Sinus Care at Alliance

Facial pain. Nasal blockage. Drainage. The symptoms of sinus disease can be debilitating. Many people suffering from this condition received suboptimal care. Fortunately, we can help.

Focusing on nasal care and sinus disease, the experienced doctors at Alliance offer a broad range of solutions to your sinus problems.  We are board-certified ear, nose & throat physicians dedicated to diagnosing and treating patients with breathing difficulties, sinus headaches, allergies, chronic sinusitis, nasal congestion, and other sino-nasal problems.

Since there are many different causes of sinus symptoms, it is important to receive comprehensive treatment that addresses your specific underlying problem.  At Alliance, we offer a multidisciplinary approach to sinus and nasal problems.  Our team of professionals includes specialists in Neurology, Allergy, and Otolaryngology (ENT).

Our single most important goal is to relieve your sinus suffering.  Because our doctors focus on nasal and sinus disorders, we are able to utilize multiple modalities to alleviate your symptoms. We utilize the latest technology and treatment options available to treat sinus and nasal disease, including:  functional endoscopic sinus surgery (FESS), Balloon Sinuplasty, stereotactic image guidance,immunotherapy, septoplasty and turbinate reduction procedures.

With a long history of nasal and sinus care in southeastern Wisconsin, we have pioneered and refined many innovative techniques and have helped thousands of patients end their nasal and sinus suffering.  We are the first Sinus Center of Excellence in Wisconsin dedicated to the treatment of sinus disease utilizing a coordinated multidisciplinary approach.  Each patient we treat is evaluated by our team of professionals and a unique customized plan of treatment is developed to address each patient’s symptoms and specific sinus or nasal problem.

We work with each patient to ensure that they always know what to expect — and understand each option available to them.  In most cases, we attempt to treat patients non-surgically.  For those who fail medical therapy, however, our surgeons are known for their skills in balloon sinuplasty, endoscopic sinus surgery, septoplasty, and turbinoplasty. Prior to surgery, every patient’s case will be reviewed by our sinus board of professionals to ensure that the most appropriate surgical option and technique is utilized.

At Alliance, we are committed to educating our patients and other healthcare professionals.  We offer opportunities for other professionals to learn from our experience by being involved with us or sharing their complex patient cases with the sinus board.

If you suffer from sinus or nasal problems, let our specialized team help you develop a customized plan of treatment. Our offices are conveniently located in Milwaukee, Brookfield, and Franklin,  Wisconsin.

Sinus Treatment Options at Alliance

Functional endoscopic sinus surgery (FESS) is a minimally invasive technique used to restore sinus ventilation and normal function.  The most suitable candidates for this procedure have recurrent acute or chronic infective sinusitis.  Fiber optic telescopes are used for diagnosis and during the procedure, and computed tomography is used to assess the anatomy and identify diseased areas.  Functional endoscopic sinus surgery should be reserved for use in patients in whom medical treatment has failed.  The procedure can be performed under general or local anesthesia on an outpatient basis, and patients usually experience minimal discomfort.

The reasoning and concepts supporting the use of FESS are widely accepted.  (The term “functional” was introduced to distinguish this type of endoscopic surgery from non-endoscopic, “conventional” procedures.) The goal of FESS is to return the mucociliary drainage of the sinuses to normal function.  The paranasal sinuses are maintained in a healthy state by ventilation through the individual ostia and by a mucociliary transport mechanism that keeps a continuous protective layer of mucus flowing out of the sinuses.

Stereostactic sinus surgery, also called image guidance, utilizes preoperative computed tomography (CT) images that are converted to three-dimensional (3D) digital maps of a patient’s anatomy and the sinuses that require surgery, this allows the surgeon to correlate the real-time operative findings with structures.  The system then tracks the actual movements of the surgical instruments and displays these movements in relationship to the converted 3D images of the patients anatomy.  This allows more precise, complete, and safe sinus surgery.

Septoplasty and turbinate reduction procedures are frequently used to correct anatomic issues that cause nasal obstruction.  The nasal septum is the partition that divides one side of the nose from the other.  It is rarely perfectly straight–it is slightly crooked in over 80% of people.  When the septum is so crooked or deviated that it blocks the nasal passage, then a surgical operation called a septoplasty may restore clear breathing.

If your nose is congested on one side during part of the day and later congested on the other side, then it is not just the septum that is causing the nasal obstruction.  In this instance, an abnormal turbinate–a structure that projects from the lateral wall of the nose into the nasal cavity–may be the cause. Usually medical treatment (such as a nasal steroid spray) is recommended before considering surgery. If the medical treatments fail to bring relief, then your doctor may also recommend a procedure known as a turbinate reduction.  Turbinate reductions can be done in the office or in the operating room.  A septoplasty may be combined with a turbinate reduction so the normal nasal airway can be restored.

Learn More About Sinus Care Treatment Options

Balloon Sinuplasty (BSP) is a safe and effective procedure for chronic sinusitis patients who are not responding well to medications and are seeking relief from uncomfortable and painful sinusitis symptoms. Dr. Rieder and Dr. Hertler are the leading experts in Wisconsin for providing this procedure. If you live in the Milwaukee, Franklin, or Brookfield area, Alliance can offer Balloon Sinuplasty treatment to help alleviate your symptoms.

 

With Balloon Sinuplasty, ENT doctors open inflamed sinuses in the same way that heart surgeons open up blocked arteries during balloon angioplasty. The procedure is less invasive than traditional sinus surgery, and effective at relieving symptoms of chronic sinusitis. Balloon Sinuplasty allows patients to return to normal activities quickly. Unlike conventional sinus surgery, it does not include removal of bone or tissue from the nose.

The Benefits of Balloon Sinuplasty Include:

  • Safe: More than 150,000 patients have been treated safely with Balloon Sinuplasty.
  • Proven: Over 95% of patients who’ve had the procedure say they would have it again.(1)
  • Fast: While recovery time varies with each patient, people can quickly return to normal activities. (2)

If you have been diagnosed with chronic sinusitis and are not responding well to antibiotics, you may be a candidate for sinus surgery. There is now a less invasive option used by ENT doctors to treat chronic sinusitis that is clinically proven to be safe, effective and improve the quality of your life.

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Sinusitis Overview

Sinusitis affects 37 million people each year, making it one of the most common health problems in the U.S. It is more prevalent than heart disease and asthma and has a greater impact on quality of life than chronic back pain or congestive heart failure. Symptoms may significantly affect people physically, functionally, and emotionally.

The Role of the Sinuses

To understand sinusitis, it is important to first learn about your sinuses and their role within your body.


The sinuses are air spaces behind the bones of the upper face, between the eyes and behind the forehead, nose and cheeks. The sinuses are covered with a mucus layer and cells that contain little hairs on their surfaces called cilia. These help trap and push out bacteria and pollutants.

Each sinus has an opening that allows mucous to drain – this drainage is essential to keeping your sinuses working well and you healthy. Anything that obstructs that flow may cause a buildup of mucus in the sinuses and trigger symptoms that range from minor to severe.

Experts agree that healthy sinuses are a key to a good quality of life and that unhealthy sinuses may cause some unwanted complications.

What is Sinusitis?

Sinusitis is defined as an inflammation of the sinus lining commonly caused by bacterial, viral and / or microbial infections; as well as, structural issues such as ostial blockage. Symptoms include nasal congestion, facial discomfort, nasal discharge, headache, and fatigue.

Types of Sinusitis

There are two main categories of sinusitis: acute and chronic.

Sinusitis is usually preceded by a cold, allergy attack or irritation from environmental pollutants. Often, the resulting symptoms, such as nasal pressure, nasal congestion, a “runny nose,” and fever, run their course in a few days. However, if symptoms persist, a bacterial infection or acute sinusitis may develop.

Most cases of sinusitis are acute (or sudden onset); however, if the condition occurs frequently or lasts 12 weeks or more, you may have chronic sinusitis.

Nasal congestion and sinus pressure have many causes: colds, flu, allergies, to name a few. Whatever is triggering them, the symptoms can be a pain — literally. These tips may help make congestion and sinus pressure a bit more bearable — and help you breathe a little easier.

 

Home Treatments for Sinus Pressure

What’s actually causing that stuffed up feeling? When you’ve got a cold or allergies, the membranes lining your nasal passages become inflamed and irritated. They begin to produce excess mucus as a way of flushing out whatever is causing the irritation, such as an allergen.

When you’re stuffed up, you need to focus on keeping your nasal passages and sinuses moist. Although people sometimes think that dry air might help clear up a relentlessly runny nose, it actually has the opposite effect. Drying out the membranes will irritate them further.

So to keep your nasal passages moist, you can:

  • Use a humidifier or vaporizer.
  • Take long showers or — very carefully — breathe in steam from a pot on the stove.
  • Drink lots of fluids, which will thin out your mucus and may help prevent your sinuses from getting blocked up.
  • Use a nasal saline spray – simple unmedicated salt water – to help prevent your nasal passages from drying out.

To further ease your nasal congestion and sinus pressure, here are some other things you can try at home.

  • Irrigate. It may seem odd, but the time-honored technique of flushing out nasal passages with salt water has some good scientific evidence behind it. The water washes out mucus and other debris – including allergens or germs – while keeping your nasal passages moist. There are many different approaches. You could just use a syringe, a neti pot, or one of the more elaborate and expensive nasal irrigators available in stores. Use distilled, sterile or previously boiled water to make up the irrigation solution. It’s also important to rinse the irrigation device after each use and leave open to air dry.
  • Use warm compresses on your face. Sitting with a warm, wet towel on your face may relieve discomfort and open your nasal passages.
  • Prop yourself up. At night, lie on a couple of pillows. Keeping your head elevated may make breathing more comfortable.
  • Avoid chlorinated pools. Although you might think the moisture will help, the chlorine in pools can irritate the mucous membranes in your nasal passages.

OTC Sinus Pressure Medicines

Over-the-counter drugs can also play a role in controlling your symptoms.

  • Decongestants. These medicines help reduce the swelling in your nasal passages and ease the stuffiness and sinus pressure. They come as nasal sprays, like naphazoline (Privine), oxymetazoline (Afrin, Dristan, Duramist), or phenylephrine (Neo-Synephrine, Sinex, Rhinall). They are also available as pills, such as phenylephrine (Lusonal, Sudafed PE, Sudogest PE, and others) and pseudoephedrine ( Sudafed, Sudogest).Follow the directions for using them correctly and safely. Don’t use an oral decongestant for more than a week without checking with your doctor. Don’t use a decongestant nasal spray for more than three consecutive days as it may cause worsening congestion. Do not give decongestants or any over-the-counter cold medicine to children under 4.
  • Antihistamines. If allergies are behind your nasal congestion and sinus pressure, controlling them will help reduce your symptoms. Look for allergy medications that contain both an antihistamine to help relieve sniffling and sneezing along with a decongestant to help relieve congestion and sinus pressure. You may also find antihistamines in cold medicine, which can help a runny nose and sneezing. You’ll usually find them in nighttime cold medicine because antihistamines can make you sleepy. Again, read and follow the label and talk to a health care provider or pharmacist. Also, in children, you should always use products intended for their age.
  • Pain relievers. Although they’re not helpful for nasal stuffiness, pain relievers like acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen sodium (Aleve) can help ease the pain caused by sinus pressure. When taking any over-the-counter medication, be sure to read and follow the label closely and not to take more than the recommended dose.

Seeing Your Doctor at Alliance

Although there’s a lot you can do to ease your nasal congestion and sinus pressure, there are limits to what you should do on your own.

A rule of thumb: if you have nasal congestion and sinus pressure for more than seven days, you should see your doctor. By that point, the odds are higher that you could be dealing with a condition that needs medical treatment. Obviously, go to the doctor sooner if your symptoms are severe.

Keep in mind that the tips above will still help relieve your symptoms, no matter what the cause. It’s just that they may need to be accompanied by other medications or treatments to help control the underlying problem.

Sinus infections often follow a cold and cause pain and pressure in your head and face.

Sinusitis can be either acute (sudden) or chronic (long-term). With chronic sinusitis, the infection or inflammation does not completely go away for 12 weeks or more.

 

What causes sinusitis?

Sinusitis can be caused by three things:

  • Viruses.
  • Bacteria.
  • Fungi.

The same viruses that cause the common cold cause most cases of sinusitis.

When the lining of the sinus cavities gets inflamed from a viral infection like a cold, it swells. This is viral sinusitis. The swelling can block the normal drainage of fluid from the sinuses into the nose and throat. If the fluid cannot drain and builds up over time, bacteria or fungi (plural of fungus) may start to grow in it. These bacterial or fungal infections can cause more swelling and pain. They are more likely to last longer, get worse with time, and become chronic.

Nasal allergies or other problems that block the nasal passages and allow fluid to build up in the sinuses can also lead to sinusitis.

What are the symptoms of sinusitis or sinus infections?

The main symptoms of sinusitis are a runny or stuffy nose and pain and pressure in your head and face. You may also have a yellow or green drainage or drip from your nose or down the back of your throat (postnasal discharge). Where you feel the pain and tenderness depends on which sinus is affected.

Other common symptoms of sinusitis may include:

  • A headache.
  • Bad breath.
  • A cough that produces mucus.
  • A fever.
  • Pain in your teeth.
  • A reduced sense of taste or smell.

How is sinusitis diagnosed?

Your doctor can tell if you have sinusitis by asking questions about your past health and doing a physical exam. You probably won’t need any other tests.

How is sinusitis treated?

Viral sinus infections usually go away on their own within 10 to 14 days. Antibiotics don’t work for viral infections. But there are some things you can do at home to help relieve your symptoms:

  • Drink plenty of fluids.
  • Put a hot, damp towel or gel pack on your face for 5 to 10 minutes at a time, several times a day.
  • Breathe warm, moist air from a steamy shower, a hot bath, or a sink filled with hot water.
  • Use saline nose drops and sprays to keep the nasal passages moist and use saline nasal washes to help keep the nasal passages open and wash out mucus and bacteria.
  • Try over-the-counter medicine to help relieve pain and pressure in your head and face.

Home treatments may help drain mucus from the sinuses and prevent a more serious bacterial or fungal infection.

Bacterial infections can be treated with antibiotics. You will probably feel better in a few days, but some symptoms may last for several weeks. You may need to take the medicine for a longer time if you have chronic sinusitis.

If you have a fungal infection—which is not common—antibiotics won’t clear up your sinusitis. With this type of infection, you may need treatment with antifungal medicines, steroid medicines, or surgery.

If you have taken antibiotics and other medicines for a long time but still have sinusitis symptoms, you may need surgery. You may also need surgery if the infection is likely to spread or if you have other problems, such as a growth (polyp) blocking the nasal passage.

A stuffy nose, also known as nasal obstruction, is a fairly common problem. Patients with nasal obstruction have trouble breathing through their nose. This can force them to breathe through their mouth, leading to a sensation of a dry mouth. In many patients, these symptoms get worse at night when they are lying flat. This can cause them to have less restful sleep.

 

Nasal Obstruction

Nasal obstruction can be caused by a number of problems. For example, things like allergies can cause nasal obstruction. Another very common cause of nasal obstruction is narrow nasal passages. Often, narrow nasal passages are the result of problems with the nasal septum and turbinates.

The nasal septum and the turbinates are normal structures inside the nose. The nasal septum is the structure that divides your nasal passages into the right and left sides. A deviated septum refers to a septum that is crooked.

The turbinates are near the septum, but there is usually space between the septum and turbinates to allow air to pass through the nose. The turbinates can contribute to nasal obstruction if they are too large. There are several different types of turbinates in the nose. The ones that most commonly affect airflow are called the inferior turbinates.

The picture below shows the nasal septum and the inferior turbinate on the left side of the nose.

Deviated Septum

The septum is made of cartilage and bone. The cartilage and bone of the septum are lined by a thin membrane called mucosa. This layer acts like a layer of skin for the inside of the nose. This layer covers and protects the cartilage and bone. It also helps to keep the inside of the nose moist.

When the septum is deviated, one or both sides of the nose can become blocked. In these instances, surgery can help to correct the deviation and improve airflow.

The CT scan and picture of the nose shown below demonstrate show examples of a deviated nasal septum. Both of these images point to a deviated nasal septum on the left side of the nose.

Diagnosis

The diagnosis of a deviated septum can be made by your doctor. Your doctor will perform a thorough evaluation of your symptoms and will examine your nose. You may undergo a procedure in the office called a nasal endoscopy to diagnose the cause of your nasal obstruction. A deviated septum can also be seen on a CT scan, but a scan is often not necessary to diagnose the cause of nasal obstruction.

After making the diagnosis, your doctor can discuss treatment options for you. If you have troublesome symptoms, you may be a candidate for surgery to straighten your septum.

Surgery

Surgery to correct a deviated septum is called a septoplasty. Septoplasty is most commonly performed to help relieve nasal obstruction. Sometimes, septoplasty is a necessary part of other surgical procedures like sinus surgery or nasal tumor removal.

During a septoplasty, your surgeon will attempt to straighten the cartilage and bone that have led to the septum being deviated. During the procedure, the lining (the mucosa) is first raised off the cartilage and bone. The cartilage and bone can then be reshaped. Sometimes, portions of the cartilage and bone need to be removed. The lining is then laid back down.

Because the septal cartilage has ‘memory’–it has an intrinsic tendency to assume its initial shape–the septal cartilage can sometimes bend after the surgery.

Septoplasty is a procedure that is done in the operating room under anesthesia. The procedure is typically performed under general anesthesia, but your doctor can help you decide if local anesthesia is an option for you. The procedure is typically performed on an outpatient basis. This means that patients come in and go home the same day.

You may have splints or packing inside your nose during the healing process. In some instances, there may be nothing more than dissolving stitches inside your nose. Your surgeon can let you know whether packing or splints will be placed in your nose and how long they will stay in place.

Turbinates

The turbinates are structures on the side wall of the inside of the nose. They project into the nasal passages as ridges of tissue. The inferior turbinates can block nasal airflow when they are enlarged. The pictures below demonstrate how the inferior turbinates can block airflow when they are enlarged and touch the nasal septum.

The turbinates are made of bone and soft tissue. Either the bone or the soft tissue can become enlarged. In most patients, enlargement of the soft tissue part of the turbinate is the major problem when the turbinates become swollen. When the turbinates are large, they are called hypertrophic turbinates.

Diagnosis

The diagnosis of enlarged inferior turbinates can be made by your doctor with a thorough evaluation of your symptoms and nasal examination. Your doctor may perform a procedure in the office called a nasal endoscopy to diagnose the cause of your nasal obstruction.
After making the diagnosis, your doctor can discuss treatment options for you. If the turbinates are swollen, your doctor may recommend medications for you. For many patients, medications can help reduce the size of the turbinates and can help improve their nasal obstruction. If you have troublesome symptoms even after using medications, you may be a candidate for surgery to shrink the size of your turbinates.

Surgery

There are many ways to shrink the size of the turbinates. Surgery is typically called turbinate reduction or turbinate resection. Surgery can be performed either in the office or in the operating room. In many instances, turbinate surgery is performed in conjunction with septoplasty.
It is important that the turbinate not be removed completely because its removal can result in a very dry and crusty nose. In the absence of a turbinate, the air that is breathed may not be to adequately humidified and warmed. Occasionally, turbinate tissue will re-grow after turbinate surgery and the procedure may need to be repeated. This is preferable to the situation of totally removing the turbinate.

You may hear of many different terms being used when it comes to surgery for the turbinates. Examples of these terms are cauterization, coblation, radiofrequency reduction, microdebrider resection, and partial resection. These all refer to different methods of reducing the size of the turbinates.

Some methods rely on shrinking the turbinates without removing any of the turbinate bone or tissue. These methods include cauterization, coblation, and radiofrequency reduction. In each of these methods, a portion of the turbinate is heated up with a special device. Over time, scar tissue forms in the heated portion of turbinate, causing the turbinate to shrink in size.

In some instances, a portion of the turbinate is removed. It is important that enough of the turbinate be left intact so that the turbinate can warm and humidify the air that is flowing through the nose. If a portion of the turbinate is removed, a procedure called a submucosal resection is typically performed. This means that the lining of the turbinate is left intact, but the “stuffing” from the inside of the turbinate is removed. As the turbinate heals, it will be much smaller than before surgery. Sometimes, this resection can be performed with a device called a microdebrider. This device allows the surgeon to remove the “stuffing” through a small opening in the turbinate. In some instances, more of the turbinate is removed.

In some instances, packing may be placed in your nose during the healing process.

The ear, nose, and throat specialist will prescribe many medications (antibiotics, decongestants, nasal steroid sprays, antihistamines) and procedures (flushing) for treating acute sinusitis. There are occasions when physician and patient find that the infections are recurrent and/or non-responsive to the medication. When this occurs, surgery to enlarge the openings that drain the sinuses is an option.

A recommendation for sinus surgery in the early 20th century would easily alarm the patient. In that era, the surgeon would have to perform an invasive procedure, reaching the sinuses by entering through the cheek area, often resulting in scarring and possible disfigurement. Today, these concerns have been eradicated with the latest advances in medicine. A trained ENT surgeon can now treat sinusitis with minimal discomfort, a brief convalescence, and few complications.

A clinical history of the patient will be created before any surgery is performed. A careful diagnostic workup is necessary to identify the underlying cause of acute or chronic sinusitis, which is often found in the anterior ethmoid area, where the maxillary and frontal sinuses connect with the nose. This may necessitate a sinus computed tomography (CT) scan (without contrast), nasal physiology (rhinomanometry and nasal cytology), smell testing, and selected blood tests to determine an operative strategy. Note: Sinus X–rays have limited utility in the diagnosis of acute sinusitis and are of no value in the evaluation of chronic sinusitis.

Functional endoscopic sinus surgery (FESS):

Developed in the 1950s, the nasal endoscope has revolutionized sinusitis surgery. In the past, the surgical strategy was to remove all sinus mucosa from the major sinuses. The use of an endoscope is linked to the theory that the best way to obtain normal healthy sinuses is to open the natural pathways to the sinuses. Once an improved drainage system is achieved, the diseased sinus mucosa has an opportunity to return to normal.

FESS involves the insertion of the endoscope, a very thin fiber-optic tube, into the nose for a direct visual examination of the openings into the sinuses. With state of the art micro-telescopes and instruments, abnormal and obstructive tissues are then removed. In the majority of cases, the surgical procedure is performed entirely through the nostrils, leaving no external scars. There is little swelling and only mild discomfort.

The advantage of the procedure is that the surgery is less extensive, there is often less removal of normal tissues, and can frequently be performed on an outpatient basis. After the operation, the patient will sometimes have nasal packing. Ten days after the procedure, nasal irrigation may be recommended to prevent crusting.

Image guided surgery:

The sinuses are physically close to the brain, the eye, and major arteries, always areas of concern when a fiber optic tube is inserted into the sinus region. The growing use of a new technology, image guided endoscopic surgery, is alleviating that concern. This type of surgery may be recommended for severe forms of chronic sinusitis, in cases when previous sinus surgery has altered anatomical landmarks, or where a patient’s sinus anatomy is very unusual, making typical surgery difficult.

Image guidance is a near-three-dimensional mapping system that combines computed tomography (CT) scans and real-time information about the exact position of surgical instruments using infrared signals. In this way, surgeons can navigate their surgical instruments through complex sinus passages and provide surgical relief more precisely. Image guidance uses some of the same stealth principles used by the United States armed forces to guide bombs to their target.

Caldwell Luc operation:

Another option is the Caldwell-Luc operation, which relieves chronic sinusitis by improving the drainage of the maxillary sinus, one of the cavities beneath the eye. The maxillary sinus is entered through the upper jaw above one of the second molar teeth. A “window” is created to connect the maxillary sinus with the nose, thus improving drainage. The operation is named after American physician George Caldwell and French laryngologist Henry Luc and is most often performed when a malignancy is present in the sinus cavity.

Sinus headaches are headaches that may accompany sinusitis, a condition in which the membranes lining your sinuses become swollen and inflamed. You may feel pressure around your eyes, cheeks and forehead. Perhaps your head throbs.

Many people who assume they have sinus headaches, including many who have received a diagnosis of sinus headaches, actually have migraines or tension headaches.

When sinus headaches caused by sinusitis do occur, proper diagnosis and treatment are the keys to relief.

Sinus headache signs and symptoms may include:

  • Pain, pressure and fullness in your cheeks, brow or forehead
  • Pain worsening when bending forward or lying down
  • Yellow-green or blood-tinged nasal discharge
  • Stuffy nose
  • Sore throat
  • Fever
  • Cough
  • Fatigue
  • Achy feeling in your upper teeth
  • Decreased ability to smell or taste

 

Sinus headache or migraine?

It’s easy to confuse migraines and sinus headaches because the signs and symptoms of the two types of headaches overlap.

As with sinus headaches, migraine pain often gets worse when you bend forward, and migraines can be accompanied by various nasal signs and symptoms — including congestion, facial pressure and a clear, watery nasal discharge. In fact, studies have shown that approximately 90 percent of people who see a doctor for sinus headaches are found to have migraines instead.

Sinus headaches, however, usually aren’t associated with nausea or vomiting or aggravated by noise or bright light — all common features of migraines.

When to see a doctor about sinus headaches

Consult your doctor if:

  • Your symptoms last longer than 10 days
  • You have a severe headache, and over-the-counter pain medicine doesn’t help
  • You have a fever greater than 100.5 F (38 C)
  • You’ve had several episodes of sinusitis within a year

Sinus headaches accompany sinusitis, a condition in which the membranes lining your sinuses become swollen and inflamed. Sinusitis can be caused by colds, bacterial or fungal infections, an impaired immune system, or structural problems in the nasal cavity. The resulting pressure changes in the sinuses can trigger headaches.

Sinusitis can affect anyone. You may be more likely to develop chronic sinusitis if you have:

  • Asthma
  • Nasal growths (polyps)
  • Allergies to dust, mold or pollen
  • A weak immune system
  • Exposure to pollutants, such as airborne chemicals
  • A condition that affects the way mucus moves within your respiratory system, such as cystic fibrosis
  • Exposure to irritants, such as cigarette smoke

You’re likely to start by seeing your family doctor or a general practitioner. You may be referred to an ear, nose and throat doctor (otolaryngologist). Here’s some information to help you get ready for your appointment and to know what to expect from your doctor.

Most nosebleeds are not usually serious and can be stopped with home treatment. Most nosebleeds occur in the front of the nose (anterior epistaxis) and involve only one nostril. Some blood may drain down the back of the nose into the throat. Many things may make a nosebleed more likely.

 

Changes in the environment. For example:

  • Cold, dry climates; low humidity
  • High altitude
  • Chemical fumes
  • Smoke

Injury to the nose. For example:

  • Hitting or bumping the nose
  • Blowing or picking the nose
  • Piercing the nose
  • An object in the nose. This is more common in children, who may put things up their noses, but may be found in adults, especially after an automobile accident, when a piece of glass may have entered the nose.

Medical problems. For example:

  • An abnormal structure inside the nose, such as nasal polyps or a deviated nasal septum
  • Colds, allergies, or sinus infections
  • High blood pressure
  • Kidney disease
  • Liver disease
  • Blood clotting disorders, such as hemophilia, leukemia, thrombocytopenia, or von Willebrand’s disease
  • Abnormal blood vessels in the nose, such as with Osler-Weber-Rendu syndrome. This syndrome is passed in families (inherited). The abnormal blood vessels make it hard to control a nosebleed.

Medicines. For example:

  • Those that affect blood clotting, such as aspirin, warfarin (such as Coumadin), enoxaparin (Lovenox), clopidogrel (Plavix), or nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Cold and allergy medicines
  • Oxygen
  • Nasal inhalers, such as Afrin
  • Steroid nasal sprays

Nasal abuse of illegal drugs, such as cocaine and amphetamines

A less common but more serious type of nosebleed starts in the back of the nose (posterior epistaxis) and often involves both nostrils. Large amounts of blood may run down the back of the throat. Posterior epistaxis occurs more often in older adults because of other health conditions they may have. Medical treatment will be needed to control the bleeding from posterior epistaxis.

Thousands of Americans suffer from chronic sinusitis every year, and the disease can be incredibly debilitating, causing regular runny noses and painful headaches among other symptoms. For people suffering from chronic sinusitis, surgery may be the best option to remove the tissue causing the issue. However, surgery can sometimes result in long-term inflammation and scarring, causing more sinus blockage later on. Propel sinus implants are a safe and effective way of helping the healing process after sinusitis surgery proceed smoothly.

 

What is Propel?

The Propel implant is a small sent-like device that can be implanted in the sinus cavity after surgery. The implant contains anti-inflammation medication which it releases into the surrounding tissue to help the tissues heal and prevent scarring. Propel is designed to harmlessly dissolve over the course of 30 to 45 days, although it can be removed at any time during this process if it is required.

Why Does Alliance Use Propel?

Chronic sinusitis is a life-affecting disorder, and with proper surgical intervention it can be corrected. However, post-surgical inflammation and scarring can eventually create a situation where further surgeries are needed. In some cases, patients may require repeated surgeries to alleviate their sinusitis. For these patients, by using Propel we can help reduce the chances that they will require additional surgeries and give them peace of mind knowing their chronic sinusitis will not be reoccurring again.