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Ear, Nose, and Throat Disorders

Chronic Sinusitis

01/12/2010

Question:

Dear Dr.,

I have been suffering with sinus issues for about 2-3 years. The problems became worse last January. Sore throat, rash, sinus headaches, facial swelling, etc. I went to an ENT. I was put on an Antibiotic for around 4 weeks. After finished with the antibiotic, a CT scan was done. It still showed congestion and a mucous cyst in one of the sinuses. Allergy test were done, and I do have new allergies. The problem is more than just allergies, I believe. I continuously get sick with sinusitis. It is just an ongoing vicious cycle. I start to feel better and then it begins all over again. I have the post nasal discharge all of the time, along with sinus pressure. The ENT did have me use a nasal steroid for the past two months to see if that gave any relief, but it did not. I am going back to the ENT this week but just wanted to have some information or another opinion of the situation before I return. I have and do have some past history of medical conditions so this problem is really effecting me. I have trouble sleeping and am ALWAYS worn out and tired. Short Synopsis of past history: Brain tumor of the cerebellum removed in 2000, double vision, balance issues, two benign cysts removed from the breasts, stomach emptying issues.... Oh and by the way I am ONLY 30 years old so I really want to solve this problem because I am way too young to be tired and worn out. Thank you so much for reading this and I hope that maybe I can get some info before my appointment this week. THANKS again!!!

Answer:

Chronic sinus problems may be caused by a variety of different factors, including allergies, anatomic or inflammatory changes that obstruct the sinuses, and a variety of possible systemic conditions that impact the immune system.  Your ENT surgeon is in the best position to recommend appropriate treatment, since he has had an opportunity to talk with you, examine you, and review your test results.  This is especially so since you do have a number of other medical problems.  A second opinion is always a good idea, but for it to be meaningful, the physician providing that opinion needs to have access to the same information. 

Chronic sinus problems can be treated with a variety of medications and surgery when appropriate.  Without more information, it is difficult to provide you with more specific recommendations.

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Response by:

Allen M Seiden, MD Allen M Seiden, MD
Professor of Otolaryngology, Director of Division of Rhinology and Sinus Disorders, Director of University Taste and Smell Center, Director of University Sinus and Allergy
College of Medicine
University of Cincinnati