Harvard Medical School Guide to Healing Your

Vital treatment options for sinus problems.

Ralph B. Metson, M.D., is a clinical professor at Harvard Medical School who practices at the Massachusetts Eye and Ear Infirmary. His work has been profiled in the New York Times and Wall Street Journal, and he has appeared on "Good Morning America."

Steven Mardon is a freelance writer specializing in health issues who has written for newsletters, newspapers, and magazines for more than ten years.

Preface

xi

Acknowledgments

xiii

PART I The Sinuses in Health and Disease

CHAPTER 1 Sinusitis and Quality of Life

3

(8)

You Are Not Alone

4

(1)

Sinusitis Is a Serious Problem

5

(2)

Diagnosis and Treatment Have Improved Dramatically

7

(1)

You Can-and Should-Play an Active Role in Your Treatment

8

(3)

CHAPTER 2 How Your Sinuses Work

11

(14)

Entering the Nasal House: Your Nose as the Foyer

11

(1)

The Nasal Cavity: A Hallway with a Climate Control System

12

(4)

The OMC: A Critical Passageway

16

(2)

A House with Eight Rooms: Your Four Pairs of Sinuses

18

(1)

Inside Your Sinuses: Mucus, Cilia, and Glands

19

(2)

Why We Have Sinuses: Seven Theories

21

(4)

CHAPTER 3 When Healthy Sinuses Become Blocked

25

(10)

The Direct Cause: It's the OMC

26

(4)

Sinusitis Symptoms: The Big Three

30

(2)

Other Sinusitis Symptoms

32

(3)

CHAPTER 4 Making the Diagnosis: Do You Really Have Sinusitis?

35

(12)

Primary Care Visit

37

(1)

CT Scan

38

(1)

Treatment and Referral

39

(1)

Off to the ENT Doctor

40

(4)

Other Tests

44

(3)

CHAPTER 5 Acute Sinusitis: When a Bad Cold Gets Worse

47

(8)

How a Common Cold Can Lead to Sinusitis

48

(1)

Easing Symptoms

49

(1)

Medications for Acute Sinusitis

50

(2)

My Choice of Medications for Acute Sinusitis

52

(1)

Surgery for Acute Sinusitis?

53

(2)

CHAPTER 6 The Sinusitis Spectrum: Where Do You Fit In?

55

(10)

Three General Types: Locals, Systemics, and Intermediates

55

(5)

A Treatment Plan That's Right for You

60

(5)

PART II Nonsurgical Treatments for Sinusitis

CHAPTER 7 Nasal Irrigation: A Key to Healthier Sinuses

65

(10)

Keeping It Simple: Using a Bulb Syringe

66

(2)

Nasal Irrigation FAQs

68

(2)

Alternatives to the Bulb Syringe

70

(5)

CHAPTER 8 A Trip to the Drugstore: Products for Your Nose and Sinuses

75

(6)

Humidifiers

75

(2)

Nasal Tape

77

(1)

Mechanical Dilators

78

(1)

Saline Sprays

78

(1)

Moisturizing Sprays and Gels

79

(2)

CHAPTER 9 Cold and Allergy Medications: Which Ones Can Help Your Sinusitis?

81

(10)

Decongestants

82

(1)

Mucus-Thinning Agents

83

(1)

Antihistamines

84

(2)

Pain Relievers and Cough Suppressants

86

(1)

Combination Products

86

(2)

Other Medications

88

(3)

CHAPTER 10 Steroids: A Way to Reduce Inflammation, Congestion, and Polyps

91

(6)

Nasal Steroid Sprays

92

(1)

Nasal Steroid FAQs

93

(2)

Oral Steroids

95

(2)

CHAPTER 11 Antibiotics: The Mainstay of Sinusitis Treatment

97

(12)

Symptom Relief

97

(1)

Choosing an Antibiotic

98

(2)

Classes of Antibiotics

100

(2)

Minimizing Side Effects

102

(2)

Short- and Long-Term Dosing Regimens

104

(1)

Topical and Intravenous Antibiotics

105

(4)

CHAPTER 12 Diet and Lifestyle: How Everyday Decisions Can Affect Your Sinuses

109

(6)

Food Allergies: Milk and Wheat

109

(3)

Alcohol

112

(1)

Smoking

112

(1)

The Workplace

113

(1)

The Fragrance Factor

114

(1)

CHAPTER 13 Alternative Therapies for Sinusitis

115

(10)

Using Common Sense

116

(1)

Acupuncture

116

(1)

Herbal Therapy

117

(2)

Nutritional Supplements

119

(1)

Homeopathic Medicine

120

(1)

Stress Reduction Techniques

120

(5)

PART III Surgery for Sinusitis

CHAPTER 14 Making the Decision to Have Sinus Surgery

125

(6)

Your Doctor's Recommendation

125

(1)

It's Your Decision

126

(1)

Realistic Expectations

126

(2)

Surgery Really Does Help

128

(1)

Factoring in Complications

129

(2)

CHAPTER 15 What to Expect with Sinus Surgery

131

(12)

A Brief History of Sinus Surgery

131

(1)

The Modern Way: Minimally Invasive Surgery

132

(2)

Anesthesia

134

(1)

The Preoperative Visit

134

(1)

Arriving for Surgery

135

(1)

The Operation

135

(1)

Specialized Instruments

136

(3)

Advanced Techniques

139

(1)

Image-Guided Surgery

140

(3)

CHAPTER 16 Recovering from Sinus Surgery

143

(10)

Going Home: The First Few Days

143

(2)

Getting Back to Your Normal Self: The First Few Weeks

145

(2)

Completion of Healing: The First Few Months

147

(1)

Revision Surgery

148

(5)

PART IV Special Considerations in Sinusitis

CHAPTER 17 Fungal Sinusitis

153

(6)

Types of Fungal Sinusitis

154

(2)

A Larger Role for Fungi?

156

(3)

CHAPTER 18 The Deviated Septum and Other Sinus-Related Problems

159

(10)

The Deviated Septum

159

(2)

Enlarged Turbinates

161

(1)

Empty Nose Syndrome

162

(1)

Eustachian Tube Dysfunction

163

(1)

Triad Asthma

164

(1)

Vacuum Sinusitis

165

(1)

Sinus Tumors

166

(3)

CHAPTER 19 Special Circumstances of Sinusitis

169

(8)

Children and Sinusitis

169

(2)

Sinusitis During Pregnancy

171

(1)

Genetic Causes of Sinusitis

171

(1)

Sarcoidosis

172

(1)

Wegener's Granulomatosis

173

(1)

Immune Deficiency Syndromes

174

(3)

CHAPTER 20 Disorders That Mimic Sinusitis

177

(6)

Reflux

177

(2)

Dental Disease and TMJ

179

(1)

Migraines

180

(1)

Neuritis

181

(1)

Neuralgia

182

(1)

Atypical Facial Pain

182

(1)

CHAPTER 21 Future Considerations: Where Do We Go from Here?

183

(6)

Genomics and Gene Therapy

183

(2)

Computerized and Robotic Surgery

185

(1)

New Medications

186

(3)

Glossary

189

(12)

Additional Resources

201

(2)

Index

203

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Harvard Medical School Guide to Healing Your Sinuses

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Table of Contents

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