Did you know that if you have asthma, you also have an increased risk of developing sleep apnea, and vice versa?

Research indicates asthma and sleep apnea are indirectly connected, and each condition can potentially exacerbate the other. Although other contributing factors also play a role, knowing how asthma and sleep apnea are related and pursuing effective treatments for each may help you sleep better at night and feel well-rested throughout the day.

Let’s take a close look at each of these conditions and explore how they’re related.

How Are Asthma and Sleep Apnea Related?

Based on our professional experience and our review of recent data, we know that obstructive sleep apnea syndrome (OSAS) and asthma are indirectly connected, with each condition negatively influencing the other.

Although asthma and sleep apnea affect one another, it’s not entirely accurate to say one directly causes the other. Because there are several hypotheses out there, several factors need to be considered.

Recently, researchers have found that obstructive sleep apnea could actually be a trigger for asthma exacerbations. There are a number of different pathways as to how. It may be because OSAS causes hypoxia, or low oxygen levels in the blood and tissues. With a lack of oxygen, asthma symptoms may worsen.

Alternatively, a particular person’s airway lining could have increased irritability or a propensity for inflammation. If so, both asthma and obstructive sleep apnea may be exacerbated by that hyperactive airway lining.

What is Asthma?

Asthma is a chronic long-term condition that affects your lungs’ ability to carry air in and out. If you have asthma, your airways are overreactive and sometimes become inflamed and narrow, making breathing much more difficult.

Your entire respiratory system is split into two parts: the upper respiratory tract (your nose, mouth, and throat) and the lower respiratory tract (your lungs). When a person without asthma has an upper respiratory reaction to a trigger, their upper respiratory tract swells, causing nasal congestion and mucus production, which leads to a runny nose.

Asthma is a similar response, except that symptoms occur in the lower respiratory tract — in the lungs instead of the nose. Asthma triggers narrow the airways and makes breathing much more difficult.

Asthma exacerbations can be triggered by many things, including:

• Exercise
• Cold weather
• Pollen or other allergens
• Viral infections

Asthma symptoms can vary from person to person, but they often include:

• Chest tightness and pain
• Shortness of breath
• Wheezing when exhaling
• Sleep difficulty
• Coughing attacks that get worse with a cold, the flu, or respiratory infections

Unfortunately, there’s no “cure” for asthma, but an individualized treatment plan incorporating medications, medical monitoring, and lifestyle changes can help manage it.

What is Sleep Apnea?

Sleep apnea is a sleep disorder in which breathing repeatedly starts and stops during sleep. Unlike asthma, which is a narrowing of the airways within the lungs themselves, sleep apnea is a physical obstruction of the airways before air reaches the lungs.

Usually, the physical blockage, which can be by the tongue, the tonsils, or one’s own body weight, occurs above the trachea, aka the windpipe.

There are three main types of sleep apnea:

• Obstructive sleep apnea is the most common type of sleep apnea, which occurs when the throat muscles relax too much during sleep.
• Central sleep apnea happens when your brain doesn’t send proper messages to the muscles that control breathing.
• Complex sleep apnea syndrome occurs if you have both obstructive sleep apnea and central sleep apnea.

Common signs and symptoms of sleep apnea include:

• Loud snoring
• Waking up with a parched mouth
• Gasping for air while you sleep
• Insomnia
• Excessive daytime sleepiness
• Headaches in the morning
• Long pauses where you’re not breathing while sleeping (reported by someone else)

What Are the Treatment Options for Asthma and Sleep Apnea?

Thankfully, both asthma and obstructive sleep apnea have a variety of treatment options.

Treatment Options for Asthma

For asthma, there’s an increasing spectrum of treatment options from minimal to maximal. These include:

• A rescue inhaler, a small, handheld device that pumps medication into your mouth and down to your lungs. The medicine opens your airways so you can breathe easier. Some people with mild asthma may only need to use an inhaler every once in a while. If you find yourself using a rescue inhaler more than twice a week, you probably need more long-term treatment.
• Inhaled steroids or bronchodilators are like inhalers, but they are long-acting and are used to control asthma symptoms instead of just providing quick, short-term relief. The steroids work to treat asthma by reducing inflammation in the lungs.
• A combination of treatments may be necessary if you have very severe asthma. A doctor might have you use a rescue inhaler, bronchodilator, and oral steroids together to control and relieve your asthma symptoms.
• Injectable medications for asthma are also sometimes necessary for severe asthma. These medications are in a class of drugs called monoclonal antibodies, which block the response to airway triggers that cause inflammation. People with severe asthma typically receive this type of treatment every 2–8 weeks, and it may be administered at a doctor’s office, hospital, or via self-injection at home. 

Treatment Options for Sleep Apnea

For those with sleep apnea, treatment options include:

• Continuous positive airway pressure (CPAP) therapy, which is a machine with a hose that connects to a mask. The hose delivers constant and steady oxygen while you sleep. Unfortunately, some people have problems with leaky masks, insomnia, dry mouth, and/or other issues related to CPAP, and should consider CPAP alternatives in those cases.
• Weight loss can help treat sleep apnea by reducing fat deposits in your neck and tongue to improve airflow while you’re sleeping.
• Surgery is another alternative treatment for sleep apnea and may include a tonsillectomy (removal of the tonsils), nasal surgery, or Inspire (hypoglossal nerve stimulator surgery). Inspire is a tiny, implanted device that controls your breathing by sending a small electrical signal to the nerve that controls your tongue. Once it’s implanted, you use a small handheld remote to turn it on before bed and off when you wake up. Unlike CPAP, there’s no hose or mask needed.

When Is It Time to See a Doctor?

Asthma and sleep apnea are severe conditions that require ongoing treatment and medical monitoring. If you’re experiencing symptoms of either condition, such as shortness of breath, difficulty breathing, loud snoring, or you stop breathing intermittently overnight, see a doctor immediately.

Here at ENT Associates of Lubbock, we’re eager to help you address your asthma and sleep apnea with a treatment method that’s tailored to you.

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Persistent nasal congestion can have a significant impact on your life. Whether you experience fatigue from poor quality sleep or struggle with the constant discomfort of breathing through your mouth, not being able to breathe well through your nose can cause a myriad of effects that are difficult to juggle.

One solution we offer is VivAer, a non-invasive, in-office procedure done to relieve nasal obstructions. This surgical procedure is quick, effective, and safe, with very little recovery time. However, that doesn’t mean the recovery period shouldn’t be observed seriously.

Let’s review the importance of following your doctor’s VivAer post-op instructions, what to expect after the procedure, and some quick tips for a worry-free recovery.

What Is VivAer?

Previously, the only solutions for chronic nasal obstruction were medications or nasal strips that only offered short-term relief from uncomfortable symptoms. Alternatively, you could opt for surgery, but these procedures were often painful and invasive.

Fortunately, VivAer is now an option for millions of people who suffer from chronic nasal congestion. The VivAer Nasal Airway Remodeling surgery is ideal for people with chronic nasal congestion or stuffiness. It only takes a few minutes and is completed under local anesthesia right in your doctor’s office.

During the procedure, your ENT doctor will insert a small wand into your nostril and apply low-temperature radiofrequency (RF) energy to the specific areas of obstruction. This gently reshapes the inside of your nose, improving airflow so you can breathe easier.

The Importance of Following Your VivAer Post-Op Instructions

As with any surgical procedure, you’ll need to partner with your doctor to ensure that you recover smoothly and without any major or minor issues. Being gentle with yourself and following your ENT doctor’s VivAer post-op instructions is essential for a few reasons:

• The surgery might not be as effective. If you neglect to care for your nose after the procedure, you could reverse the effectiveness of the procedure or undo the procedure altogether. In this case, your VivAer surgery will have been pointless.
• Your recovery time might take longer. Without proper care after surgery, your nose could take longer to heal, making life more difficult in the meantime. If you meticulously follow your doctor’s VivAer post-op instructions, you’re much more likely to experience a fast and easy recovery period.

What to Expect After VivAer

Because VivAer is a non-invasive procedure, there are very few uncomfortable postoperative side effects. You may experience some bleeding for about a day after the procedure, and for about a week or so, you will experience nasal congestion.

You’ll also notice some crusting on the side of your nostrils for about 2–3 weeks. You also may experience mild tenderness in your nostrils if you wiggle your nose, but that’s normal too.

There is no lasting external change to the appearance of your nose after VivAer surgery. Occasionally, some patients experience some swelling of their nostrils, but that only lasts for a few weeks while the nose heals.

4 Tips for a Quick and Problem-Free Recovery

Most people recover from this procedure very well. Follow these VivAer post-op instructions to ensure your recovery is as painless and simple as possible.

Tip #1: Apply a prescribed antibiotic ointment two times per day.

After the surgery, we’ll prescribe you a special antibiotic ointment to prevent infection and expedite the healing process. Apply the ointment to the inside of your nostrils twice a day. Doing so will also keep the inside of your nose from getting too dry and prevent excessive crusting.

Tip #2: Avoid picking at the crusting inside your nose.

It may be tempting to pick at the crusting that will develop inside your nose, but doing so will prolong your healing time. To ensure a fast and easy recovery, do your best to leave the crusting alone. As annoying as it is, it’s a part of the natural healing process.

Tip #3: Use saline spray generously.

Saline spray is a water-based mixture that contains salt, similar to the composition of your tears. After the VivAer procedure, gently spray the inside of your nose with a saline solution as needed. This will prevent uncomfortable dryness and help keep your nostrils moisturized. It will also help soften or dissolve some of the crusting.

Tip #4: Don’t squeeze your nostrils together for one week.

Immediately after surgery, you’ll want to avoid squeezing your nose together when blowing to allow your nasal valve time to heal in the outward position. Pressing your nostrils together might undo the surgery, so it’s important to strictly adhere to this recommendation and give your nose the chance to heal correctly. Avoid accidentally hitting your nose, as well.

We Can Help You Follow Your VivAer Post-Op Instructions Safely

VivAer Nasal Airway Remodeling surgery is a simple procedure that can relieve those who struggle to breathe through their nose, and we’re happy to provide it for our patients.

After the procedure, you don’t need to alter your normal daily activities very much. Take it easy for a few days, don’t overextend yourself or breathe too heavily, and follow our simple VivAer post-op instructions. The ENT Associates of Lubbock are here to help you with any questions you may have along the way, no matter what.

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Being able to breathe through your nose is easy to take for granted. But when structures within your nasal passageways swell and impede normal breathing, it’s impossible to ignore. Among those structures are turbinates.

Swollen turbinates make your nose feel stuffy, often forcing you to breathe through your mouth, which can be really uncomfortable. They can even contribute to headaches and sleep disorders like snoring and obstructive sleep apnea if left untreated.

Let’s take a closer look at congestion from swollen turbinates to determine why it happens and what you can do about it.

What Are Turbinates?

Turbinates are structures made of bone and soft tissue. They sit along your nasal walls opposite the septum, which separates your nostrils into right and left sides.

You might have noticed that the word “turbinate” is similar to the word “turbine.” That’s because, very basically, turbinates affect the airflow in the nose.

Each of your nostrils has three turbinates: inferior, middle, and superior. The inferior turbinates most directly affect airflow because they’re situated further down toward the opening of your nostrils. Normally, there’s a space between the septum and the turbinates that allows air to pass through your nose so you can breathe with no problems.

Turbinates serve an important function. Their job is to filter, moisten, and warm air as it passes through your nose to your throat. Without them, breathing would be much more uncomfortable, coming with a rush of cold as air passed through your nose. Not pleasant!

What Happens When Turbinates Swell?

Everyone has a natural nasal cycle. One side of your nose will always be more congested than the other, and which side it is changes every few hours.

The problem begins when turbinates become so swollen that they prevent air from flowing in. At that point, they’ve become counterproductive. Since turbinates sit right in the midst of your nasal passages, any swelling can easily obstruct your breathing.

Several causes can trigger turbinate swelling, including:

• Allergies (environmental or food)
• Respiratory tract infections
• Sinus infections
• COVID-19
• A cold or the flu
• Pregnancy or other hormonal fluctuations
• The natural aging process
• Prolonged Afrin or topical decongestant usage

What Non-Surgical Treatments Are Available?

ENT doctors typically treat swollen turbinates on a case-by-case basis. That means they look at your symptoms and the efficacy of previous treatments you’ve tried to develop an individualized treatment plan for you.

Most often, we start by treating allergies with medications like oral antihistamines, topical decongestants, or topical antihistamines.

• Antihistamines block the effects of histamines, which are chemicals in your immune system that cause sneezing, itchiness, watery eyes, or a runny nose to help your body expel allergens like pollen and pet dander.
• Decongestants work by narrowing your blood vessels, which shrinks the swollen tissue inside your nose so air can pass through more easily.

Most antihistamine and decongestant combinations are available over the counter (OTC), but some require a prescription from your doctor. An ENT doctor can also give you detailed instructions on how and when to use these medications for the best results.

If allergies cause your turbinates to swell, you can limit your exposure to your allergens as much as possible. Some helpful tips include:

• Remove excess dust and pet dander from your home.
• Don’t smoke indoors.
• Use specialized cleaners to remove any mold and mildew in your bathrooms, kitchen, or basement.
• Use a high-efficiency particulate air (HEPA) filter inside your home. (especially in your bedroom or wherever you sleep.)

If these OTC treatments and environmental adjustments work to reduce the size of your swollen turbinates, you’ll be able to breathe normally through your nose, and surgery won’t be necessary.

When Should I Consider Surgery for Swollen Turbinates?

Sometimes OTC treatments don’t work, and people still experience nasal congestion. If this is the case for you, it may be time to consider turbinate reduction surgery. 

The following surgical treatments are minimally invasive, safe, and can address enlarged inferior turbinates:

• Submucosal turbinate reduction: This is the most common turbinate surgery. It’s usually an outpatient procedure performed under general anesthesia, but some advanced practices offer this procedure in the office with local anesthesia. During this procedure, an ENT doctor uses an endoscope (a small medical device with a light and camera on it) to see inside your nose. Then, they make a small incision in the mucosal lining of each inferior turbinate and remove the tissue causing the swelling.
• Turbinectomy: With this procedure, the ENT doctor removes the bottom half of each inferior turbinate with a tiny, high-speed device. You’re sedated during the entire procedure, so it’s pain-free. Turbinectomies used to be the preferred surgical treatment for addressing swollen turbines, but have fallen out of fashion because taking too much tissue out of the nose can make nasal breathing uncomfortable. However, sometimes it’s necessary for excessively swollen turbinates.
• Thermal application: An ENT doctor may also use heat to shrink swollen turbinates. This option is more commonly used with children because their noses are small, and there’s minimal space to insert surgical instruments into their nostrils. Instead, the ENT doctor will insert a probe into the turbinate to heat and shrink it.

Recovery from turbinate surgery usually takes about five to seven days. You might experience some nasal congestion during this time, but that’s normal. Nasal irrigation can help reduce congestion and speed up the recovery process.

You might also have some nasal discharge after surgery. If it’s yellow, green, or accompanied by a cough or fever, it may be a sign of infection and you should call your ENT doctor.

An ENT Doctor Can Help You Get Relief

If you’re frequently stuffed up and can’t breathe through your nose, swollen turbinates may be the cause. An experienced ENT doctor can review your treatment options and help you determine which one is best for you. Getting rid of that pesky stuffy nose might be easier than you thought!

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

You’ve probably experienced a headache before. Whether it’s a migraine, cluster headache, tension headache, or some other type of headache, none are pleasant. 

Sinus pressure headaches are a common type of headache occurring in the face that many people live with for years because they don’t know there are long-term solutions. What if you could prevent sinus pressure headaches and avoid all the pain and discomfort in the first place? 

Let’s look at what sinus pressure headaches are and explore five potential treatments to relieve their uncomfortable symptoms.

What Are Sinus Pressure Headaches?

Your sinuses are a series of connected air-filled cavities behind your cheeks, forehead, and nose. Sinus pressure headaches occur when the lining of your nose swells and obstructs your sinuses. 

Typically, sinus pressure headaches start behind your eyes, forehead, or cheeks and radiate out, creating a feeling of fullness, pressure, and pain in the front of your face. Sometimes the pain can even radiate down into your teeth. Sinus headaches can also trigger other types of headaches, like migraines, causing a throbbing or pulsing sensation in your head.

Anything that causes swelling in the nose might cause a sinus headache, such as:

• Allergies
• A cold or the flu
• An upper respiratory tract infection
• Weather (barometric changes)
• Traveling by plane (due to changes in air pressure)

Some people may be more likely to experience sinus pressure headaches than others because of the natural anatomy of their sinuses. Each sinus cavity is like a room with a window. If the window gets shut, then the pressure or fluid in the room builds.

People with persistent sinus problems have naturally small windows. If the lining around their sinus openings swells, the window “shuts,” and they experience all the unpleasant symptoms associated with sinus pressure headaches.

If you have “small windows” and are more prone to getting sinus headaches, don’t worry! There are still ways to find relief.

5 Solutions for Sinus Pressure Headaches

1. Use a Decongestant

Oral decongestants can provide immediate relief from sinus headache symptoms. Some common options you might see in stores include:

• Sudafed (pseudoephedrine)
• Suphedrine PE, Wal-Phed PE, etc. (phenylephrine)

While these decongestants can be helpful, they have some side effects, like increased blood pressure, heart palpitations, dizziness, and insomnia. So it’s best to only use them every once in a while, and to consult your doctor before use if you have a history of heart disease. 

Topical decongestants like Afrin (oxymetazoline) nasal spray are also effective, but you shouldn’t use them for more than a few days. If you do, you can experience something called rebound congestion, making your original symptoms worse.

2. Use Steroid Medications

Decongestants work immediately, but only provide short-term relief from sinus headache symptoms. To keep those sinus “windows” open and get long-term relief, you might need to try a steroid like:

• Flonase (fluticasone)
• Nasonex (mometasone)
• Rhinocort (budesonide)
• Nasacort (triamcinolone)

These medications usually come as nasal sprays and belong to a class of drugs known as corticosteroids. They work by reducing swelling and inflammation in your nasal passages.

3. Try Nasal Irrigation

Nasal saline irrigation is another treatment method that uses salt water to bathe and cleanse your nasal passages gently.

So, how does it work?

Essentially, you pour a saltwater solution into one of your nostrils and let it flow through your nasal cavity into the other nostril. As it travels through your nasal passages, it washes out mucus and allergens to reduce your symptoms.

For effective nasal irrigation treatment, you’ll need saline solution and a container, like a syringe, squeeze bottle, or Neti pot. You can buy a pre-packaged set at most drugstores with everything you need to get started.

You’ll likely see results after rinsing your nasal passages once or twice. Research indicates that nasal irrigation can significantly relieve acute or chronic sinus symptoms and inflammation, clear nasal secretions, and reduce post-nasal drip.

4. Get Balloon Sinus Dilation

Balloon sinus dilation is a minimally invasive procedure performed under local anesthesia at an ENT’s office. It’s a treatment for chronic sinusitis (long-lasting sinus inflammation, swelling, and infection) and is quick and safe.

During the procedure, the ENT doctor inserts a small balloon into your nose using an endoscope, a small medical device with a light and camera. Then they gently inflate the balloon to permanently enlarge your sinus cavities.

Most people recover within one to two days and enjoy long-term relief afterward. We typically recommend balloon sinus dilation to people with chronic sinus symptoms that haven’t responded well to other treatments like decongestants or nasal steroid sprays. 

5. Consider Endoscopic Sinus Surgery

Unlike balloon sinus dilation, which follows the natural contours of your sinus cavities and expands the openings, endoscopic sinus surgery completely removes blockages from your sinuses.

This type of sinus surgery is an outpatient procedure performed under general anesthesia. We complete the entire surgery through the nose with an endoscope, eliminating the need to make any incisions in the skin. 

During the procedure, the ENT doctor inserts the endoscope into your nose. Then, they carefully remove anything that they see keeping the sinuses from draining, including mucous membrane, polyps, tumors, or bone.

Balloon sinus dilation is a little like taking those “windows” in your sinus cavities and turning them into doors, while endoscopic sinus surgery is like completely remodeling the house.

It takes most people about a week to recover from endoscopic sinus surgery, and it’s not usually painful. You can expect to experience some nasal congestion. We recommend irrigating your nose once or twice daily to speed up your recovery time.

Not everyone with acute or chronic sinus pressure headaches needs endoscopic sinus surgery. But if you have ongoing congestion and infection that isn’t improving, it might be right for you.

When to Call an ENT About Sinus Pressure Headaches

Sinus headaches are incredibly uncomfortable and can make it difficult to function at work, school, or home. If you experience persistent and bothersome sinus pressure headaches, it’s time to see an ear, nose, and throat doctor. An ENT doctor can help you determine the right treatment based on your situation.

The sooner you take steps to address the root of the problem, the faster you’ll start feeling better!

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Philip Scolaro, MD

Dr. Scolaro is a board-certified Otolaryngologist servicing the South Plains area. He has been practicing in Lubbock since 1990 and has earned a reputation as a skilled and experienced surgeon. He currently serves as the Medical Director for Covenant High Plains Surgery Center campuses, is a member of Covenant Health Partners and is an adjunct faculty professor for Texas Tech University Health Sciences Center School of Medicine. Learn more about Dr. Scolaro. 

“Nasal endoscopy.”

Just the words sound intimidating. Your doctor wants to put a tube… where?

Fortunately, a nasal endoscopy is one of those scary-sounding medical terms that sounds much worse than it actually is.

Read on to find out why, despite how it sounds, a nasal endoscopy really isn’t bad at all — we promise!

What Is a Nasal Endoscopy?

A nasal endoscopy is a simple way for your ear, nose, and throat (ENT) doctor to look deeper inside your nasal passages. The physician first sprays a local anesthetic into your nose to numb your nasal passages and the back of your throat. They then insert an endoscope, a very thin tube with a tiny light and camera on its tip, into your nostril and use it to see all around inside the back of your nose and throat.

Depending on the purpose of the nasal endoscopy, your physician will use one of two kinds of endoscopes.

Flexible Endoscope Tubing

Sometimes your ENT just needs to take a quick look around inside your nose or throat. An exploratory nasal endoscopy like this usually involves a very flexible endoscope tube, which the physician guides with handheld controls. This tiny tube can turn and bend to allow the doctor a good view of anything they need to see. The camera on the end of the endoscope sends detailed video from within the nose to an eyepiece the physician wears.

Rigid Endoscope Tubing

Sometimes a physician needs to use an endoscope for more than just looking around. If they’re also performing a procedure, such as a sinus surgery, an ENT surgeon will use a rigid endoscope so the tube remains steady and in place. They can hold the rigid endoscope with one hand while operating the surgical instruments with the other hand. In this case, the endoscope’s camera usually sends video to a large monitor that the doctor, and sometimes even the patient, can see.

Who Needs a Nasal Endoscopy?

Since we can’t see all the way into the nose just by shining a light up a patient’s nostril, we often use an endoscope to look deeper. When a patient comes in with a complaint that we can’t entirely explain simply by looking up the nose with the naked eye, we can use a flexible endoscope to look for an explanation right there in the office.

Health concerns we might investigate using nasal endoscopy include:

• Suspected deviated septum
• Frequent nosebleeds
• Loss of ability to smell (unrelated to COVID-19 virus)
• Nasal blockage of unknown origin
• Nasal or sinus infection
• Nasal polyps
• Spinal fluid leaking from the nose
• Suspected tumor in the nose

Patients may also need a nasal endoscopy as part of a separate procedure, like endoscopic sinus surgery.

Risks and Side Effects of Nasal Endoscopy

A nasal endoscopy is incredibly low risk. Many times, the complications from medical procedures arise from the general anesthesia. Nasal endoscopy carries none of those risks since it only involves a topical numbing spray that wears off shortly afterward.

In essence, a nasal endoscopy is just looking around. You can think of it similarly to how you’d view a doctor looking into your ear or your mouth. You don’t have to worry about side effects or complications from a tongue depressor, and you don’t have to worry about them with a nasal endoscopy either.

If you’re nervous about feeling pain from a nasal endoscopy, you don’t have to worry. While you may feel a small amount of pressure, you shouldn’t feel any pain at all. As far as after-effects, the worst you might experience is a little nosebleed, and even that is rare.

At ENT Associates of Lubbock, we’ve been performing nasal endoscopies five to ten times per day every day for many, many years. After tens of thousands of nasal endoscopies, we’ve never had a complication.

Before, During, and After Your Nasal Endoscopy

Because a simple nasal endoscopy isn’t surgery, there’s nothing you need to do to prepare. You don’t need to fast or take any special antibiotics. We’ll give you a quick spritz of lidocaine to make sure your nose is numb before inserting the endoscope. The whole process only takes a few minutes, and then you’re on your way!

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Philip Scolaro, MD

Dr. Scolaro is a board-certified Otolaryngologist servicing the South Plains area. He has been practicing in Lubbock since 1990 and has earned a reputation as a skilled and experienced surgeon. He currently serves as the Medical Director for Covenant High Plains Surgery Center campuses, is a member of Covenant Health Partners and is an adjunct faculty professor for Texas Tech University Health Sciences Center School of Medicine. Learn more about Dr. Scolaro. 

If you know or suspect you have nasal polyps, you’re probably familiar with chronic nasal congestion and difficulty breathing. Add to that the facial pressure, difficulty smelling, and recurrent sinus infections, and many people are desperate for an effective nasal polyps treatment.

In this post, we’ll take a look at what nasal polyps are, why they happen, and four of the best nasal polyps treatment options available.

What Are Nasal Polyps?

Nasal polyps can form in the nasal passages or the sinuses and block airflow through the nose. They most commonly form when an allergic response in the nose causes an overgrowth of the nasal mucosa, or nasal lining. The swollen lining then fills with fluid, and pressure from this fluid causes the polyp to herniate out into the nasal cavity like a tiny, drooping water balloon.

Thankfully, nasal polyps are almost never cancerous; they simply make life miserable.

Unfortunately, we don’t know why some people get nasal polyps and some don’t. Certain individuals just seem to be more prone to them than others.

Nasal polyps can develop from a number of different factors. A few of the more common associations include:

• Allergies
• Asthma
• Sensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen and ibuprofen
• Samter’s triad, a chronic condition that includes aspirin sensitivity, asthma, and nasal polyps
• Cystic fibrosis

Nasal Polyps Treatment Options

For something so small, nasal polyps cause some significant symptoms. Because of how much they affect a person’s breathing and cause sinus infections, nasal polyps need treatment.

Fortunately, there are several helpful nasal polyps treatment options available.

Nasal Polyps Treatment #1: Oral Steroids

Nasal polyps respond well to oral steroids, which can produce a substantial improvement in the polyps’ size and symptoms. The main problem with oral steroids is that extended use can cause some significant side effects, including mood changes, high blood pressure, glaucoma, cataracts, osteoporosis, weight gain, and diabetes.

So despite their effectiveness, steroids aren’t a long-term fix for chronic nasal polyps.

Nasal Polyps Treatment #2: Topical Steroids

Topical steroids can serve as an additional or alternative treatment to oral steroids. Topical steroid sprays like Nasacort and Flonase control inflammation in the nasal lining caused by asthma and allergies. Decreasing that inflammation also helps decrease the size of nasal polyps.

Your allergist or ENT doctor may even add a topical steroid to a saline sinus rinse so the steroids can wash through your nasal passages more thoroughly.

These medications may help shrink nasal polyps or slow their growth. They may not be as effective with larger polyps, however.

Nasal Polyps Treatment #3: Surgery

Surgery isn’t the first line of treatment for nasal polyps. As with other conditions, we always start with medical treatment first before proceeding to surgery. That said, almost everyone with significant nasal polyps will eventually end up needing endoscopic sinus surgery.

Most endoscopic sinus surgeries are performed in an outpatient surgical center under general anesthesia. The ENT surgeon uses an endoscope, a thin tube with a tiny camera and light, to see into your nose and sinuses and delicately remove any polyps from your nasal passages using small instruments. Often, the surgeon will also open up your sinuses to let air flow more freely in those spaces as well.

During surgery, some surgeons place small drug-eluting stents into the sinus cavities. As the stents dissolve over the next month or two, they release a small amount of steroids into the nasal passages to prevent nasal polyps from reforming.

Because endoscopic sinus surgery opens the nasal passages and sinuses, topical steroid sprays and steroid sinus rinses can reach much more of your nasal lining for a more thoroughly wash. This allows the medications to do a better job of preventing new nasal polyps from forming.

Nasal Polyps Treatment #4: Monoclonal Antibody Injections

Since the COVID-19 pandemic, more people are familiar with the concept of monoclonal antibody treatment. Some monoclonal antibody treatments, such as Dupixent, specifically target the inflammatory markers that cause nasal polyp formation.

Monoclonal antibodies are remarkably effective for nasal polyps treatment, causing polyps to just disappear. These treatments come in the form of injections, which means you have to give yourself a shot every two weeks. The main drawback of monoclonal antibodies for nasal polyps is that the polyps can start to come back as soon as you stop treatment.

Conclusion

Nasal polyps can make breathing — and life — miserable. If you suspect you have nasal polyps, we suggest visiting an ENT office to find out for sure what’s causing your symptoms. If nasal polyps are the culprit, your ENT doctor will be able to recommend the treatment that best fits your situation.

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Philip Scolaro, MD

Dr. Scolaro is a board-certified Otolaryngologist servicing the South Plains area. He has been practicing in Lubbock since 1990 and has earned a reputation as a skilled and experienced surgeon. He currently serves as the Medical Director for Covenant High Plains Surgery Center campuses, is a member of Covenant Health Partners and is an adjunct faculty professor for Texas Tech University Health Sciences Center School of Medicine. Learn more about Dr. Scolaro. 

Everyone experiences a stuffy or runny nose from time to time. We’ve all had the unpleasant sensation of being unable to breathe with bad allergies or a cold.

But sometimes these symptoms can become chronic. Frequent nasal congestion from thick mucus and other causes can make daily life miserable. So what do you do when you feel like there’s a huge mucus plug in your nose?

How Does Nasal Blockage Happen?

Even though it probably feels like thick mucus is what’s plugging your nose, this isn’t the only type of nasal blockage. Frequently, swollen nasal tissues are the culprit. Here, we’ll look at some well-known and not-so-well-known causes of both kinds of nasal blockage.

Overuse of Topical Decongestants

The most common reason for chronic nasal congestion we see in our office is rhinitis medicamentosa. This fancy term simply means that your medication is actually causing your symptoms.

Topical nasal decongestants, like oxymetazoline and phenylephrine, work extremely well to reduce nasal congestion — in the short term. These nasal sprays, drops, and gels are only designed to be used for about three days at a time. If used for longer than that, patients can experience something commonly called “rebound congestion,” meaning their symptoms actually become worse as a result of using the medication.

This kicks off a vicious cycle of further congestion, more topical decongestant use, followed by even worse congestion. This is rhinitis medicamentosa.

Because not everyone knows not to use these nasal decongestants for longer periods of time, we see patients with this condition often.

Allergic Rhinitis

Environmental allergies are a common cause of nasal congestion. When pollen, pet dander, or mold hit your nose, they can cause severe swelling in your nasal lining and turbinates (small structures that increase the surface area in your nose and humidify the air you breathe). This irritation also leads to excess mucus production as your nose tries to flush out the offending particles.

Combined, this nasal swelling and mucus production can plug up your nasal passageways quickly.

Structural Problems in the Nose

Problems with the structure of the nose can also lead to nasal congestion. A person experiencing nasal valve collapse, for example, will have trouble breathing in, especially during strenuous exercise.

A deviated septum can also lead to nasal congestion. You may not produce excess mucus, but your nose might feel plugged often, especially on one side. This happens because the wall of bone and cartilage in the middle of your nose has deviated to one side or the other.

How Can I Prevent Mucus From Plugging My Nose?

One thing is certain: Whether it’s structures, swollen tissues, or mucus plugging your nose, it’s unpleasant. So let’s take a look at some ways to avoid congestion in the first place.

Don’t Get Hooked on Nasal Decongestants

If you use topical decongestants frequently, make sure you don’t use them for more than a couple days in a row. This will help you avoid developing a dependence on them that results in constant congestion.

Saline Irrigation and Saline Spray

Irrigating your nasal passages and sinuses with saline can help clear your nasal passages of any lingering pollen or allergen residue. It can also wash out excess mucus buildup to maintain a clear nasal passageway.

Saline spray can also be helpful to hydrate the nose, especially if you have mucus that crusts over and causes blockage. Some pharmacies also sell a viscous, gelatinous form of saline you can spray into your nose to help the mucus move along while providing hydration as well.

Although most saline sprays are formulated with isotonic saline, you can also purchase hypotonic saline solution, which has a decreased concentration of salt. Because this solution contains less salt than your body, your tissues may absorb fluid from the solution, helping hydrate your nasal passages. Hypertonic saline solutions, which have a higher salt concentration than your body, may have the opposite effect, pulling fluid from swollen nasal tissues and decongesting the nose.

Treat Your Allergies

If you suffer from seasonal or environmental allergies, treating these proactively with oral antihistamines or topical steroids can go a long way to decreasing nasal swelling and mucus production before they plug your nose.

Hydrate!

Drinking more water may seem like an overly simple treatment, but staying well hydrated can help thin the mucus you produce. When you’re dehydrated, your mucus is thicker, stickier, and harder for your body to eliminate.

Consider Further Treatment

If your issue is more a constant excess production of mucus than swollen tissues or structural problems, and no other solutions have helped, you might consider a procedure like RhinAer or Clarifix. These procedures deactivate the overactive nerve at the back of the nose that stimulates excess mucus production.

How Can I Treat Mucus Buildup?

If you’ve been unable to prevent thick mucus from plugging up your nose, we suggest you start with saline nasal irrigation and staying well hydrated to thin and flush out the mucus buildup.

Additionally, if you’ve been using a topical decongestant, such as a nasal spray like Afrin, for more than three days, stop use immediately. The rebound congestion will go away; it may just take one to two weeks.

If you think your congestion results from allergies, an over-the-counter antihistamine is your next step. If this doesn’t work, it’s probably time to call in a professional!

When Should I Call a Doctor?

What if you’ve kicked the decongestant habit and tried all the over-the-counter antihistamines and saline irrigations with no success? At this point, it’s time to contact your ENT doctor or allergy specialist. They can evaluate your nasal congestion to determine its source and how best to approach treatment.

We always attempt medical treatment first, which could involve further over-the-counter remedies or prescription medication. If that doesn’t work, we also have the option of surgical procedures, such as VivAer for nasal valve collapse or septoplasty for a deviated septum.

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Philip Scolaro, MD

Dr. Scolaro is a board-certified Otolaryngologist servicing the South Plains area. He has been practicing in Lubbock since 1990 and has earned a reputation as a skilled and experienced surgeon. He currently serves as the Medical Director for Covenant High Plains Surgery Center campuses, is a member of Covenant Health Partners and is an adjunct faculty professor for Texas Tech University Health Sciences Center School of Medicine. Learn more about Dr. Scolaro. 

Your nose is an infection-fighting machine.

It’s a self-cleaning organ with mucus and hair cells that trap and push out the bacteria and debris from your environment. It’s a filter between you and the outside world.

But sometimes, that filter gets into trouble.

When the nose and sinuses are functioning properly, you don’t really need to do much to care for them. Maybe you find an occasional saline sinus rinse helpful, but other than that, things work well on their own.

But the nose and sinuses don’t always function properly, and this can give rise to a number of nasal and sinus issues.

6 Common Nasal and Sinus Issues and How To Identify Them

The nose and sinuses are small parts of the body that can cause big problems. Let’s take a look at six of the most common nasal and sinus issues.

1. Allergic Rhinitis

Allergic rhinitis is also sometimes referred to as hay fever or seasonal allergies.

Your immune system’s job is to fight off pathogens that try to enter your body from the environment to prevent them from causing an infection. But sometimes your immune system flares up at inappropriate times, misidentifying a piece of dust or pollen as a dangerous threat to your health.

Allergic rhinitis occurs when the mucosa that lines the inside of the nose becomes thick and swollen in response to this perceived threat. The nose tries to get rid of that pollen with mucus production, which produces the congestion and drainage so many of us are familiar with.

People in all different parts of the world suffer from allergic rhinitis. Here in the West Texas panhandle, we have our own unique allergens. The dust storms, cotton, ragweed, and tumbleweeds can send our immune systems into overdrive, wreaking havoc on our nasal mucosa.

Hallmark signs of allergic rhinitis include a runny nose, sneezing, headache, postnasal drip, and itchy, watery eyes.

2. Sinus Infections

Sometimes nasal swelling from allergies or a viral infection blocks off the opening to your sinuses. When this blockage lasts long enough, mucus and bacteria become trapped, continuing to build up in the sinus cavities.

Sinus infections cause thick drainage, headache, nasal congestion, and facial pain and pressure. You might also experience a fever or fatigue. Sometimes, if a sinus infection lingers long enough, it can even drain down into the lungs and lead to bronchitis.

Although some sinus infections resolve successfully with home remedies, others may require antibiotics.

3. Vasomotor Rhinitis

Vasomotor rhinitis is when the nose just drips and drains on its own.

In people experiencing vasomotor rhinitis, an overly excited posterior nasal nerve sends abnormal signals to the nose, causing excess mucus production. Sufferers then experience either postnasal drip or a runny nose with no apparent cause.

For unknown reasons, vasomotor rhinitis often happens at mealtimes and in the older population. We don’t fully understand the causes of vasomotor rhinitis, but it certainly can be frustrating!

4. Deviated Septum

The wall of cartilage and bone that divides your nose into two halves is called the nasal septum. The septum is usually straight, but it can sometimes deviate to one side, becoming a deviated septum.

We usually associate a deviated septum with a broken nose. While trauma can cause a deviated septum, it doesn’t necessarily have to be a broken nose.

A car crash, sports injury, or other hit to the face could all result in a deviated septum, and some people are even born with a deviated septum.

The main symptom of a deviated septum is congestion that’s more severe on one side of the nose. People with a deviated septum often find it easier to sleep on one side to keep their nasal passages open. Snoring is also a common result.

An ENT surgeon can treat a deviated septum surgically with septoplasty.

5. Nasal Valve Collapse

The nostrils have another, lesser-known name: the nasal valves.

When some people breathe in deeply, the external wall of one or both of their nasal valves caves in. The nose just collapses in on itself and hinders breathing. This is nasal valve collapse.

The primary symptom of nasal valve collapse is difficulty breathing in through the nose. Sometimes a nasal valve remains collapsed all the time, causing constant breathing trouble, and other times it only collapses during intense exercise or exertion.

We can treat nasal valve collapse with over-the-counter remedies like Breath Right Strips, but we’ve also seen great permanent results with the VivAer nasal remodeling procedure.

6. Allergic Fungal Sinusitis

A more difficult sinus issue we sometimes see is allergic fungal sinusitis.

Most often, bacteria and viruses cause sinus infections. But some sinus infections can be caused by a fungus in the air, such as mold.

While a healthy immune system can usually clear this problem, people with immune deficiencies can’t fight it off so easily. This obstruction can lead to production of extremely thick mucus, and the fungus stays trapped in the sinuses with the mucus.

It’s almost impossible to get rid of all the fungus and thickened mucus without surgery to clean out the sinuses.

If allergic fungal sinusitis, or any kind of chronic sinusitis, goes untreated long enough, it can lead to the formation of a mucocele. A mucocele occurs when the mucus is unable to drain for so long that it builds up and puts enough pressure on the sinuses to begin remodeling the bone structures. This can result in facial deformities, even eroding through the skull and eventually into the brain.

This is a rare complication of untreated chronically blocked sinuses.

More Resources for Sinus Issues

Nasal and sinus issues can be a real pain and significantly impact the quality of your life. For more information about dealing with various nasal and sinus issues, take a look at our other articles on the subjects!

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Philip Scolaro, MD

Dr. Scolaro is a board-certified Otolaryngologist servicing the South Plains area. He has been practicing in Lubbock since 1990 and has earned a reputation as a skilled and experienced surgeon. He currently serves as the Medical Director for Covenant High Plains Surgery Center campuses, is a member of Covenant Health Partners and is an adjunct faculty professor for Texas Tech University Health Sciences Center School of Medicine. Learn more about Dr. Scolaro. 

Is your nose constantly running, even though the rest of your body feels fine? Are you the friend everyone knows always has a tissue available?

If you’re experiencing a constant runny nose or mucus running down the back of your throat, you’ve probably tried all the sprays, pills, and home remedies available. Perhaps you’re considering a more permanent solution: a procedure like RhinAer or ClariFix.

But which procedure is best? How do RhinAer and ClariFix stack up against each other? Or should you have both for good measure?

Let’s take a look at the similarities and differences between these procedures and which might be right for you.

Postnasal Drip and Runny Nose

Mucus is the wet, slimy stuff produced by the various mucous membranes in your body. Mucus helps lubricate your mucous membranes for optimal function, keeps your body moist, and prevents microbes in your environment from causing infections.

The nose and throat are lined with mucous membranes, and the nose constantly produces some mucus. Because the back of the nose drains down the throat, most of this mucus normally slips down your throat unnoticed.

Postnasal drip happens when you do notice this sensation. It usually occurs because your nose is producing excess mucus, or you’re having trouble clearing a normal amount of mucus from your throat.

A constant runny nose can happen for the same reason — too much mucus production. But instead of the mucus falling down the back of your throat, it flows out of your nose instead.

Common Causes of Excess Mucus Production

Sometimes, your nose produces excess mucus because of legitimate reasons like a bacterial or viral infection, allergens, or weather changes. Less frequently, however, the nose can produce excess mucus for no apparent reason.

The posterior nasal nerve sits behind the nose and sends signals to the nose to produce mucus. But this nerve can become overactive, signaling the nose to constantly produce excess mucus even when no external trigger is present. The medical term for this type of overactive mucus production is intractable vasomotor rhinitis.

Treating Chronic Postnasal Drip or Runny Nose the Old Way

Before simple procedures like RhinAer and ClariFix existed, ENT surgeons relied on a much more invasive, time-consuming procedure known as a vidian neurectomy. This procedure required general anesthesia and involved drilling at the skull base in order to sever the offending nerve. It solved the issue, but also resulted in some side effects, such as chronic dry eyes.

RhinAer vs. ClariFix

The RhinAer and ClariFix procedures both adapt the thought process behind the old vidian neurectomy procedure: to knock the overactive nerve out of function.

But these newer procedures work on a more targeted area of the nerve branches right behind the nose, so they tend to not cause eye dryness. They’re also much less invasive and much safer; they don’t involve cutting, drilling, or general anesthesia.

All About RhinAer

For the RhinAer procedure, an ENT doctor numbs your nose with a local anesthetic. They then insert a small stylus-type instrument and a camera through the nose.

Your posterior nasal nerve isn’t visible on the surface, but an experienced ENT surgeon will know the areas where the nerve usually runs. They use the stylus to apply heat to those areas at the back of the nose using low-temperature, non-ablative radiofrequency energy. This heat deactivates the nerve through the tissue without any cutting.

All About ClariFix

Similar to RhinAer, ClariFix is a short in-office procedure performed by an ENT doctor. It begins exactly the same way — with your doctor providing a local anesthetic prior to the procedure for your comfort.

Instead of using an instrument that heats up, ClariFix uses cold to deactivate the target nerve. An ENT doctor inserts a tiny camera into the nose along with the ClariFix device. The device then uses nitrous oxide to become cold and apply cryotherapy to the areas behind the nose where the nerve usually runs.

Should You Get RhinAer and ClariFix at the Same Time?

Because RhinAer and ClariFix use opposite methods to achieve results in the same area, the procedures should not be performed at the same time. However, if you undergo one of these procedures and find it didn’t work as well as you hoped, you could try the other procedure after some time.

RhinAer vs. ClariFix: Similarities

In our ENT practice, we see similar outcomes with both RhinAer and ClariFix. The procedures themselves are extremely similar, except that one uses heat and the other uses cold to accomplish the same purpose.

Both are minimally invasive, low-risk, in-office procedures. They require no time off work, but you may face some increased nasal congestion for a few weeks due to post-procedure swelling. Most patients see results within two to six weeks.

RhinAer vs. ClariFix: Differences

While neither procedure causes much in the way of discomfort or side effects, some patients do complain of a “brain freeze” type headache during the ClariFix procedure because of the cold in the nose. However, this typically only lasts for a few minutes.

Final Thoughts

The choice between RhinAer vs. ClariFix really boils down to personal preference and what your doctor has available. And keep in mind that if one procedure isn’t effective for you, you still have the option to try the other.

Regardless of whether you choose RhinAer or ClariFix, it’s important to find an experienced ENT surgeon to perform these procedures. Because the posterior nasal nerve isn’t visible during the procedure, a knowledgeable physician familiar with the nerve placement is crucial.

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Philip Scolaro, MD

Dr. Scolaro is a board-certified Otolaryngologist servicing the South Plains area. He has been practicing in Lubbock since 1990 and has earned a reputation as a skilled and experienced surgeon. He currently serves as the Medical Director for Covenant High Plains Surgery Center campuses, is a member of Covenant Health Partners and is an adjunct faculty professor for Texas Tech University Health Sciences Center School of Medicine. Learn more about Dr. Scolaro. 

We all know the frustration of a run-of-the-mill cold virus that turns into a raging sinus infection. The sinus headaches, facial pressure, and facial pain are no joke!

So what is the single best antibiotic for a sinus infection? As it turns out, the answer isn’t quite that simple.

What Is a Sinus Infection?

Your sinuses are simply air-filled pockets in your head. They lighten the skull and allow your voice to reverberate. The membranes that line the sinuses also produce mucus to lubricate the inside of the nose.

Your sinuses are connected to your nose by small drainage tubes called ostia. Ostia allow mucus to flow from the sinuses into the nose and air to flow up through the nose into the sinuses.

Ostia can become blocked by inflammation due to a cold, the flu, or allergies, preventing mucus from flowing out of the sinuses into the nose. Instead, the mucus backs up and accumulates in the sinuses, causing the pressure and pain sufferers know so well.

Many sinus infections start off as cold or flu viruses, which means antibiotics — which only fight bacteria — can’t do anything to help them. These sinus infections can get better on their own or with alternative treatments, especially once the source of the sinus blockage clears up.

That said, sinus infections provide a perfect breeding ground for bacteria, so if the blockage lingers, the infection can become bacterial. This may involve yellow or green mucus, further pain and pressure, and even an unpleasant odor. A bacterial sinus infection can require antibiotics to resolve.

Other Options To Consider Before Antibiotics

Antibiotics are one of the most important advances in modern medicine, but it’s best not to use them if you don’t need to. For sinus infections, whether viral or bacterial, there are several effective over-the-counter remedies you can try at home before turning to antibiotics.

Sinus Rinses and Irrigation

In many cases, sinus irrigation is a very effective treatment for sinus infections. One method is to simply rinse out your nose and sinuses with a neti pot or other irrigation system using a saline solution. You can buy saline solution over the counter or mix your own at home with distilled water.

Alternatively, you can buy bottles of saline solution made to spray directly into your nose from most pharmacies and grocery stores.

Sinus rinses work by flushing mucus out of the nose and sinuses to help things flow freely. Saline also has a natural decongestant effect, shrinking swollen nasal tissues and opening up nasal passages.

We recommend using sinus irrigation once or twice per day as tolerated.

Topical Steroid Sprays

Topical steroid sprays work to reduce inflammation in the nasal lining. These over-the-counter medications are a great complement to saline nasal sprays and irrigations. Side effects are minimal, especially when used short term.

Flonase, Nasacort, and Rhinocort are the most common over-the-counter name brands. But their generic counterparts — fluticasone, triamcinolone, and budesonide — are just as effective and usually much less expensive.

The main problem with topical steroid sprays is that they can take time to become effective. So while they can be helpful when treating a lingering sinus infection, they’re not as effective at relieving more severe acute sinus infection symptoms.

Antihistamines

Antihistamines block receptor cells for histamine, a chemical that the body produces in response to allergens and that causes inflammation. If your sinus infection originated because of a nasal blockage due to allergy inflammation, treating this underlying cause may help open the sinuses and lead to healing.

We recommend only taking antihistamines on a short-term or as-needed basis because they tend to cause severe drying. Long-term use can lead to bloody noses and can even make you more susceptible to future sinus infections.

We prefer non-drowsy antihistamines such as Claritin, Zyrtec, and Xyzal so you can stay alert. Be sure to look for their generic counterparts — loratadine, cetirizine, and levocetirizine — for effective, cheaper options.

The Best Antibiotic for a Sinus Infection

If you’ve tried the home remedies mentioned above and are still fighting a sinus infection, it’s time to see your doctor. You may have a bacterial infection, and only a doctor can prescribe you the best antibiotic for your specific sinus infection.

Why There Is No Single “Best” Antibiotic for a Sinus Infection

Different antibiotics target different types of bacteria in the body. The specific type of bacteria causing your sinus infection will react to a specific antibiotic, but you may need to try several of them before your doctor finds one that’s effective.

Most doctors will start by prescribing a first-line antibiotic for 10–14 days. This antibiotic broadly targets the most common types of bacteria in the nose and throat that cause sinus infections.

If you have a true chronic sinus infection, you may require 4–6 straight weeks of antibiotic use.

Sometimes bacteria can form a film to protect themselves, in which case doctors can wash the sinuses with an antibiotic rinse. Other times, your physician may want to culture the bacteria causing your infection to determine exactly what you’re dealing with. Then they can prescribe an antibiotic specific to the bacteria causing your sinus infection.

There are hundreds of possible antibiotics to use for a sinus infection. Only a doctor can determine the best antibiotic to use for your sinus infection based on your specific case.

How Many Sinus Infections Is Too Many?

It’s difficult to say exactly how many sinus infections per year is “too many.” Of course, you should consult with your healthcare provider, but it’s best to consult an ENT specialist if you’re dealing with more than two sinus infections per year. An ENT specialist can discover what’s causing your ongoing sinus struggles and help you figure out what to do about them.

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Philip Scolaro, MD

Dr. Scolaro is a board-certified Otolaryngologist servicing the South Plains area. He has been practicing in Lubbock since 1990 and has earned a reputation as a skilled and experienced surgeon. He currently serves as the Medical Director for Covenant High Plains Surgery Center campuses, is a member of Covenant Health Partners and is an adjunct faculty professor for Texas Tech University Health Sciences Center School of Medicine. Learn more about Dr. Scolaro. 

Difficulty sleeping. Snoring. Congestion that never seems to end. Trouble breathing through your nose while working out.

If you know these symptoms well, you may have a nasal airway obstruction. Maybe you’ve had it so long, you didn’t even realize breathing could be different!

If this is your situation, you may benefit from the VivAer nasal airway remodeling procedure. Let’s take a deeper look at the VivAer procedure, its benefits, who the procedure is right for, and what to expect with VivAer recovery.

What Is Nasal Airway Obstruction?

Nasal airway obstruction is any blockage in the nose or nasal passages that prevents air from flowing freely.

Your body is designed to take in air through the nose, which warms and humidifies air as you breathe it in. Obstructed nasal passages force you to instead breathe through your mouth, which can lead to a dry mouth, sore throat, dental problems, and difficulty sleeping.

To see if you have nasal airway obstruction, an ENT doctor will look at four main components in your nose and evaluate whether they are contributing to an obstruction.

Nasal Septum

The nasal septum is the central wall that divides the nose into two distinct halves. When the septum is deviated, or pushed to one side, it can restrict airflow on one (or sometimes both) sides of the nose.

Some people are born with a deviated septum. Other times it results from trauma to the nose, such as a car accident or sports injury.

Inferior Turbinates

The inferior turbinates are structures on the interior sidewalls of the nose. The inferior turbinates increase the nose’s surface area to help humidify and warm air before it enters the lungs. If these turbinates become enlarged from allergies, infection, or another cause of inflammation, they can cause an obstruction.

Mucosa

The nasal mucosa is the lining that covers the entire interior surface of the nose. When this lining becomes inflamed from allergies or a sinus infection, it narrows the nasal passages and obstructs nasal breathing.

Nasal Valve

Also known as nostrils, the nasal valves maintain their shape to help funnel air into the body as you breathe in.

Some people’s nasal valves collapse when they inhale deeply or breathe vigorously, as with exercise. In some people, the nasal valves remain collapsed all the time. Collapsed valves restrict airflow and force a person to breathe through their mouth. This is where VivAer Nasal Airway Remodeling comes in.

What Is the VivAer Nasal Airway Remodeling Procedure?

The VivAer procedure specifically addresses nasal airway obstruction caused by nasal valve collapse. It quickly, gently, and permanently widens and reshapes the nasal valve to remove the obstruction for good. VivAer can also sometimes help when the patient has a widened septal body (when the nasal septum is a little too wide toward the top of the nose).

The VivAer procedure is performed in a physician’s office with local anesthetic to keep you comfortable throughout the process. The doctor inserts a very small wand through your nostril to target your nasal valve area.

The wand uses low-temperature radiofrequency energy to heat the nasal tissues and make them more malleable. The physician applies a bit of pressure and gently reshapes the area. The entire VivAer procedure, including numbing, takes about half an hour.

The VivAer procedure usually expands the nasal airway by 1 to 2 millimeters. This may not sound very impressive, but think about how small the nasal airways are. That extra 1 to 2 millimeters can make an enormous difference in airflow!

What Are the Benefits of the VivAer Procedure?

VivAer offers significant advantages over previous treatments.

In the past, the standard treatment for nasal valve collapse was a cartilage graft. A surgeon took cartilage from a patient’s septum and implanted it in the sidewalls of the nose to help maintain an open airway. Cartilage grafts are invasive procedures that require general anesthesia in a hospital or surgery center and several weeks’ recovery time.

VivAer is a noninvasive procedure performed right in your ENT doctor’s office. It is incredibly well tolerated by most patients, causes little to no discomfort, and requires almost no recovery time.

While other procedures like septoplasty and turbinate reduction address certain causes of nasal airway obstruction, they don’t address collapsed nasal valves. Sometimes patients who’ve undergone other surgeries in the past find relief with a simple VivAer procedure.

VivAer Recovery

VivAer is often performed along with other nasal procedures, which can increase recovery time. But if VivAer is the only procedure being performed, patients can resume their normal activities right away. They will have no pain and little to no bleeding.

VivAer recovery mainly involves only two things. First, patients experience some crusting in the nostrils for two to three weeks after the procedure. We send them home with an ointment to put on the inside of their nostrils to keep them comfortable. Second, they also experience some congestion for a week or so, but after that time, airflow significantly improves.

Interested in VivAer Nasal Airway Remodeling?

The physicians at ENT Associates of Lubbock are experts in helping you breathe better. Our team would love to help you evaluate whether VivAer Nasal Airway Remodeling is right for you. Give us a call today.

David Cuthbertson, MD

Dr. Cuthbertson is a physician at Ear Nose & Throat Associates of Lubbock. He joined the team at ENT Lubbock from Houston, where he was chief resident of the prestigious Bobby R. Alford Department of Otolaryngology at Baylor College of Medicine. He is board certified in Otolaryngology and Head & Neck Surgery and has quickly built a reputation, not only as an extremely skilled surgeon, but as an approachable and compassionate clinician adept in the newest standards and technologies. Learn more about Dr. Cuthbertson.

Philip Scolaro, MD

Dr. Scolaro is a board-certified Otolaryngologist servicing the South Plains area. He has been practicing in Lubbock since 1990 and has earned a reputation as a skilled and experienced surgeon. He currently serves as the Medical Director for Covenant High Plains Surgery Center campuses, is a member of Covenant Health Partners and is an adjunct faculty professor for Texas Tech University Health Sciences Center School of Medicine. Learn more about Dr. Scolaro.