Chronic Sinus Infection

One of the most common problems I encounter as an Ear, Nose and Throat specialist is the person with chronic recurring sinus infections who does not seem to respond to usually effective treatments. In children, enlarged and infected adenoids (tonsil-like tissue above the palate and behind the nasal passages) are often a contributory factor as is stomach acid reflux, which can be difficult to diagnose. Children who are heavy breathers or snorers with recurring sinus infections need to be evaluated for enlarged and chronically infected adenoids which can transmit infection to the sinuses. Stomach acid reflux is often obvious in infants who frequently burp or regurgitate after eating, but may not be as obvious in older children who can have this problem while sleeping. Acid reflux often responds well to antacid medication such as Zantac, and removal of infected and enlarged adenoids often helps with sinus infections. Sometimes a three or four week course of antibiotics is required to completely eliminate all infection so that it won’t recur. By this time a strong, broad spectrum antibiotic is usually the only kind that will work.

In both children and adults, allergy is often a major factor. By the time recurrent sinus infection becomes a problem, various allergy treatments are usually required. These usually include prescription antihistamines, nasal steroid spray, air filters, and often allergy testing and treatment. It is rare that some combination of these treatments do not help. When they do not help enough, CT scan x-rays of the sinuses are usually needed to look for sinus blockage causing infection. This can be corrected surgically often with tremendous improvement.

More and more however, I am seeing patients who are getting sick from environmental exposure at work and at home. An often overlooked problem is mold. This is especially a risk in older houses and offices, or anywhere moisture has leaked into the building. Synthetic stucco homes can trap moisture leading to mold growth. If you have synthetic stucco, look up “E.I.F.S.” on the internet.

In mold exposure situations, often whole families or co-workers seem to be sick more than usual. Looking for signs of mold growth around pipes, ceilings and air vents can often identify the problem. Testing the building or room for excess mold may be necessary. Environmental treatment of the air conditioning system and building can help, but may be difficult and expensive.

Occasional sinus infections can be treated adequately by primary care or nurse practitioners, but if it becomes chronic or complicated, an Ear, Nose and Throat specialist can help.

Dr. Chuck Guice