Recurrent Sinus Infections - Facial Plastic, Nasal, & Sinus Surgery

General Information

Many of our patients struggle with recurrent sinus infections. You can learn more about recurrent sinus infections and treatment options on his page. The good thing is that many patients can find some relief with treatments like sinus rinses, medications, allergy treatments, and sinus surgery.

Some people never seem to get sick with sinus issues. Other people to get sick with sinus infection all the time.

It’s important to know that sinus infections are actually very common. Most sinus infections are caused by viruses. A routine cold (also called a “viral upper respiratory tract infection”) is caused by viruses. Most of the time, a cold will go away on its own in a week or so.

Bacterial sinus infections are less common than viral infections. A bacterial sinus infection can sometimes develop after a routine cold. The thought is that the viral infection will cause lots of swelling in the nose and sinuses. The swelling and other changes can cause mucus to build up inside the sinuses. This is when bacteria can get into the sinuses and a cause a full blown bacterial sinus infection.

Some people have one or two sinus infections every year. For them, that’s their typical pattern. But if someone at least 4 sinus infections every year, we say that they have “recurrent acute sinusitis.” This is sometimes often shortened to RARS, which stands for Recurrent Acute RhinoSinusitis.

Someone with recurrent acute sinusitis may not have any sinus problems when they aren’t battling a bacterial sinus infection. Their sinuses may be perfectly healthy for much of the year. But, they have bacterial sinus infections much more frequently than others. They have bacterial sinus infections at least 4 separate times over the course of a year.

Recurrent acute sinusitis is also different from chronic sinusitis. People with chronic sinusitis have sinus problems that last continuously for at least 3 months. Many people with chronic sinusitis suffer with their sinuses for years and years.

Symptoms

These are the symptoms people have during a bacterial sinus infection:

Sinus pain
Nasal obstruction
Nasal drainage
Decreased sense of smell

Diagnosis

It can be hard to diagnose sinus infections accurately. That’s because lots of different types of conditions can cause symptoms that can be confused for sinus infection symptoms. The first thing is that it’s hard to tell a viral sinus infections and bacterial sinus infections apart. Both viral and bacterial infections can cause the same types of symptoms. So having things like stuffiness, nasal drainage, and sinus pressure don’t always mean that there’s a bacterial sinus infection.

That’s why it’s helpful to know how long someone has had symptoms. Most viral infections will get better or go away completely in 7-10 days. So, someone who has had symptoms only for a week might be told that they have a viral infection. But, if the symptoms have lasted longer than 10 days, it’s often presumed that they have a bacterial infection.

For a routine sinus infection, getting a CT scan or seeing a specialist isn’t usually necessary. But, if there is a concern that the infection is spreading beyond the sinuses, things like CT scans can be helpful.

Seeing a sinus specialist can also help when someone has recurrent sinus infections. An ENT doctor who is a sinus specialist can offer a detailed evaluation to see what other types of treatments might help your sinus issues. At our office, Dr. Goyal will start by learning about your symptoms. He will want to know what types of symptoms you have when you have a sinus infection. He will also examine your nose with a little camera called a nasal endoscope. The nasal endoscope helps the doctor see if there is a lingering infection and look for things that might be leading to recurrent infections. A sinus specialist will also want to look at a sinus CT scan to see how much swelling, blockage, or fluid is inside the sinuses.

Someone with recurrent sinus infections might also see an Allergy and immunology doctor. Allergy issues and immune system issues are a few other things that can cause recurrent sinus infections. Looking into these types of issues can help the doctor determine some other types of treatments.

Treatment

Medications

For many people with recurrent sinus infections, the first step is determining what can be done to keep the nose and sinuses as healthy as possible on a day-to-day basis. For example, if someone has chronic swelling from allergies, managing the allergies may help their nose be healthier in the first place. Using things like sinus rinses, allergy medications, and nasal steroid sprays can help some patients. These types of things can make some patients less prone to having bacterial sinus infections.

Sinus surgery for recurrent acute sinusitis

For some people with recurrent acute rhinosinusitis, sinus surgery can help. Sinus surgery won’t eliminate sinus infections, but can help in a few different ways. First, having better sinus openings can help decrease the number of infections someone has. This is thought to be because the sinuses are less likely to have material become trapped in the sinuses. Surgery can also help patients clean their nose and sinuses. For example, many people use a sinus rinse. With larger sinus openings, a sinus flush will “wash” the inside of the sinuses much more effectively after surgery. That helps get mucus and other debris out more easily. Another advantage of surgery is that your sinus doctor may be able to treat future sinus infections more precisely. A sinus doctor can look inside the sinuses with an endoscope after surgery. This can help diagnose bacterial sinus infections more quickly and accurately than before surgery. The doctor can also suction some of the infected material and send it to the lab for a culture. The culture can help the doctor understand what type of bacteria are causing the sinus infection. This can make it easier to select the best antibiotic for that particular bacterial strain.

There are four sinuses on each side of the nose and face. These are the maxillary sinuses, the ethmoid sinuses, the sphenoid sinuses, and the frontal sinuses. That means most people have eight sinuses that drain into the nose. Surgery for recurrent sinus infections usually focuses on two of these sinuses: the maxillary and the ethmoid sinuses. Sometimes, a deviated septum might also need to be corrected at the same time. This is called a septoplasty. Each person’s body is different, though. Your sinus surgeon will be able to determine which specific sinuses need to be treated in your particular case.

The good thing is that many patients do have a lot of improvement in their sinus infections after sinus surgery. Surgery can’t eliminate sinus infections. But many patients find that the infections happen less frequently and are not as severe after surgery. Also, infections after surgery can be managed more precisely. Your doctor can get a culture from inside your sinuses after surgery so that antibiotics can be used more precisely.

You may read more about endoscopic sinus surgery for recurrent sinusitis.

What are the typical symptoms of a sinus infection?

Symptoms typically seen during a bacterial sinus infection sinus pain, nasal obstruction, nasal drainage, and a decreased sense of smell.

What is recurrent acute sinusitis?

Recurrent acute sinusitis (also called recurrent acute rhinosinusitis or RARS) refers to a condition when someone has multiple bacterial sinus infections. Each sinus infection lasts less than 4 weeks, and the sinuses are healthy between sinus infections. Patients with recurrent acute rhinosinusitis have at least four sinus infections every year.

What are some treatments for recurrent acute sinusitis?

Treatments can include sinus rinses, nasal steroid sprays, antibiotics, allergy treatments, immune system treatments, and endoscopic sinus surgery.

Does sinus surgery help recurrent sinus infections?

Endoscopic sinus surgery can help patients with recurrent acute sinusitis. For some, endoscopic sinus surgery helps decrease the number of sinus infections they have on a yearly basis. For others, sinus surgery can help decrease the amount of medications they need to manage sinus infections and related sinus problems. Surgery can also help your sinus doctor treat future sinus infections more precisely. That is because the doctor can look inside your sinuses after surgery with a scope. This gives the doctor more information to make an accurate diagnosis and to get samples for sinus cultures.