible for the shape of these bacteria to evolve. The N. meningitidis and M. catharralis found today in humans are spherical and missing the yacF gene.
The bacteria’s changing from stick-shaped to spherical has allowed the composition of certain molecules on their surface to transform. These molecules, peptidoglycans, play a vital role in how the immune system recognizes bacteria.
“We have long believed that the shape of bacteria was a fixed variable,” noted Professor Veyrier. “We even use it as a way to classify bacteria. Some mystery remains as to how the various species regulate their shape. This research demonstrates that the environment in which the bacteria evolve has an impact on their morphology. These are exciting results because we were able to identify the same change in two different species–and therefore its impact could be a key aspect in the specific way these pathogens are adapting to the human nasopharynx.”
By deepening our understanding of the evolution of bacteria, researchers believe they’ll be able to create new tactics that will prevent severe infections, even those related to sinus infections. This research about bacteria evolving over time could lead to preventing and treating such nasal passage infections that attack more than your head and sinuses, but your entire body.