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What causes sinus problems? Sinus Problems occur when the openings into the sinus become blocked. This is when symptoms of nasal congestion, coughing, facial pressure, fatigue, and other symptoms take place. Colds or other infections, allergies, or physical obstructions may lead to "sinus shutdown" or blockages in the sinuses. This is usually the result of a swollen sinus lining or damage cilia that can not effectively clear your sinuses of mucus. Stress can also contribute to sinus problems.
What are Sinuses and why do we have them? Sinuses can best be described as air filled spaces or cavities within the face and head.
There are four (4) groups of sinuses - the frontal, ethmoid, maxillary and sphenoid. Normally the sinuses form mucus that drain into the nose. This helps to continually clean the nose. No one really understands the function of the sinus but occasionally the sinuses can be the site of infections.
What is a Sinus Infection? Sinus infections (also known as sinusitis) usually follow a viral infection. Adults and children alike usually experience at least two or three viral infections a year. Often viral colds or upper respiratory infections are followed by a common cold and will usually clear up on their own. After a week of having cold symptoms a viral infection can turn into a bacterial infection. When the mucus from your nasal discharge changes from clear to yellow or green , it usually indicates a bacterial infection has developed.
What does a Sinus Infection do to your nose? Sinus infections cause swelling of the lining of the sinuses and thickening of the mucus. The swelling of the sinus tissue and thickening of the mucous causes congestion. The infection slows down the normal sinus drainage.
There are two types of Sinusitis. Acute Sinusitis, and Chronic Sinusitis.
The symptoms are:
Acute (more than four infections per year)
Green/yellow discharge
Facial pressure
High fever
Upper tooth pain
Congestion
Chronic (continuous infections)
Congestion/nosebleeds
Mild to moderate headaches
Chronic sore throat and cough
Chronic post nasal drip
Bad breath/taste
Constant fatigue/discomfort
 My doctor tells me I have a Deviated Septum and that is why I'm always congested. What is a septum? The septum is the partition that separates your nasal canals. It is made up of cartilage and bone. Most people have slight deviation (or bend) in their septum but in most cases this does not cause any sinus problems. Some people have a more severe deviation of the septum either naturally or from an injury to the nose. This causes blockage in the nasal canals and restricts the proper air flow through one side or sometimes both sides of the nose. People with this condition tend to have more episodes of infections due to abnormal mucus drainage. Excessive accumulation of mucous in the nasal canals can lead to more infections, and possible growths called polyps.
How do we treat Sinus Problems? Most people with acute sinusitis are treated with antibiotics, decongestants and antihistamines. People with chronic sinusitis are treated the same way but will need long-term treatment for maximum effectiveness. In addition to this they may also be given nasal steroid sprays, or oral steroids. If these medical treatments prove ineffective a CT scan may be necessary to evaluate the sinuses. An otolaryngologist or ear nose and throat specialist will also use endoscopes to exam the nose and throat. Endoscopes are instruments that enable specialist to look inside the nose to help them evaluate patients more thoroughly. This can be performed without much discomfort to the patient. Our new digital computer imaging technology helps physicians to take pictures of the inside of the nose while using the endoscopes. After performing a nasal endoscopy, our specialists save these pictures on a computer and review pictures with patients to help them better understand the treatment plan.
If patients do not improve after weeks of traditional treatment, they may require sinus surgery. Sinus surgery is now done utilizing endoscopes and specialized instruments that reduce the discomfort to the patients after surgery. There are no visible incisions in almost all nasal or sinus surgeries. Gauze that was packed in the nose for seven to ten days is now usually removed in just a few days. Most patients experience stuffiness in the nose for a few weeks following surgery until the swelling subsides. The surgeon will examine their patients closely for a few months after surgery to ensure proper healing.
It is recommended that if you suffer from chronic sinus problems, you speak to an ear nose and throat specialist to find out what treatment is best for you. To learn more about the specialists affiliated with the St. Joseph Nasal Sinus Center visit our physician directory.
Nasal Endoscopy
Prior to the widespread use of fiber optics, examination of the nasal cavity relied on a limited view of the anterior portion of the nose, which would often miss important findings in the posterior nasal cavity.
Nasal Endoscopy is a technique in which the physician examines the nasal cavity in the office setting with a rigid or flexible endoscope. This allows excellent visualization of all nasal structures and of the nasopharynx (the junction between the nose and the throat). In these areas many abnormalities can be found which are frequently responsible for nasal and paranasal sinus disease. A posterior nasal polyp, a posterior nasal septal deviation, enlarged adenoids, or an infection near the opening of the sinuses would be easily be missed if a nasal endoscopy is not performed.
Nasal endoscopy is essentially painless and free of complications. It is normally performed following the use of a topical anesthetic (no injection needed). It has become an essential step in the initial diagnostic evaluation of a patient who has nasal or sinus complaints. It is also very important in the follow-up of patients who have had surgery, allowing for easier nasal cleaning and faster recovery. In these patients it frequently decreases the need for radiologic studies as the paranasal sinuses can be seen through the endoscope.
(Now available at St. Joseph Hospital Nasal and Sinus Center) is a minimally invasive procedure that occurs in our outpatient environment. It utilizes a needle electrode to emit radiofrequency energy to shrink excess tissue to the upper airway including the palate and uvula (for snoring) and base of tongue (for obstructive sleep apnea), and nasal turbinates (for chronic nasal obstruction).
Endoscopic Sinus Surgery
Endoscopic sinus surgery is a procedure that is performed to improve the natural drainage of the sinuses. It was popularized in the United States about ten years ago and has developed into the standard for most surgeons performing sinus surgery. Like a Nasal Endoscopy, a rigid endoscope is used during the procedure to improve the visual field for the surgeon during surgery. The surgeon then removes the diseased area and opens the natural openings into the sinus cavities to improve natural drainage. It usually takes one to two hours and is done on an outpatient basis. The pain is minimal although there are a few days of discomfort while packing is in the nose. Most people feel better three to fibe days after surgery and are able to return to normal activities within a week. It should be noted that all sinus surgeries, when possible should be performed when the infection is at a minimum, with good light, good visibility so the surgeon can visualize the nasal cavity clearly.Sinus surgeries do sometimes need revisions and at these times the recently developed InstaTrak technology is invaluable. Surgery is performed only when medical therapy has failed.
Image Guided Sinus Surgery 
The St. Joseph Hospital Nasal Sinus Center is one of few facilities in California to offer a new, three-dimensional computerized image guidance system for sinus surgery. Developed with Gulf War missile-tracking technology, The InstaTrak System provides a critical element previously missing in sinus surgery--depth perception. To surgeons who must work deep inside the nasal cavities, within millimeters of delicate areas of the eyes and brain, the new system allows the sinus surgeon to navigate the sinus cavities with an added margin of precision and safety.
 Before surgery, the patient undergoes a CT scan. During the CT scan the patient wears a special InstaTrak headset, which is placed on the bridge of the nose and the external ear canals. The headset is used with the CT scan to create a three-dimensional "road map" of the patient's sinus anatomy. During surgery, the surgeon uses a special device tipped with electromagnetic sensors to register, or create, an exact correlation between the sensor location and the "3-D" CT scan image of the sinuses. In essence, this special technology provides increased accuracy to the physician letting the physician know where and how close they are to important structures within and surrounding the sinuses. This new computerized technology guidance system raises the standard of care for sinus surgery to the next level, and it's available right now at the St Joseph Nasal & Sinus Center.Saint Joseph Hospital Nasal & Sinus Center is one of few facilities in California to offer a new three-dimensional computerized image guidance system for sinus surgery. Developed with Gulf War missile-tracking technology, The InstaTrak System provides a critical element previously missing in sinus surgery--depth perception. To surgeons who must work deep inside the nasal cavities, within millimeters of delicate areas of the eyes and brain, the new system allows the sinus surgeon to navigate the sinus cavities with an added margin of precision and safety.
Laser Turbinate Surgery
Laser turbinate surgery is designed to reduce the size of your turbinates (structures in your nose that can cause congestion). This surgical procedure is designed to be quick and painless, with no general anesthesia and no downtime. This procedure is done in a laser lab with topical anesthesia and usually takes about 15-20 minutes. CO2 and KTP lasers are the most common used for this procedure.The procedure usually takes about an hour. There is no packing required in the nose and you could return to work the same day. After surgery, there is very minimal discomfort other than a little congestion for about a week. For those who want some relief from chronic congestion without significant downtime, or are just frightened by a complicated surgery, this may be the best treatment.turbinate surgery is designed to reduce the size of your turbinates (structures in your nose that can cause congestion). This surgical procedure is designed to be quick, painless, no general anesthesia and no downtime. This procedure is done in a Laser Lab with topical anesthesia and usually takes about 15-20 minutes. CO2 and KTP lasers are the most common used for this procedure. Patients are only at the Surgery Center for about an hour. There is no packing required in the nose and you could return to work the same day. After surgery there is very minimal discomfort other than a little congestion for about a week. For those who want some relief from chronic congestion without significant downtime, or are just scared of a complicated surgery this may be the best treatment.
Sinus Headaches
One of the most frustrating symptoms for is facial pain or 'sinus' headaches. Headaches caused by sinus disease are so rare that they are the least likely cause of a headache. Those rare headaches caused by sinus disease are mild, and are almost always associated with unmistakable changes in secretions, massive swellings and losses of sensation over the face. The sinuses are in no way affected by tapping on the face or forehead. Unusual facial tenderness has nothing to do with the nose or sinuses. The advertising programs of the cough and cold industry have done the public a great disservice by exaggerating, for sales purposes, the probability of sinus disease as a cause of headache.
People who suffer from frequent severe headaches usually will be found to have a mixed headache syndrome. The mix' includes muscle tension and contraction, causing a 'Charlie Horse to the muscle and face, head and neck. This component produces most of the tenderness patients often believe points to the sinuses.
A second major element is tempero-mandibular joint syndrome (TMJ) from clenching the teeth in severe pain. This contributes to the tenderness and headaches on the side of the head.
The most important element of the mix is the vascular headache. These intense headaches arise in the blood vessels in the brain. They can be located anywhere on the head...even the face or teeth! They are often accompanied by nausea, and are relieved by sleep. They can be triggered by several foods, hormonal fluctuations, and some are convinced, certain weather conditions. Vascular headaches seemed to be caused by abnormalities in brain chemistry. There is a strong inherited element. They are the major cause of severe headache misery. Migraine headaches are just one example of this kind of headache. These occasionally cause nasal swelling and wetness...(which misleads people onto thinking the nasal symptoms were pointing to the cause, rather than the effect). In some headache sufferers, the nasal swelling causes a crowding and pinching in the nose, which in is experienced as face pain...adding to the misery. Occasionally this component can be reduced or eliminated by nasal or sinus surgery.
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