What is Sinusitis?


If you have nasal congestion, facial pressure, cough and thick nasal discharge, you may have rhinosinusitis, commonly referred to as sinusitis.

Your sinuses are hollow cavities within your cheekbones, around your eyes and behind your nose. They contain mucus, which helps to warm, moisten and filter the air you breathe. When something blocks the mucus from draining normally, an infection can occur.

Acute Sinusitis

Acute sinusitis refers to sinusitis symptoms lasting less than four weeks. Most cases begin as a common cold. Symptoms often go away within a week to 10 days; but in some people, a bacterial infection develops.

Chronic Sinusitis

Chronic sinusitis, also referred to as chronic rhinosinusitis, is often diagnosed when symptoms have gone on for more than 12 weeks, despite medical treatment.

People with allergic rhinitis or asthma are more likely to suffer from chronic sinusitis. This is because the airways are more likely to become inflamed when allergic rhinitis or asthma are present. Sinusitis may also be caused by an infection, a fungus, deviated nasal septum, nasal polyps or in rare cases an immune system deficiency.


Sinusitis symptoms, whether acute or chronic, frequently develop after a cold or during times of severe or ongoing allergic rhinitis symptoms. The most obvious sign of sinusitis is a painful pressure in the cheeks and forehead. Other symptoms include:
•    Thick yellow-green nasal discharge
•    Postnasal drip, often with a bad taste
•    Cough
•    Congestion
•    Toothache
In cases of acute sinusitis, a fever may develop.

Allergy testing performed by an allergist / immunologist can identify what allergic triggers might be behind your chronic or reoccurring sinus infections.

In chronic or severe cases, your doctor may also examine your nasal passages using a technique called rhinoscopy or nasal endoscopy. In this procedure, a thin, flexible instrument is inserted up the nostril to view the sinus passages and look for blockages.

If you come in to see us, we may order an MRI or CT scan to look for abnormalities in the sinuses – narrow drainage passages, polyps or a deviated septum.

Make an appointment with us right away if you have: a fever, pain or swelling in the face or eye, redness on the cheek or around the eye, severe headaches, confusion or a stiff neck.


The 411 on Hives

A rash showed up on your skin. Now what? Don’t panic. We will go over the possible cause of hives and help you figure out why in the world you have them!

What are Hives?
Hives, also known as urticaria, is an outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly — either as a result of the body’s reaction to certain allergens, or for unknown reasons.

Hives can itch, burn or sting. They can appear in different sizes and on different areas of your skin. They can even show up on including lips, tongue, or ears.

Many times the hives may occur with or without angioedema. Angioedema is when the swelling occurs beneath the skin instead of on the surface. Angioedema is typically characterized by deep tissue swelling, commonly around the eyes, ears and lips. Sometimes it can be found on the genitals, hands, and feet. Most episodes of swelling go away in less than 48-72 hours.

Angioedema of the throat, tongue, or lungs can block the airways, and can be life-threatening, but such life-threatening episodes are uncommon.

What Causes Hives and Angioedema?
Viral infections are the most common cause. However allergic reactions to medications, insect stings, sunlight exposure, or physical stimuli such as temperature and vibration can cause urticaria and angioedema. It’s sometimes impossible to find out exactly why a person has urticaria and angioedema.

Think you Might have Urticaria or Angioedema?
Come in and see us. A thorough history and physical exam will be performed in an attempt to find the possible cause. Some specific tests for common causes of urticaria and angioedema may also be performed.

Skin tests may be performed to determine if  you are allergic to a specific allergen. Blood tests may also be done to determine if a systemic illness is present.

How is Urticaria/Angioedema Treated?
The best treatment for hives and angiodema is to identify and remove the trigger if one is identified, but this is often not possible. Antihistamines are usually prescribed by your doctor to provide relief from symptoms. Antihistamines work best if taken on a regular schedule to prevent hives from forming. If the urticaria and angioedema is persistent, we may opt to treat with a combination of medications. Though oral corticosteroids may be prescribed, we would try to find the safest and most effective treatment plan for each individual patient. An injectable drug, omalizumab (Xolair), is also approved to treat chronic hives in those at least 12 years of age.

All patients with urticaria and angioedema should see a healthcare professional with expertise on this condition.

Vandana K. Patel, MD, FAAAAI