Dr. Hazenfield -- Ear, Nose, and Throat Doctor in Hawaii

Sinusitis and Other Sinus Disease

Hugh N. Hazenfield, M.D., F.A.C.S.

The Sinuses

•  Sinusitis and Sinus Disease

   

  • Sinusitis, or sinus infections, fall within one or more of the following:

    •  Acute (up to 4 weeks)

    •  Subacute (4-12 weeks), or

    •  Chronic (over 12 weeks).  

  • There may be an acute infection in addition to an underlying subacute or chronic sinus infection

  • Sinus infections may be secondary to allergies

  • Sinusitis may also cause chronic coughing or bronchitis

  • Sinusitis frequently responds to medical therapy, but it may require surgery 

  • Other conditions such as polyps and tumors also occur in the sinuses

  • Many symptoms attributed to the sinuses are in fact due to nasal problems:

    • Allergic rhinitis

    • Deviated nasal septum

    • Polyps

    • Foreign bodies in the nose

    • Nasal infections or inflammation (called "rhinitis") 

    • (For a further discussion of nasal disease, please go to that page in this website.)  

•  Treatment of Sinusitis: 

  • Allergic management

     

    • Treatment of allergic rhinitis and other symptoms of allergies may include avoidance of exposure to various environmental factors or foods to which the patient is allergic. Skin testing usually is not necessary. 

    • A careful medical history and some detective work frequently help determine to what patients are allergic.  Feather and/or old pillows are frequently the culprit.  If we perspire during the night, the pillow becomes moist and grows mold.  Then we have our noses in mold all night.  I advise purchasing new pillows every six months. 

    • Usually, medication is required.  This may be in the form of steroid or antihistamine nasal sprays, oral non-sedating antihistamines with or without decongestants, and sometimes montelukast, which has recently been approved by the FDA for nasal allergies. 

    • Infrequently, desensitization injections are required.

   

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  • Medication

     

    • In many patients, sinusitis may be cured or controlled with medication only. 

    • Medications may include the following:

      • Antibiotics, which may be required for several weeks

      • Various types of nasal sprays (steroids, decongestants, and/or saline)

      • Antihistamines

      • Oral decongestants. 

    • If medication fails or if there is a suspicion of a tumor, then surgery may be indicated.

     

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  • Surgery

     

    • Surgery involves opening the sinuses, making the openings larger to allow better aeration, and draining any infected material and/or removing masses or polyps

    • This is usually done endoscopically through the nose. 

    • Rarely, it requires incisions under the lip or in or near the eyebrows.

     

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• X-rays or computerized tomography showing "sinusitis"

  • Many individuals have X-ray evidence of chronic sinusitis but are asymptomatic 

  • "Sinusitis" on an X-ray report does not necessarily require medical or surgical treatment

  • If there is bone thinning, this may be due either to a benign mucocele or mucopyocele, or a tumor.  This may require opening the sinuses to both obtain tissue to be certain it is not a tumor and to treat the condition

  • Dr. Hazenfield treats patients, not X-rays

   

• Dr. Hazenfield has extensive experience in treating sinus disease.

  • He specializes in endoscopic sinus surgery, offering it at several hospitals in Hawaii

  • This is performed in the operating room on an ambulatory basis under general anesthesia

    • Small telescopes are used to examine the nose and observe and monitor the rest of the procedure

    • There are no incisions in the face.  The sinuses are opened and drained or biopsied with small instruments inserted through the nose.  This is usually effective in relieving sinusitis and its symptoms

    • If a tumor is discovered, further treatment or surgery might be required

Sinus endoscope inserted through nose