A Source of Common Complaints: Understanding Our Sinuses | TheUnion.com
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A Source of Common Complaints: Understanding Our Sinuses

Sinus pain can have many different causes, including allergies, fungal disease, a virus, or infection. Getting the right treatment depends on finding the exact cause.

They serve a crucial function to our overall health but few of us really understand what they are and what they do.

They’re our sinuses – four open spaces on both sides of the head, connected to the nose by narrow channels. Dr. Andrew Thomas says they are the source of many grumbles in his office.

“All I get is complaints about the sinuses, which is sad for the sinuses as nobody ever comes in to tell me how happy they are with their sinuses,” Dr. Thomas says with a laugh. “They’re probably only matched by the tonsils as the most frequently frustrating structure in people’s heads!”



Dr. Thomas has spent his career trying to help solve some of the problems people have with their sinuses. He is a fellowship-trained rhinologist and sinus surgeon who recently relocated from New Orleans to Grass Valley and began seeing patients at his practice at 123 Margaret Lane. He anticipates sinus issues to continue to be one of the top reasons patients come to see him, both because of his unique expertise in treating these conditions and because sinus issues are such a prevalent and impactful problem.

“While many different disease processes can occur in the sinuses, the most common disease state of the sinuses is inflammation from some cause,” he explains. “Inflammation of the sinuses is called sinusitis. This can be related to allergies, infection, physical obstruction, or even chronic inflammation.”



The sinuses normally make thin mucus that drains out of their channels into the nose, which then drains down the throat and is swallowed. When functioning properly, over a quart of mucous is made per day and the constant flowing drainage helps keep the sinuses and nose clean, and prevents obstruction and infection. Normally filled with air, the sinuses can get blocked and filled with fluid, causing what we all know as sinus pain.

Dr. Thomas says the symptoms related to sinusitis can range from facial pain and pressure over the sinuses (sometimes described as ‘sinus headaches’), to congestion, nasal drainage, decreased sense of smell/taste, and even complete nasal obstruction.

He says it’s important to realize that not all sinus symptoms are due to an infection.

“Sinus infections are very common, but so too are inflammatory conditions of the sinuses that are not due to infection,” Dr. Thomas explains. “Figuring out if a sinus inflammatory condition is actually due to an infection is critical to getting the right treatment, as treating allergies, fungal disease, a virus, or some other non-bacterial cause of sinus inflammation with antibiotics is not effective and not advisable given the potential issues that can arise from inappropriate use of antibiotics.”

Dr. Thomas says the extent of a sinus infection varies depending on how many of the four sinuses are involved and how severe the infection is in the involved sinuses. Typical symptoms include facial pain or pressure sometimes felt as pain in the upper teeth or jaw; discolored nasal discharge that may be described as thick and opaque green or yellow material; nasal drainage down the back of the nose to the throat (post-nasal drip) which can sometimes also cause cough; as well as nasal congestion/stuffy nose. Someone with a sinus infection may also experience a fever, fatigue, or simply feel sick.

The treatment for sinus infection should be tailored to the specific cause, Dr. Thomas says.

“There are a number of ways I sort out the cause of sinus issue so that I can make sure the patient gets the most appropriate treatment for their specific issue,” he explains. “In addition to the information I get from talking with the patient and looking in their nose and throat, for patients that have chronic, persistent or frequent infections I may look into the nose with a small telescope (called endoscopy) to get a direct view of these structures, and sometimes get a sample of the drainage from the sinuses for testing. A patient may also need a CT scan to provide a complete image of all the sinuses.”

Many common sinus infections are related to viral illness, Dr. Thomas says. Those infections typically resolve within two weeks without antibiotics.

One concerning sign that a common viral sinus infection has turned into a bacterial sinus infection is called the “double worsening sign.”

“This occurs when a seemingly typical (likely viral) sinus infection appears to be getting better on its own after maybe a few days or a week, but then the symptoms start to return or get worse,” Dr. Thomas explains. “This is often due to a bacterial infection occurring secondarily after the initial viral infection. This would then need to be managed with antibiotics.”

If you are one of the unlucky people who find themselves struggling through multiple sinus infections every year, Dr. Thomas says you may want to dig a little deeper for the cause.

“Regular sinus infections certainly can be a sign of an underlying issue,” he says. “It is very common for people to have one or two sinus infections per year normally, but if someone is experiencing recurrent infections more than three times per year, ongoing symptoms lasting for many weeks, severe symptoms that aren’t resolving with usual medical treatments like antibiotics, or complications from a particularly severe sinus infection then I would advise them to be seen by a rhinologist like myself.”

Studies have shown that chronic sinus issues are similar to other chronic illnesses like heart disease in terms of the negative impact they can have on your quality of life. Dr. Thomas encourages anyone experiencing that level of sinus struggle to seek help from a specialist.

“Let us help figure out what the particular problem is and treat it.”

Meet Dr. Andrew Thomas


Dr. Andrew Thomas

Dr. Andrew Thomas is a fellowship trained rhinologist and expert in sino-nasal conditions. He treats patients for a variety of ear, nose and throat related issues and is currently accepting new patients.

123 Margaret Lane, Suite B1

Grass Valley, CA 95945

530-4100-ENT (530-410-0368)


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