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Ear, Nose, and Throat Disorders

Sinusitus - does it ever go away by itself?

05/17/2006

Question:

Following a cold in November 2005, I have had sinusitis/rhinitis symptoms for over six months now:

- Thick, yellow mucous (sometimes clear/golden, sometimes cloudy/yellow) ALL THE TIME. Perpetual. Constant. Seemingly eternal. - Only on the right side. The left is clear. - Worse at night, leading to dry mouth/sleeping problems - Annoying/embarassing nasal dripping - Swollen lymph gland under chin - General fatigue/malaise (interrupted sleep?) - No facial pain, no headaches, no toothache, no vision problems or any other symptoms (thank God).

For the first three months I saw three separate doctors on three consecutive occassions and got three separate 10-day prescriptions for antibiotics (amoxcylin followed by 2 rounds of augmentin), all to no avail. Various steroidal anti-inflamatory nasal sprays and drugs also prescribed: no effect at all. Not even temporary relief.

For the past three months I`ve been practicing regular hypotonic saline nasal flushing. At one point I added a small amount of diluted hydrogen peroxide, but that didn`t seem to do anything other than irritate my sinuses. I now just stick to a pinch each of sodium bicarbonate and sea salt.

This cleans me out and feels good for a few minutes, but the mucous never fully goes away. It`s back in force within just a few minutes.

Recently I`ve been experiencing a `crinkling` sound in my right ear, along with a fullness that changes as I breath in and out. I fear my saline flushing may have deposited some fluid in my eustuchian tube on the right side.

I have variously avoided dairy products and/or alchohol in my diet. I can discern no difference. The symptoms roll on regardless.

My nose/sinuses have become a highly efficient producer of golden mucous. Unfortunately, this is a product I have no use for and it`s abudance is starting to drive me insane.

I am at my wits end. I no longer have faith in my general practitioner(s), the internet is mainly full of hocus-pocus, and I cannot afford to see a specialist.

Will this problem/infection ever go away on its own? Does it ever?

Is it in danger of spreading/causing complications?

Should I continue with the saline rinsing, or should I cease and desist?

I thank you for your time and any advice you may care to offer.

Answer:

An acute sinus infection can sometimes clear on its own.  However, your situation appears to have become more chronic, and it is unlikely to resolve without therapeutic intervention.  It sounds as though you have a persisting infection, and therefore a more prolonged course of treatment may be required, including a longer course of antibiotics and perhaps systemic steroids to facilitate decongestion and drainage. 

At this point, I would consider returning to an ENT physician.  Such a physician would be best able to determine the most appropriate therapy, and even consider obtaining a culture to help direct the selection of an antibiotic.

There is no harm in using a salt water nasal rinse, but at this point I don't think this alone will resolve your symptoms.

For more information:

Go to the Ear, Nose, and Throat Disorders health topic, where you can:

Response by:

Allen M Seiden, MD Allen M Seiden, MD
Professor of Otolaryngology, Director of Division of Rhinology and Sinus Disorders, Director of University Taste and Smell Center, Director of University Sinus and Allergy
College of Medicine
University of Cincinnati