Sinuses, Sinusitis, Sinus Surgery Overview - what are sinuses, what do they do, how do we treat them

Sinuses, Sinusitis, Sinus Surgery Overview - what are sinuses, what do they do, how do we treat them
Sinuses are air filled spaces in the skull. The 4 pairs of sinuses are the Frontal, Maxillary, Ethmoid, and Sphenoid.
The sinuses are lined with pink skin covering called Mucosa. The mucosa of the nose and sinuses help heat, humidify, and filter the air that we breathe.
When the sinuses become inflamed or infected, it is called Sinusitis.
When the sinuses are swollen shut or blocked, pain and pressure in the face and forehead can develop.
When the sinus mucosa is inflamed, but the sinuses are still open, runny nose and post nasal drip develop.
Sinus inflammation can be caused by viruses, bacteria, allergies, chemicals, pollution, dust, smoke, and other environmental factors.
Sinus infections are usually viral and much less commonly from bacteria. Most sinus infections, even bacterial ones do not require antibiotics.
Most sinus infections will go away with time. Saline irrigations, decongestants, nasal steroid sprays, and allergy medications help decrease the swelling and help clear sinus infections.
The color and consistency of the mucus does not help in telling a viral infection from a bacterial one...and does not help determine if you need antibiotics or not.
Allergies can cause similar symptoms as sinusitis. Many sinusitis patients also have allergies. Thus, the evaluation and management of allergies is frequently part of the treatment for someone with chronic or recurrent sinus issues.
An endoscopy (or scope evaluation) and CT scan are the best ways to evaluate chronic and recurrent sinusitis.
If someone chronic or recurrent sinusitis, we look for structural or anatomic issues, environmental factors, and evaluate how well the immune system is working.
Surgery can address anatomic/structural issues and improve drainage of the sinuses and may be an option for some patients. In the right patients, surgery can result in dramatic improvements. Surgery is not always the right answer and does not fix everything.
Medical Disclaimer: All comments are generalizations and intended to be for educational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

[@michellebrietz4568]

No question here just a comment. Your presentation of the sinus was just what I was looking for. I understood every word you said and doc I gotta say you kept it mean and clean and I feel better already. Have an awesome day.

[@sarabenaquista4352]

Thank you very much Doc, this is awesome.

[@kauaireed9006]

Doc you’re video was the best out of what feels like a thousand, thanks

[@jennifersuzanne4764]

VERY helpful! Thank you

[@kayramirez5577]

You are very informative. I appreciate your work.

[@leonardodeangelis4403]

Thanks for sharing your knowledge on the topic! Your video has been incredibly helpful to me 😁

[@davidwilliams4484]

Thanks for this. Very well done

[@maryo2560]

Thank you doctor , very helpful and easy to understand information even for a layman like myself.

[@khalid6050ify]

#Sinuses: Gene you are excellent in parting knowledge. Mine is Allergy from Ragweed from August to Oct , but last 2 years due to open area & chill -10 to -30 Temperature in Ontario gave rise to crusting & pitting in Vestibule area and Septum on left side as I sleep on right side, leaving stone block feeling even using Nasonex, which loosen the mucous. Saline solution with few Vinegar drops in throat and nose clear the left Sinus. Mucous created in throat goes up, which is white sticky gel become sticky with cold temperatures. Anti histamine also in continuous use. The problem of blocking only happens while lying flat, while all day clear, being 69 years old gives some dreams effect under air pressure, when washed clear sleeps again.

[@WR-ny6bg]

Thank you for such useful information. Very helpful to someone looking for info on sinus issues!

[@rinjinglama9285]

Thank you

[@joshuatalksmoney]

Great video! Super helpful

[@shoshoakram3357]

Well explained thnx doc

[@beverleynugent651]

I really appreciate this video i learn a lot from it.

[@Jillybeej]

Thank you for this! I’m having Septoplasty and FESS surgery in 2 days because of chronic sinus infections and food smells and tastes awful. My ENT was shocked when he saw my CT scan. Wish me luck because I’m definitely nervous 😬

[@irenefaith7421]

Any update

[@epiry]

God has u

[@wingspparow6048]

How are you now?

[@Hugecannonballs]

Hope it went successfully!

[@rebeldeperulibre6059]

Are you alive? How did it go?

[@technopost7296]

thank u for information

[@rajeshchaudhary5779]

Its really worth watching this video. Thank you for the information. Actually i have DNS issue as per Dr. I have checked. They suggested for surgery called setoplasty and some recommends not to do so. After seeing CT scan report. If you can help, i will be sending details in your mail. I m from Nepal and having this issue since 3-4yrs. Thank you

[@carlawilliams8136]

Thank u watching from md

[@juditterplan4712]

Thanks this is videó very helpfully AND learning ,my nose is give through a injury , therefore inflamed...Én nagyon jól türöm , így legalább kifolyik a sok víz a felyemből..

[@sephassimiyu433]

Thank you so much sir I have this problem of sinus for many years its so stressed

[@TheMaclays]

I found you to be very informative. Thank you very much. You gave me a better understanding. I am finally getting a CT scan tomorrow. I just hope this hasn't caused any permanent damage to my eye or ear. Thanks again!

[@epiry]

God is with u

[@jessepinkman6404]

how are you doing now

[@sethcashman1011]

Informative video! What about about fungal sinusitis (invasive or not). How is that typically diagnosed/treated?

[@soullight2932]

Awesome vid

[@felixkuriaunage4283]

top advice

[@MsSUPER73]

Well explained thank you Dr I just went through a sinusitis surgery been confused for 14 yrs hope this helps me live a normal life,,,,

[@DangerousTv1]

how's it going so far? did the surgery help?

[@momentosvirales2023]

This is just superb, I've been looking for "bacterial sinusitis symptoms" for a while now, and I think this has helped. Have you ever come across - Franaar Easy Breath Formula - (just google it ) ? Ive heard some incredible things about it and my neighbour got excellent results with it.

[@iannecalimag6722]

00

[@anam.aria.]

How are you now? Hope things have become better after the surgery!

[@squarebob3813]

Thank u

[@mdmoinuddin6957]

This video was helpul

[@tigertigercrypto]

Excellent video. Thank you. Just had my maxillary cleared through FESS with a general anaesthetic.. it was completely blocked. It's only been a week and I feel fantastic. 😄😄

[@GeneLiuMD]

Awesome. Glad you are doing so well!

[@TheEliteAnimal]

How are you doing now and are you still glad you went through with the surgery?

[@demolaj1]

DID YOU HAVE TO GET A ct SCAN ?

[@lupeavila4595]

What were your symptoms? Did you have a CT scan?

[@tigertigercrypto]

@@lupeavila4595 Tension in my forehead and a blocked nose. I also had a rancid smell all the time and lots of dark mucus. I believe it was 6 or 7 years build up.... could have been up to 10 years. Below my right ear there was also a little swelling, like there was fluid in it, that has completely gone now. Things are great now, no more rancid smell and very, very little tension every now and again. At the beginning I had a CT scan and it showed one side of my sinus completely cloudy and full. Initially my dentist discovered the cloudiness after having an X-ray taken. The operation went smoothly. I was walking around and wanting to leave within an hour but they made me stay for 3 hours...lol. So glad I had the operation.

[@ATLTraveler]

You're a goatologist, cool. I like goats too, not that much to go to 8 years of additional school though. You must really like goats. Also is 1:18 the official medical term for that? How is that spelled? You said and I quote "so we'll have BLAH BLAH down the back or blowing constantly out the front", just curious if you could spell that word for me? Always trying to improve my goat knowledge and I've never heard that term before. Thanks Doc!!!

[@oscarriley465]

I have a polyp which has completely blocked my left frontal sinus and it causes dryness as the air is not being filtered properly on the left side of my nose. Booked in for surgery to remove polyp

[@cypressmaccarthy8132]

刘大夫，对于鼻窦口没有增生的鼻窦炎，只需要通过鼻窦球囊扩张术清洗应该可以解决该问题吧？这项手术算是小手术还是中等性质的手术？

[@luvfitall]

I just finished 22 days of cefridin antibiotics for a bacterial infection I e been battling for 3mths. Should I be concerned I have small thick clumps of yellowish brown every few times a day that I can pull from nasal thru back of throat? I check it everytime I have drainage and it’s usually either clear, white, or pale yellow, or dark yellow brown. Does this still indicate an infection. The CT scan says all is clear in nasals other than an “cyst” (or what the dr thinks) in the middle/on the side of my septum. Now sure why he doesn’t think it’s still a ball of infection tho. Could it be?

[@paulachey5350]

thank you dr. I will have mine done soon on 6-14-19 @noon, I been have this for over four year, and it very very bad

[@GeneLiuMD]

Wishing you a speedy recovery

[@rm9308]

@@GeneLiuMD Do you or anyone at your practice do the YAMIK procedure?

[@rehanawajahat8128]

Thank u Dr my right nostril is blocked, i find very difficult to breath. I had Xray done, Im going thru antibiotics for 10 days- polyps found in both the nostrils left nostril is almost blocked.after 10 days i have to get my NCCT PNS DONE, I LIKELY TO NEED ENDOSCOPIC SURGERY.

[@nikahmadridhwan5178]

Just had my sinus operation yesterday.

[@himanikhanna85]

Hello doctor, what would be your suggestions for xylitol rinse or saline xylitol spray for nose. My son aged 7 has ear echo issue and has been troubled with otitis media. Momeflo steroid spray helps control his allergy but even after no signs of allergy he says he hears an echo. I have even tried otovent to pop ear.

[@Reneebenson]

well saw the ent today i have a nasal obstruction as well as chronic rhinosinusitis as well as eustachian tube dysfunction :P i have 3 weeks of pills then get a ct on my sinus's :P

[@justusodame6312]

Good evening doctor, I'm also having the same issue of chronic sinusitis, which led me to facial pain but the now the pain has subsides. The only problem I'm facing is the postnasal drip which has led me to bad breath. I v having this challenge for almost six months now. I have being irrigating with sinus wash of Neil med solution and be spraying with Avamys and taking doxycycline oral antibiotics. But still facing the problem. I need your help please.

[@rowenarogado9337]

Hi Doctor, is it possible to get ethmoid sinus without the present of colds. I’ve noticed whenever back of my head touches I feel some pressure on my nose n eyes. What might be the cause and treatment pls

[@dobido9020]

I have a chronic sinus it could be allergy rhinitis too.I’m carrying this several years ago been to the doctor took antibiotics, home remedies, nothing works. My nose always block im always in pain, headaches and my throat always felt have lamp and I’ve been trying to get rid of. I’m very stress because I find this causes me a bad breath also.. been convincing my doctor to send me to ct scan or specialist for nose,throat and ear.I’m really hoping that this will find a solution. I also told myself I’m willing to pay just get cure my sinus and my throat just to get back my life to normal.. would you recommend something? Thank you for this video very nice of you to share something like this.

[@motivationalcompilation63]

I have maxillary sinus polyp but I don't wanna surgery cause I am scared of general anesthesia. Which anesthesia is used in unilateral sinus surgery?

[@judythrogerson803]

Dr. I have a partially blocked maxillary antrum. I have chronic sinusitis. I have dark green particles going down my throat which acts as a foreign body and I choke it up. These particles are solid. Other times I have like green thick gelatin globs. This all goes down throat. I do not have nasal drip. Have lots of drainage down throat. I get terrible pressure in my nose and Max. Sinus area. When this occurs I have severe sweating and feel ill. This happens many times a day. Have you ever heard of this? I am going for a C.T. I am very apprehensive about having surgery as I hear surgery is very risky. Can you shed some light on this.

[@dragonmax2000]

@Gene, where do you practice? In CS?

[@vaishalipanchal1019]

Sir, I been have ethmoid sinus problem since 4-5 years. I m feeling stuffy while breathing and my 1 side nosal got blocked. What should I do for this? And my ear drum have hole I can't hear clearly. Plz tell me the treatment. i don't have cold problem since 4-5 years. liquid coming from my ears. Is there any connection with sinus.

[@wingspparow6048]

Hey Dr!, I am 16 and I have pressure in my temple of my head and cheekbone, and teeth on the same side as my temple, also I am afraid it will get worse, what are your thoughts? Also my nose is not blocked and can breath clearly.

[@sunnyd6019]

A major question I have and no ENT to date has really told me is will your Turbinates return to normal once irritation is removed? So if your allergic resolving allergies, etc. I always ask is swelling perm or will they return to normal and get well not sure time will tell. I guess is there a point of no return for swelling and you have to get surgery or if given time all turbinates return to normal, I guess when is surgery a must and when can you allow time to heal you up? Seems like you would never need surgery if you can allow the irritation to subside. Again not sure no one seems to have a firm answer just it depends which is hard to digest when thinking about surgery.

[@francisfrancis6830]

I have chronic rhinosinsuits with DNS to right with spur this type operation needed or not please tell us

[@nokubongamaphanga8301]

Hi Doc, I had my tonsils removed and was supposed to come back for sinus. I went to another to get second opinion about my sinus and sadly the Dr ddnt recommend the surgery mainly because if I do the it , I might be in danger of lung disease or something else. After some years trying to cope with my sinus, taking some medication and avoiding everything might trigger them. Now the problem is that I have blood coming out my noise every morning without me touching my noise. Sometimes I would wake up with blood stains on my pillow. They are worse than before so I don't know if I should continue with the surgery. I'm afraid that what if I do the surgery and I don't have tonsils and I would have nothing to help n might develop other serious diseases in the long run like the other Dr said. I do wear my spectacles but somehow I would have the worst headache that pains right through my eyes and my forehead. Also the yellow nasal drip and sometimes smells bad.

[@kingofmphs]

I have chronic bleeding and scabs in both nares. It looks like I have abrasions. I’m not sure what causes the issue or how to fix it?

[@lollywood99]

Sir What is Infrastructure of turbinates and who can it help with wide nose after turbinactmy?

[@yl7698]

Do you prefer inferior turbinate reduction along with FESS in CRS

[@conniearias9763]

Do you find CPAP users experience sinus issues more frequently?

[@SUKANTA9999]

I have ethmoidal sinusitis but my nose is clear.. I am several other symptoms like balance problem, tinnitus, eyes vision problem and weakness.. i feel sinus pressure but no pain...

[@mdmoinuddin6957]

I need at talking about this sainusitis

[@mikewest712]

I have had a sinus surgery by a very good ent. My surgery did not improve my sinuses. My head swells so much in the mornings that my hat doesn't fit for a few hours. Lots of rear neck swelling/pain. What direction should I go? I don't want to live with constant head and neck pain too much longer. Thanks.

[@ChefGnss]

I hope you can help me just kindly an advise. I have incidental findings at my c.t scan which is left maxillary sinus mucus retention cyst or polyp. Do I need to remove it? what is the best advise you could give me? Advise will be highly appreciated. God bless everyone.

[@Thepoohwennie]

doc is acute sinusitis is deadly?

[@rodneyramirez7549]

I’ve been having pressure and twitching under my left eye lid constantly and some facial twitching also for a few months now so I had an MRI Done and what they found was a mucus retention cyst in my left maxillary sinus. Nothing else was found in my MRI like tumor or mass or an artery pressing on my facial nerve, so will this retention in my sinus cause this spasming in my face?

[@jennifersuzanne4764]

I resolved a long-term eye twitch by adding a mg supplement to my nightly bedtime routine. Look into vitamin or mineral deficency. I self-diagnosed this from a lot of reading and asking my GP to do blood work.

[@user-kx6zr3cu9m]

I have the exact same problem now. How are you doing these days with it all?

[@stephenrafter1980]

I was doing press ups on the ground one day and a shit load of green shite fell out of my nose, I tried to sniff it back up my nose and it had no effect because it was coming from a different area not effected by breathing in. Putting pressure on my face and facing downward cleared the sinus. It was so thick to. I never had symptoms.

[@lizamarie7255]

Hi Doc! My CT scan result shows that I have Pansinusitis, mild deviated septum and concha bullosa. Is it treatable? Is it related to urticaria bec right now I’m having episodes of urticaria. Worried also because I have glaucoma which im not allowed to use steroids long term. Please advise. Thank you!

[@lastactionbellwether6926]

What happens if your nose has been making clicking/popping sounds for more than a few weeks? Do you seek help?

[@Ace-tc7km]

I’ve been having terrible headaches for about 2 weeks never felt this way before. On top and back of my head. mostly pain in my forehead around eyes. Eyes feel heavy, sometimes feel lightheaded or dizziness. Like you mentioned idk if it’s sinusitis or allergies. Also told I had a cyst in sphenoid sinus with a ct scan I had in 2016 but never had pain or any problems till now. Also you mentioned plumbing a lot in this video I am a plumber lol.

[@GeneLiuMD]

It sounds like more than just allergies. I would recommend seeing a doctor about this.

[@Ace-tc7km]

So I have retention cyst in my left sphenoid sinus. Seen on cat scan what are my treatment options?

[@GeneLiuMD]

@@Ace-tc7km Most retention cysts don't ever need anything done. But if they become a problem (infection or just keep growing), the only way to resolve the issue is surgery.

[@elodie8354]

i am 14 and for the past 2 years on and off i have had chronic sinusitis missing sports and lots of school because of it no one for a long time could figure out what was wrong till last month when i went to the doctors but I didn’t get my normal gp and then i got referred because of my symptoms today got a ct and the doctor said your nose is so inflamed you need Surgery i am getting it in 3 weeks but i am now scared because of the risks i have been researching is the surgery a good idea because i am so young ?

[@laurainfinity1390]

If you don't want the radiation from a ct scan can a MRI be a good way to see the sinuses to

[@Ezel21love]

This is so helpful Doctor. What about ear fluid not drain? I have this problem with makes me have a motion sickness. My doctor give me so medicine. However, I believe I have sinuses as well, because o don't smell very well and I have dizziness.

[@GeneLiuMD]

Check out my ear tube videos - they go into how the ears drain in detail. Sinus issues can definitely affect the ears.

[@dtb3392]

Too much air in my nose + throat. my face head stuffy... what does that mean...

[@DayneReedy]

I’ve always have seemed to have troubles with my eyes watering, and sinus blockage. I am a singer and feel like I have to battle clogged sinuses all the time to get the quality tone I want. If structure problems in my sinuses, would surgery clear my sinuses or draining them? Thanks for any insight Dr. Gene

[@kennykenaz8340]

Nice Video! Excuse me for butting in, I am interested in your initial thoughts. Have you considered - Donayden Phrenic Dominance (do a google search)? It is an awesome one off guide for stamping out your nasal polyps minus the headache. Ive heard some super things about it and my mate finally got amazing results with it.

[@DayneReedy]

kenny kenaz - Many thanks. I’ll check them out!

[@hafeez8240]

I had septoplasty but still get sometimes congestion and one maxillary sinuses is large.

[@bypasstoaleanerlynn8920]

Okay, this may seem odd but I have to ask. I've had sinusitis forever, it seems sometimes but just since March until now. I have been on multiple antibiotics and I get a bit better and then get worse again. My PCP referred me to an ENT who took samples of my sinuses. This is what was found: Staphylococcus species, Light growth Staphylococcus epidermidis Based on resistance to oxacillin this isolate would be resistant to all currently available beta-lactam antimicrobial agents, with the exception of the newer cephalosporins with anti-MRSA activity, such as Ceftaroline So, is this MRSA? Also, the ENT keeps asking if I've had prior sinus surgery which I have not. Is there a reason you can think of to why he asks this? Is it good or bad? After my 1st visit, he put me on clindimyacin??? and said to do sinus rinses, which I did, 2nd visit he had mupricin??? added to nasal rinses and this visit, gentamycin and budesonide irrigations. If this proves unsucessful, it will be FESS surgery which I do not want, of course. But mostly, what is prompting him to ask if I've had sinus surgery before?

[@JuanLopez-gh1rb]

Clyndamiaxcin has excellent penetration but is not the proper antibiotic for that species....Bactrim and pencilin for staphylococcus category type bacteria ...30 day supply

[@alfakrab6134]

Ive had orbital recon, and cracked sinuses in my face and brain injury while I was in the Army... It's a serious problem, causes serious pain when I fly or go under water, or even sometimes out of the blue... VA doctors say it's no big deal but it's the worst pain I have to endure. Its like my sinuses are going to explode out of my head and face. Daily headaches in forehead and behind eye, light sensitivity, Could a contrast CT scan identity what's up with my head because it's been 15 years and VA government docs don't take my problem seriously and it hurts so bad and I don't know what to do. ENT appointment?

[@GeneLiuMD]

Definitely sounds miserable. There certainly might be some narrowing, scarring, inflammation in the sinuses. For most patients, a CT of the sinuses is the best study to evaluate the sinonasal anatomy. Usually this is without contrast. It can make sense to see an ENT to determine what tests are best for any one individual.

[@anishajohn9495]

Sir l have maxillary sinus polyps my doctor recommended for fess is it helps to reduce my sinusitis . When this fess surgery gets emergency in this case 🙂

[@stevenshrii]

Nose drops with ginger supplement (about 100mg)with a sinus wash ,too clean out any mucus

[@lostinnevermore5354]

I have a huge confluent mass obstructing both sides of my ethmoid sinuses and covering my turbinates. I live in misery and I suffer everyday. The medical community take sinus issues as very unimportant and minor in my country. They even refused to do the CT scan I waited 17 years for one.

[@SlobberySlob]

Hi Dr Lui, I had a dental abcess that has perforated my maxcilary sinus. I had years of pressure and pain and a constant chest infection. My ENT prescribed antibiotics, which have helped temporary, and is reluctant to do surgery, pointing out it will be highly invasive with a low chance of success. My worry is I read that this type of sinus infection - an odontogenic sinus infection can very dangerous. Is that right? Am I best waiting till it gets worse and the antibiotics don't contain it? Thanks

[@GeneLiuMD]

Usually if the source of the infection (dental) is addressed, the sinus will calm down. If the sinus is blocked and still an issue, then surgery is usually pretty straightforward with a high success rate (as the source is already taken care of). I'm assuming there is something unusual about your situation given the statement "low chance of success". You would need to discuss in more detail with your doc and/or seek another opinion. Good luck!

[@SlobberySlob]

@@GeneLiuMD Thank you very much for your reply! The sinus is not blocked, but a persistant infection protected by a fibrin clot seems to need scraping out as the anti botics cannot get to it. He said to get to it he would need to break through the inner max. Sinus wall and he could not go via the gum. That seems strange to me as I see sinus lifts procedures going via the gum side to the sinus floor advertised by dental surgeons all the time. He said maybe i am best just taking anti boitics on a permanent basis. I think your right a 2nd opinon is needed. Thank you

[@glo8185]

PLEASE HELP! I've seen 3 different otolaryngologists. They all tell me that my ethmoid sinus osteoma cannot be causing my pressure in my ears and face. So they will not remove it. My pressure is so intense that I can barely move. I am in a wheelchair for over two years now due to a balance issue that I have been given no answers to why. They found the osteoma by CT by trying to figure out my balance issue. I still have no answers or help. My quality of life is zero. I'm only 45. I'm determined to get out of the wheelchair. What can I do to get someone to remove it? I've seen every type of specialist and everything keeps coming up normal except for that.

[@nazianaseer1451]

Then what can we do for fess surgery.

[@chubzcurl8551]

I just wana ask if will go away soon or not? How many weeks or months.?

[@barathkumar7940]

Does FESS surgery has risk of causing blindness?

[@irenefaith7421]

Hi doc my CT scan result I have concha bullosa on my nose ang. Cholesteatoma but the doctor revy my CT scan he said I'm ok but my concern is I have clog nose what do u think doc do I need to find another doctor? Any suggestions

[@cyclonecalderon3782]

Hi Doc! Hope you can help me because I constantly have post nasal drip. It's not stopping despite of medications.

[@GeneLiuMD]

There are many potential causes - most commonly allergies or sinus issues, environmental irritants, etc... Sometimes it is from chronic infection. There are other more exotic causes as well. Generally, if allergy medications, nasal sprays, nasal saline don't work, it's probably time to see an ENT.

[@jacobcollins9389]

ENT's have been the most unhelpful people I've ever seen... Not all but at least 90% off them are careless pricks who just try move you on so they can see their next patient. Slime balls. 👎

[@Hassan-ow2yd]

I already had surgery but 1 have still same issue suffering from last 4 years especially when I am sleeping always need to change position because of blocked nose it's very hard to me and very uncomfortable life because of this I wanna discuss my case with you if you can give me appointment? Please

[@summerwinter2864]

Hello Doctor, my left nostril is always clogged with thick yellow mucus, but my right nostril is always clear and I breathe normal through the right nostril I'm constantly blowing my nose to clear my left nostril so I can breathe, what type of surgery would I need if any ?

[@peggyywong]

Hi Dr Liu. Recently I started to smell of mothball. This symptom has been going on for more than 2 weeks. It’s so irritating. I don’t have other symptoms such as pain or nasal congestion. Nothing at all. Just the smell. The smell is getting worse. I sometimes feel a bitter taste. And the smell is getting so strong these two days. I saw my family dr twice, and I am finally on antibiotics for 2days. I am also using nasal and sinus cleaning. But nothing can help. I am so frustrated and feeling helpless. Don’t know what to do to get rid of the smell. Please help.

[@GeneLiuMD]

There are quite a few things that may be potentially causing this issue. Given that you have already seen a family doctor, and antibiotics aren't helping, it probably is a good idea to see an ENT if things don't get better.

[@gennerobootz6490]

What about when you don’t have a stuffy nose but you have sinus pressure, especially just in the nose area

[@tiffanyposey8186]

I think my CT scan and history might be interesting to you.

[@jacobcollins9389]

I think he doesn't give a fuck.

[@iTzShakenJoE]

@@jacobcollins9389 lol

[@nazianaseer1451]

Can it sort out all problem related to sinusitis

[@ezenyipeter7364]

My sinus inflammation switch sides , i.e (having one nostril blocked for more than 2 hours then later switch to the other side)... will you recommend sinus surgery for me?

[@hungkiet7535]

Same here

[@falloutman1843]

Doctor I just got over a case of acute sinusitis but my sense of smell is still very weak. My doc told me it's still very swollen in my sinuses but infection is gone. I dont have allergies or polyps. What could be causing the spells of prolonged swelling after ARS? Thank you. Great video!

[@GeneLiuMD]

If there is no longer an infection, inflammation can take a while. Any source of irritation can drag things out - perhaps environmental irritants, something you're breathing in, even if it's not an allergy

[@falloutman1843]

@@GeneLiuMD Ok thanks doctor. I guess it's nothing to worry about and I just have to be patient? Thanks again.

[@flydove-zx2ij]

@DR.LIU- IS IT SAFE TO HAVE A RHINOPLASTY SURGERY, EVEN IF THE PATIENT HAS A CHRONIC SINUSITIS PROBLEM?

[@GeneLiuMD]

I would be very hesitant to do any elective surgery in someone with any type of chronic infection. The only people that can determine if it is safe for you are the surgeons/doctors that take care of you.

[@flydove-zx2ij]

@@GeneLiuMD Thank you for your reply Doc.

[@yizoe3589]

Hi Doc， I have had sinuses for over 1 month， I want to ask how can I tell if I need antibiotics? thank you

[@GeneLiuMD]

If it's been going on for over a month, you really should go see a health care provider. They can help you sort out whether or not you need medications. There is no way to tell over the internet or phone.

[@stylicho]

Thanks for the video. I've been having sinus issues for over a year now. Sometimes it gets real bad but a lot of times it almost completely goes away (almost). By almost I mean I will have to cough some mucous out of my lungs every day. However, if it's cold out and say I walk my dog around the block clear nasal discharge will be coming out of both nostrils almost like water. Never had this problem until I started having these issues. Have had lung tests done including ct and they looked good. CT on sinuses showed I had problems (don't recall exactly what they were). Doctor said I could have surgery done but I've heard some negatives about surgery like people getting Empty Nose Syndrome etc. I'm also wary of flouroquinolone antibiotics due to side effects. So I've been thinking about a balloon sinuplasty. What's your take on that?

[@stylicho]

Forgot to add I've had a chemical burn in my body in the past and I do believe I'm kind of in the affected immune system community. Thanks

[@GeneLiuMD]

Empty Nose Syndrome is exceptionally rare and is typically a result of someone being very aggressive surgically along with some risk factors in the patient's medical condition. Balloon procedures are great, but generally only good for very mild disease in very specific areas. It does not work for all the sinuses. It does not work for more severe disease. There is no way for me to weigh in if it makes sense for you. We do also try to avoid the fluoroquinolones for many reasons. There are rare situations where that is what is most appropriate to use, but in the vast majority of situations, there are much better options out there.

[@stylicho]

@@GeneLiuMD Thanks for taking the time to reply to my question.

[@stylicho]

@@GeneLiuMD One other quick question if I may. What are the better antibiotics?

[@GeneLiuMD]

@@stylicho There are many reasons to choose one antibiotic over another.... it depends on what you are treating, what and when the patient recently has been treated with, any allergies/sensitivities/intolerances, what is common in the community, etc.... Admittedly, this may not be the easiest to read: academic.oup.com/cid/article/54/8/e72/367144

[@srinathsathyanath7435]

Can working out reduce sinusitis?

[@ESG13]

Hey doc I have a question o told my primary doctor that my sinuses cause me to feel off balance and o can't smell I could hardly breathe threw my nose I been like this for like three years so I told my doctor he just told me to take allergy medicine how do I get my sinuses check.???????????..??

[@GeneLiuMD]

Even if it is your sinuses, the symptoms may be allergy driven. It is 100% reasonable to see if treating suspected allergies might make things better. We usually only perform further testing such as scope exams and CT scans if someone does not improve with more conservative measures. For example, even if your sink is 100% blocked, it does not mean you have to immediately call the plumber. Sometimes, plunging it a little bit, and pouring in some Draino might completely clear the problem.

[@olphiuae1348]

I do have accute sinus infection .left eye swallow..eye discharge it was healed with antibiotics but after 2 weeks comes back I did ct scan with contrast stills showing infection.my doctor said you have sinus disease you need to have operation in 3 days . I need your second opinion doctor

[@Fal01100]

Thank you soooo much..its extremely helpful video...i am advised FESS ,septoplasty ,and turbinate reduction kindly tell me would it be beneficial for me???

[@malik3267]

have u done surgery

[@Fal01100]

@@malik3267 yes done

[@malik3267]

@@Fal01100 hows ur expernc.did ur surgery successful.

[@Fal01100]

@@malik3267 Yes it is because previously i couldn't breath from my nose ..but now significant improvement ....now i can breath from my nose .after surgery some care is required for example regular nasal rinse with salt water and putting olive oil in nose ...this is must....If u are going through turbinate surgery ..plz tell doc not to completey remove turbinate .. he should do reduction only

[@malik3267]

@@Fal01100 yes i m going fr surgery aftr a week..m too much afraid of.can u tell me pl, from where u did surgery

[@drightboy76]

Hi Doc. I have been dealing with chronic sinusitis for two years now. My CT scan shows a complete closure of my sinuses. My ENT suggested that I have surgery but it kept getting put off because I had other pressing health issues to deal with first. I recently had a stent placed in my heart to open a blockage so now I am on Plavix and aspirin. Now the doctors are saying that I have to live with it because the surgery would cause a lot of bleeding. Is there anything that can be done? This is destroying my quality of life.

[@GeneLiuMD]

Cardiovascular issues certainly increase the risk of anesthesia and any surgery. Usually, though, once a stent is placed, patients are in much better shape. The meds to thin the blood absolutely increase the risk of bleeding. If the underlying medical condition is severe enough, it might still make sense to go ahead with surgery - but the risks are higher. There are ways to manage the bleeding if it comes up. I would be more concerned about the cardiac risks and whether or not your cardiologist feels your heart could handle the physical stress. If your doctors don't feel it's worth it, consider another opinion. If multiple opinions all feel surgery is not a great idea, then you at least know for sure. And part of the additional opinions should include what can be tried non-surgically.

[@MultiMcgurk]

You need too work on building a stronger body

[@JuanLopez-gh1rb]

Your chronic sinusitis is going to put more stress on your heart because you're resting heart rate goes up because you can't breathe properly...airflow is a huge factor for resting heart rate! Get it fixed buddy asap

[@chrispenn6134]

I have a tissue growth in one nose is that a nasal polyp or tumor?

[@cledugay2596]

Hi doc,i just got a nasal polyp surgery,can i use a fluticasone nasal spray after cleaning or rinsed my nose?thank you

[@oscarriley465]

How you doing after polyp surgery? I had FESS surgery to remove massive polyp 7 months ago but now another one back! Booked back in for another surgery 😮

[@yolandabritt351]

Hello doctor today I went to my PCP, I was diagnosed with acute sinusitis. With my sinusitis I have been running fever for the past 4 days off and on. I have a follow-up tomorrow if my conditions are worse or not improve suggest I be admitted to the hospital. Is this a common suggestion for a sinusitis? I was given a steroid and a cortisone shot to see if it help! Doctor also prescribed Prednisone for 7 days. What's your advice on this prescription!

[@GeneLiuMD]

I hope that you are better now. Steroids are not unheard of for more severe sinusitis. Whether it's a good idea for you or not, I can't say - really depends on so many other factors. It's also really rare to need to be admitted, but never say never.

[@jacobcollins9389]

What do you think of Prednisone doc?

[@GeneLiuMD]

@@jacobcollins9389 strong steroid. Can make a big difference in the short term. Longer term use can wreck your body, though.

[@Ankur9518]

Hi doc, suffering from post nasal drip since 2years due to which i have chest congestion.have done septoplasty and turbinoplasty a month ago but nothing happen.taken lot of sprays and antibiotics but nothing still suffering from post nasal drip.

[@GeneLiuMD]

Septoplasty and turbinate reduction primarily help with obstruction, not drainage. Even if the septum is perfectly straight, and the turbinates small, drainage occurs because something is irritating the lining of the nose and sinuses and creating either more mucus or thicker mucus (or both). Drainage can be from allergies, environmental/inhalational irritants, something trapped in the sinuses, acid reflux, hormonal issues, adenoiditis, and many other causes. You would have to be evaluated for what the source may be. Best of luck!

[@Ankur9518]

@@GeneLiuMD thanks doctor