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How to Deal With the (Sinus) Pressure

By Joe Soto, MD

Sometimes, the pressure is just too great. I’m not talking about pressures we face in our work lives or family lives, but the sinus pressure that may result from a bad cold or an early pollen season that causes allergies to flare up.

Your sinuses are air-filled cavities in your face. Normally, they function well. If not, they can be a source of misery for a person and significantly affect quality of life. Nasal congestion, facial pressure, facial fullness, nasal drainage, dental pain, loss of smell–all these symptoms characterize sinusitis. Many people suffer from sinusitis each year. Typically, patients feel better within a week or so by treating the sinus symptoms, but what options are available if your symptoms drag on for weeks or even months?
Antibiotics are commonly prescribed for chronic sinusitis, but these are only helpful if there is a bacterial infection present. Nasal steroids (such as Flonase, fluticasone, or Nasonex) are typically prescribed when someone has chronic symptoms. These help to decrease inflammation of the lining within the nasal and sinus cavities caused by allergies, viral infections, bacterial infections, and environmental irritants (such as cigarette smoke). Saline (or salt water) irrigations (such as the Neil-Med Sinus Rinse Kit or Neti-Pot) are also helpful at improving symptoms.

Claritin, Allegra, and Zyrtec are antihistamines available over-the-counter that are useful for allergy symptoms and can be helpful to some patients suffering from chronic sinusitis. Some people who have proven environmental allergies may benefit from allergy shots if the usual medical treatments are not effective.

Unfortunately, 20 percent of people with chronic sinusitis do not respond to medical therapy alone. These patients may be candidates for surgery, but some may be hesitant to consider sinus surgery. In the past, sinus surgery involved painful gauze packing. Fortunately, ENT (ear, nose, and throat) surgeons have dissolvable gels that can be applied to the nasal cavities after surgery to help minimize bleeding and scarring. This eliminates the need to remove painful packing after surgery.

Another new advance in sinus surgery techniques is balloon sinuplasty. Using the same technology in which heart specialists use balloons to open up block heart arteries, ENT surgeons can use a balloon to open up the natural sinus openings with less trauma to surrounding tissue. The benefits are less pain and faster recovery for many patients. Some patients can return to work the next day after their procedure, and the balloon sinuplasty technique is being performed in the office under local anesthesia in some patients. This is a huge benefit to those who may not want to have surgery requiring anesthesia or who cannot tolerate general anesthesia.

If you are seeking relief of your chronic sinusitis symptoms, discuss options with your primary care provider or set up a consultation with an ENT surgeon. There is no reason you have to deal with sinus pressure on your own.

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