Acute sinusitis is one of the most common disorders seen in a primary care setting. Unfortunately, many individuals develop recurrent acute episodes. If a patient suffers 3 acute sinus infections in 1 year, they are considered to have recurrent sinusitis. This condition is very challenging for patients and providers alike, leading to lost work and school days, patient discomfort, and high medical costs. It is recommended that these patients see an allergist/immunologist and have a workup including an evaluation of environmental allergy as well as a review of how well their immune system is functioning.
What Causes It?
The allergic workup is very important, as allergic rhinitis can lead to acute and chronic sinusitis. In one study of 200 patients with chronic sinusitis, more than half of patients had allergic rhinitis. When looking at recurrent sinusitis, significant sinus disease has been found to be associated with allergy in 78% of patients. In acute sinusitis, one study of patients with acute maxillary sinusitis found more than a third of the patients suffered from allergic rhinitis. Finding the allergic triggers and treating them effectively will reduce the inflammation and swelling in the nasal passages. If untreated, the swelling can lead to poor clearance of nasal mucous that is already full of bacteria, leading to bacterial growth and infection. Secretions thicken and become more difficult to clear. An allergist can help patients manage their allergies in many ways, including teaching them to avoid allergy triggers once they are known, and developing an immunotherapy program. In patients with recurrent sinusitis, a study showed that immunotherapy resulted in a 61% improvement in sinus pain, a 49% reduction in nasal blockage, and 72% fewer days lost from school or work.
What is the Treatment?
Patients with 3 or more acute sinus infections a year or chronic sinusitis should receive a complete allergic workup as well as an evaluation for immunodeficiency. If abnormalities are found, many of these patients can be helped greatly with management. All Allergy Partners allergists are Board Certified or eligible in Allergy and Immunology and provide expert care for patients suffering from recurrent sinusitis.
By Dr. Mark Wenger
Allergy Partners of Fredericksburg