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Breathing Easier: Finding relief for chronic sinusitis

June 3, 2014

That feeling of pressure in your head and struggling to breathe often leads to a sinusitis diagnosis, but understanding what it is and why so many people suffer from it is somewhat of a mystery.

“It’s an interesting time for this disease process because, at one time, sinusitis was thought to be an infectious disease,” says John Schneider, MD, Washington University otolaryngologist (ear, nose and throat specialist) at
Barnes-Jewish West County Hospital. “It’s only been in the last 10 years when scientists and clinicians have determined it is much more of an inflammatory disease.”

Common symptoms of patients with sinusitis include nasal congestion, facial pressure, occasional facial pain and discharge in the front or back of the nose, Dr. Schneider explains.

Patients with acute sinusitis may have inflammation often caused by a virus, while those with chronic sinusitis have similar symptoms that typically last greater than 12 weeks. “It’s still a real mystery as to why the disease develops like this and why it’s primarily an adult disease,” says Dr. Schneider, who offers patients relief through a thorough evaluation of their history, nasal anatomy, and clinical data.

“I see most of my patients after they’ve been referred by their primary care physician or other ENTs because they may be more complicated cases.”

Mike McKinnis didn’t realize he had sinusitis until after undergoing an unrelated MRI when doctors noticed fluid filling his left maxillary sinus in his cheek. “For a long time, I didn’t really notice the symptoms, and I dealt with it for awhile,” the St. Louis attorney says. “I didn’t realize it might be a problem.”

Eventually, McKinnis says he wasn’t feeling good, and so his internist, Robert Saltman, MD, who also practices at Barnes-Jewish West County Hospital, recommended he see Dr. Schneider, who sees patients on Wednesdays at the hospital and performs surgeries on Fridays.

“I was told that if left untreated, the fluid in my sinus could harden and cause more significant problems,” he says. “Dr. Schneider recommended outpatient surgery, which was done at Barnes-Jewish West County Hospital. I thought the nurses and staff were quite good, and everything was organized, well done and very comfortable.”

He underwent endoscopic maxillary sinus surgery, where using a small telescope inserted into the nostril, Dr. Schneider opened that sinus and drained the fluid that was “stuck” there. This allowed that sinus to drain more effectively over time.

“Dr. Schneider did a great job. He’s very good and a real up-and-comer in this area,” McKinnis adds. “I had the procedure at end of the week and was back at work during the next week.”

Many chronic sinusitis patients don’t need surgery to help relieve their symptoms, Dr. Schneider says. The goal is to control the severe inflammation that can occur, and that may be through medicine and/or surgery if the anatomy blocks the nasal spray or irrigation medications from reaching the sinus.

One thing Dr. Schneider does caution people about is that although over-the-counter decongestants and pain relievers may cause temporary relief, they often lose efficacy if used over time. For many chronic sinusitis sufferers, prescription medications, such as nasal or oral steroids, can help, and in some cases, surgery may be necessary.  “As with everything in medicine and science, there are better anti-inflammatory treatments for chronic sinusitis today than five years ago, and there will be improvements in the future,” he adds.

To schedule an appointment with Dr. Schneider or any physician at Barnes-Jewish West County Hospital, call 314.542.WEST (9378).

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