Is your nose always stuffing? Do you have postnasal drip cough or throat clearing? Thick discolored discharge from the nose? Well, maybe you have chronic sinusitis. So what is it? What do you need to know about it and how is it treated? Let's learn more with Dr. Paul Fulmer an ENT Doctor and Otolaryngologist at Aspire Allergy and Sinus.
Bill Klaproth: Is your nose always stuffing? Do you have postnasal drip cough or throat clearing? Thick discolored discharge from the nose? Well, maybe you have chronic sinusitis. So what is it? What do you need to know about it and how is it treated? Let's learn more with Dr. Paul Fulmer an ENT Doctor and Otolaryngologist at Aspire Allergy and Sinus. This is Achoo! The podcast for people with allergies and sinus issues from Aspire Allergy and Sinus. I'm Bill Klaproth, Dr. Fulmer, thanks for your time. So first off, what is sinusitis?
Dr. Fulmer: Well, sinusitis is an inflammation of the lining in the cavities called sinuses, which are in your cheeks and your forehead, kind of between your eyes. And so that lining gets inflamed. The mucus is normally being made in there, it gets caught and you develop an infection.
Host: So many people suffer from this and the symptoms can be shared with other conditions. What are the specific signs of sinusitis we should be looking for?
Dr. Fulmer: Really, it's a common problem that so many people have where you feel this pressure or pain in your face. A lot of congestion. Your nose, you have trouble breathing through your nose, you start getting thick drainage, you need to blow out, which is kind of colored like yellow or green or it goes down your throat irritates the back of your throat. And the other thing that people don't really think about is often it sort of affects your quality of life. If you start feeling irritable and you're tired, you're not getting good sleep. And all of these things play into what is typically sinusitis.
Host: Well, I know a lot of people do suffer with this. Are there certain risk factors that we should know about?
Dr. Fulmer: You know, often it's actually goes along with people who suffer from allergies and so it's kind of a combination of the way you're reacting to your environment, which is allergy and the swelling and congestion. And then some people are just predisposed to it because of their anatomy. The sinus openings are narrowed or they have a deviated septum that's blocking part of the sinus openings and so subsequently they end up developing sinusitis easier.
Host: So it sounds like there is a link then between allergies and sinusitis.
Dr. Fulmer: Definitely there is. And I would say that in the people that we see in the office, probably at least 50% have those problems. So they, and that's why they've taken a lot of allergy medicines. They're not necessarily getting well because underlying they've got kind of a low grade chronic sinusitis that never really clears.
Host: Well, we certainly know a lot of people suffer with this and they probably just deal with it as an annoyance and try to tough it out. At what point does it make sense for someone to see a doctor about this?
Dr. Fulmer: I think it's when people have started taking their allergy medicines or over the counter decongestants nasal sprays, things like that. And it just never a clears up. Or they're like, golly, I have another cold again this year. And it just keeps coming back. It may not actually be a cold or allergies. It may actually be sinusitis and that's a perfect time to have somebody come in to see somebody like ourselves.
Host: And then how do you diagnose that someone has sinusitis?
Dr. Fulmer: You know, at least 50% of it is sitting there listening to them and they tell you the same story where they started out with allergy symptoms, they thought, congestion, drainage. Took all these medicines, didn't work. Your local doctor gave them a couple of rounds of antibiotics, they're still having the same pressure, fatigue, congestion and drainage, that sort of thing. So then when they come in the office we can take a look up in their nose, see that the lining inside of the nose is inflamed, we can even look with a nasal endoscope where it magnifies, and we can see up right where the sinus is draining. Often we'll see the cloudy or colored mucus draining at that time.
Host: So then how do you commonly treat sinusitis?
Dr. Fulmer: Well, if they haven't been on any kind of antibiotics or steroids like prednisone, nasal steroids, like Flonase or Nasacort, or something like that. That's the first thing we'll do is treat them for either two or three weeks depending on their symptoms and see them back. And at that point if they're not getting any better, that's the next step we would do, since we've looked at them with the exam, is we do a cat scan of the sinuses and see just what the problems are.
Host: So then how do you commonly treat sinusitis?
Dr. Fulmer: Well, the first thing you always do is people haven't been treated aggressively with medical management searches, decongestants, nasal steroids, antibiotics, and maybe oral steroids like prednisone. Well, we do that first and we treat them for two or three weeks. They come back. They're still having the issues of kind of chronic sinus symptoms with facial pressure, drainage, congestion, fatigue, then we'll do a cat scan and evaluate the sinuses more thoroughly.
Host: So are there certain conditions or triggers that make sinusitis worse?
Dr. Fulmer: Well for sure if you know certain environments, it's either working or certain seasons where you have allergies and things like that that can cause increased mucus production. And the sinuses get blocked. You try to avoid those and treat those with medicines. And that can often help. The other thing that people do that's really so simple is they'll do sinus rinses with normal saline. And they have quite a few different options of over the counter to do that, to keep the mucus moving in their seasons where they have trouble.
Host: So is it safe to say with proper medical diagnosis and treatment from a specialist like yourself, most people can manage this and actually see relief of sinusitis over time and improve their quality of life.
Dr. Fulmer: Absolutely. People can manage that. And often the medicines like over the medicines or decongestants and histamines for allergies may not control it, and they end up having to get allergy tests. You can get treated with immunotherapy, which would be like allergy shots or they have allergy drops now that's a good in terms of managing it. And that's definitely an option for people. And then like I said, about half the people with that end up not being able to manage it and that's when we have to do something. So just a balloon sinuplasty or another more invasive type of way to try to open up the sinuses.
Host: And since you mentioned balloon sinuplasty, can you tell us a little bit more since this is an exciting breakthrough when it comes to treating people with chronic sinusitis?
Dr. Fulmer: Sure, sure. So sinusitis is really just when the sinus is blocked. We have small little openings where the mucus normally drains but when it gets inflamed, it'll swell shut and block off and the mucus backs up and you get an infection. So what the balloon sinuplasty does is kind of an atraumatic way to dilate and reshape the opening. We take a little pin hole opening, we'll make it six millimeters with this balloon. And since we don't Pilate the lining or remove tissue people heal up very quickly. And most people have balloon sinuplasty procedure in the office go back to work the next day.
Host: Yeah, the balloon sinuplasty really is an exciting procedure and if you want to learn more about the balloon sinuplasty, please go to our podcast Page at aspireallergy.com/podcast and then you'll see a podcast called the balloon sinuplasty procedure and how it can change your life. Really a good podcast. If you want to learn more about balloon sinuplasty, please go listen to that. Dr. Fulmer, this has been really informative. Thank you so much for your time today.
Dr. Fulmer: You bet, thanks Bill.
Host: That's Dr. Paul Fulmer. And to learn more or to book a visit, please visit aspireallergy.com, that's aspireallergy.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you, such as the balloon sinuplasty procedure I was mentioning earlier. This is Achoo! The podcast for people with allergies and sinus, a podcast from Aspire Allergy and Sinus. I'm Bill Klaproth. Thanks for listening.
Dr. Fulmer focuses solely on sinus and nasal treatment and is considered an expert in the fields. Before joining the team, he ran a successful ENT practice in Tyler, TX for more than 20 years. He is a Fellow of both the American Academy of Otolaryngology - Head and Neck Surgery and the American College of Surgeons, and is a member of the Texas Medical Association.