The Three A-s of Sinus Pain

"Sinus problems” is a catch-all term many patients will use to describe a wide variety of symptoms including nasal congestion, drainage, facial pain and pressure.  Sinus surgeons often explain to patients that the cause of sinus problems can be divided into the three A's.

The anatomy is evaluated through a combination of physical exam, visualization with endoscopes in the clinic, and medical imaging. Through the exams, we typically see the bone that forms the sinus passageways may be narrowed, which causes recurrent sinus infections; the septum — the cartilage that divides the left side from the right side — may be deviated; or the turbinates — swellings in the nose that warm and humidify the air — may be enlarged. These abnormalities of the nasal and sinus anatomy often require surgery to open or repair. Fortunately, modern sinus surgery focuses on minimally invasive procedures with reduced recovery time and no removable packing.

Indiana is a rough place to live for allergy sufferers. Inhaling the many pollens and molds in our region can cause inflammation, swelling, drainage, and pain in the sinuses and nasal cavity. Frequently these symptoms can be controlled with steroid nasal sprays (e.g. Flonase®), nasal saline rinse and antihistamines (e.g. Zyrtec®). Occasionally, allergy testing and immunotherapy (shots or drops under the tongue) may be required to treat severe allergies.

While the first two As are responsible for 90 to 95 percent of all sinus complaints, the third A represents the wide variety of diseases and pathologies that are less common causes of sinus and nasal complaints. This category includes a variety of benign and malignant tumors, auto-immune disorders (e.g. lupus, sarcoidosis), trauma or extension of dental disease.

When sinus symptoms persist despite standard treatment, an evaluation by an Otolaryngologist (ENT Surgeon) at Columbus Regional Health Physicians may be useful to rule out these and other conditions. Understanding the specific cause of various sinus and nasal problems is the first step to finding relief.

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