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Sinusitis

Updated 12 June 2018

7 common sinusitis myths you shouldn’t believe

You might have heard that sinus surgery often fails, or that you need an antibiotic if your mucus is yellow. Here we separate fact from fallacy.

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If you are familiar with the sometimes debilitating symptoms of sinusitis, you might know a thing or two about the condition.

Or do you? There are a couple of myths that even die-hard sufferers who've seen it all still tend to believe.

Let's get to the bottom of things:

1. Sinusitis is contagious.

Sinusitis itself is not contagious, but if you catch a viral infection such as a cold or flu, it may lead to sinusitis, according to the Houston Advanced Nose & Sinus Institute. If the source of your sinusitis is a viral infection, you are probably contagious – but this doesn’t mean that the next person will also develop sinusitis.

2. You can easily relieve congestion with nasal spray.

Nasal spray may provide short-term relief for congestion, but it’s not viable as a long-term treatment. 

Some nasal sprays are not meant to be used longer than a couple of days and it’s possible to develop a dependence on the product with prolonged use.

Nasal spray dependence is such a well-known problem that there's even a name for the term: rhinitis medicamentosa. This describes the adverse nasal congestion that develops after using nasal decongestants for longer than the recommended period.

It is also important to keep in mind that not all nasal sprays serve the same purpose and can contain different ingredients such as steroids, saline or antihistamine.

Before you take the over-the-counter route, consult your doctor to determine what type of nasal spray you should be using, following the directions exactly as prescribed.

nasal spray

3. You always need antibiotics for a sinus infection.

This is not true. A patient’s need for antibiotics depends on the cause of the sinusitis. Sinusitis can be acute (lasting less than a week) or chronic (lasting for a couple of months) and can be either caused by a viral or bacterial infection or persisting allergies. 

According to the Massachussets Eye and Ear institution, many patients who are diagnosed with sinusitis often take antibiotics unnecessarily because there is no bacterial infection to treat. The patient doesn’t get better and, ultimately, bacteria may be created that are resistant to treatment with antibiotics.

Whether your doctor decides to prescribe an antibiotic will be determined by the duration and cause of the sinusitis.

Other ways of treating sinusitis can include decongestants, mucolytics, nasal steroids and antihistamines. In some cases, surgery may be suggested.

doctor prescribing antibiotics

4. You are more likely to suffer from sinusitis during spring.

You might think that sinusitis as a result of allergies is more likely to occur in spring, but there are a couple of factors that can make you more susceptible to sinusitis during winter. This includes change in air pressure, as well as indoor factors, such as dust in rugs and carpets.

girl blowing her nose

5. Surgery is only an option for those with physical constraints and often doesn’t work.

It is a common misconception that sinus surgery is only considered to correct a physical cause such as a deviated septum.

Dr Azgher Karjieker, a Cape Town ear, nose and throat (ENT) specialist, mentioned in a previous Health24 article that surgery to alleviate sinus problems should be considered when all other options have been exhausted. While surgery sounds invasive, it's generally not a dangerous procedure and recovery time is about two weeks.

There is also a misconception that sinus surgery often ends up not working. According to Dr Joshua Zimm, a facial plastic and reconstructive surgeon from New York, the vast majority of patients who have sinus surgery have significant improvements in their quality of life. According to Dr Zimm, studies show that 77% to 97% of patients showed improvement and that sinus surgery is highly effective.

He does note that revision surgery might be needed in those with nasal polyps. 

nose surgery

6. Your constant headache has to be sinusitis, right?

You are suffering from chronic headaches which you bluntly dismiss because it’s “only sinusitis”. But could your persistent headache actually be a migraine? According to Hossein Ansari, the medical director of the Headache Centre at Neurology & Neuroscience Associates in the USA, one reason for the high rate of misdiagnosed “sinus” headaches is that most patients don't seek care from a headache specialist.

It is therefore important to reevaluate your diagnosis if no sinusitis treatment has worked for you in the past. Beware of the subtle differences between a sinus headache and a migraine – migraines often include symptoms like flashing sensations, blurred vision and nausea.

If you suspect that your headache could be more than congestion, it might be time to seek specialist advice. 

girl with severe headache

7. If your mucus is green or yellow, it’s a sinus infection.

Nasal drainage with a green or yellow tinge is a classic sign of a sinus infection. The colour is caused by the death of white blood cells fighting off infection, but it still can’t indicate whether the infection is viral or bacterial. It’s important to consult your doctor or ENT specialist who will help determine the cause of infection and determine the correct treatment.

man blowing his nose

 Image credit: iStock

 

Ask the Expert

Sinusitis Expert

Dr Gary Kroukamp MBCHB, FCORL(SA) is an ENT Specialist, practising from rooms at Kingsbury Hospital in Claremont, Cape Town. He also has a teaching sessional appointment as an ENT Consultant at the Tygerberg Hospital. He is a member of the ENT Society of South Africa and the South African Cochlear Implantation Group. His interests in the ENT field include sinusitis and sinus surgery, nasal allergy and ENT conditions in children.

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