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Chronic Sinus Infections? What Do ENT Specialists Recommend?

By Michael Branch, MD

Chronic Sinus Infections?  What Do ENT Specialists Recommend?Many people will get a cold (URI) about 1-2 times per year. The symptoms include acute onset of nasal/head con

gestion, sore throat and cough slowly improving by about 7-10 days. Unfortunately, there’s an epidemic overuse of antibiotics prescribed for what are actually self-limiting viral infections, or the common cold. The reports of resistant bacteria are alarming and the inappropriate use of antibiotics is largely to blame. But when the symptoms are prolonged past 10 days, worsening despite conservative treatment, or associated with other complications, the diagnosis of bacterial sinusitis becomes more likely. In patients with either multiple bacterial sinus infections or chronic symptoms lasting more than 12 weeks, an evaluation by an ENT specialist is reasonable.

Chronic Sinusitis Symptoms
• Sinus pain and pressure
• Inflammation of nasal passages
• Nasal congestion
• Nasal Discharge
• Postnasal drainage
• Reduced sense of smell
• Upper teeth pain
• Throat clearing
• Coughing
• Fatigue

Getting a Proper Diagnosis
• Getting an excellent symptom history is the first step to a proper diagnosis
• Physical examination, including a fiber-optic nasal endoscope exam, is often the next step
• Getting a CT scan of the sinuses shows the details of the nasal passages and the sinuses
• Cultures can be taken to determine if there’s a bacterial cause of infection

Conservative Treatment
• Some patients may be given medications, like nasal sprays or allergy pills, to treat the chronic symptoms. But when the problem is refractory to medicine, or the sinuses are chronically blocked, medicines alone are frequently inadequate.
• Nasal washing devices like Neti Pots or flushing devices can help mitigate the constant build-up of mucus.
• Nasal Corticosteroid or antihistamine sprays can help treat congestion
• Allergy immunotherapy may help in select patients

ENDOSCOPIC SINUS SURGERY AND SEPTOPLASTY
Dr. Branch performs traditional surgery using a nasal endoscope to surgically open obstructed sinuses or remove polyps. He also does nasal surgery to correct a deviated septum and enlargement of the nasal turbinates. These procedures are performed in an out-patient surgery center.

MINIMALLY INVASIVE OFFICE PROCEDURES
Balloon Sinus Procedure
The balloon procedure is where the blocked sinuses are opened using a tiny catheter inserted into the obstructed sinus opening. It is inflated with saline for approximately 10 seconds to dilate the sinus passages. The sinus pathway is enlarged six-fold, allowing for proper drainage and ventilation. This procedure is performed in the office with mild oral sedation and local anesthetics. The purpose is to improve sinus aeration.

Celon Turbinate Reduction
This procedure is performed in the office with local anesthesia. It reduces the enlarged turbinates to improve nasal air flow. In selected patients, it is a good choice to help nasal congestion especially when it occurs lying down. The purpose is to improve the nasal airway.

Keeping in mind that some patients will require traditional surgery depending on the severity of their symptoms or anatomical issues, many chronic sinusitis sufferers and patients with nasal obstruction will significantly benefit from the Celon &/or the balloon dilation procedures. Most will have reduced need for nasal sprays and have improvement of nasal &/or sinus symptoms. These treatments have low complication rates, are generally effective and usually long-lasting. If you’ve suffered from sinus or nasal symptoms, consider an appointment with Dr. Branch for evaluation.

Michael Branch, M.D.
Board Certified Otolaryngologist
Ear, Nose, and Throat

Dr. Branch was born in Jacksonville and raised in Gainesville, Fl. His first love was music, playing drums in various rock and roll bands in Gainesville in the 1960s–1970s. He enlisted in the USAF in 1973 and served active duty as an operating room technician for four years. He was commissioned in the USN in 1984 and, after completing residency in Otolaryngology in 1993, served three years active duty as an Otolaryngologist in the Naval Hospitals at Orlando and Pensacola. He has been in private practice since 1996. He is married with three adult children and three adult stepchildren. He has special interests in systematic and reformed theology. He enjoys playing, writing and recording music with his band mates in Gainesville and loves fishing with his lovely wife, snorkeling and diving.

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