ENT and Rhinology Specialist in Boise, Idaho

Treasure Valley Nasal and Sinus Center, founded by Dr. Peter Killian, is Idaho’s premier center for rhinosinusitis treatment. After completing a residency in Otolaryngology, Head and Neck Surgery (ear, nose, and throat [ENT] specialist training) Dr. Killian completed a one-year fellowship in Rhinology (endoscopic sinus and anterior skull base surgery). With this training he is the most qualified, educated, and experienced rhinologist and sinus surgeon in the state of Idaho.

What Is Acute or Chronic Rhinosinusitis?

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Your sinuses are hollow, air-filled cavities in your skull and facial skeleton which connect through very narrow passageways to the nasal cavity. Most people have four pairs of sinuses:
  • Frontal sinuses - In the forehead or above the eyes.
  • Sphenoid sinuses – Behind and between the eyes.
  • Ethmoid sinuses - In the face between the eyes.
  • Maxillary sinuses - In the cheeks or below the eyes.

Sinusitis (or rhinosinusitis, because the symptoms involve both the lining of the nose and paranasal sinuses) is a very common problem affecting 1 in 8 adults each year. Rhinosinusitis means that there is an inflammatory process of the nose and sinuses, which cause many of the symptoms described below. This inflammation may be caused by a number of underlying conditions such as infection by a virus or cold, bacterial infection, and allergies. The inflammation or swelling can block the narrow opening from the sinuses to the nasal cavity leading to mucus build up, bacterial colonization and infection, and facial pain and pressure.

Acute sinusitis refers to inflammation or infection that lasts fewer than 4 weeks. A diagnosis of chronic sinusitis requires that symptoms last longer than 12 weeks. Patients with chronic sinusitis can also develop nasal polyps, which are predominantly watery overgrowths of inflammatory tissue that contribute to nasal and sinus blockage and decreased sense of smell. Recurrent sinusitis is when an individual has 4 or more infections or episodes of acute sinusitis in one year, but does not have chronic symptoms between these episodes.

The symptoms of a virus or cold, allergies, and bacterial sinus infection can be difficult to differentiate. The process for developing a bacterial infection takes 5 to 7 days and typically starts with a cold or viral infection that causes blockage and bacterial overgrowth. Antibiotics do not treat viruses or allergies and therefore are not generally recommended in the first few days to treat symptoms unless a sinus culture demonstrates a bacterial infection.

The most common symptoms of sinusitis include:

Sinus pressure, fullness, and headache
Pain and pressure are usually felt in the face, nose, and behind the eyes. A moderate or severe sinus headache can also extend into the upper jaw and teeth. If your headache comes with moderate-to-severe neck pain and stiffness, nausea, vomiting, and balance problems, it could instead be a cerebrospinal fluid leak or meningitis.
This results from inflammatory swelling in the lining of the nose and can also be from overproduction of mucus--runny nose--due to allergies or due to a bacterial, viral, or (less commonly) fungal sinus infection.
Discolored mucus or nasal discharge
Mucus may turn greenish or brownish. It is often thicker and not clear.
Reduced or lost sense of smell
Also called hyposmia and anosmia respectively, these symptoms are not exclusive to rhinosinusitis, but may be present. They may also be present with other ear, nose, and throat disorders, including COVID-19.
Other symptoms can include:
Post-nasal drip
PND can cause irritation in the throat that results in a post-nasal drip induced cough. You may also need to clear your throat frequently.
A temperature above 100.4°F.
Any time your body is fighting inflammation, you are more likely to feel tired by normal activities.
Eye swelling or affected sight
This may be seen when the sinus infection spreads to the eye which is called orbital cellulitis or abscess. This can also be seen with allergic fungal rhinosinusitis or with a thyroid disorder called Grave’s Disease (Grave’s Ophthalmopathy). This is not seen with typical sinus infections.
If you’re dealing with any or all of these sinusitis symptoms, Treasure Valley Nasal and Sinus Center can help with an accurate diagnosis and an appropriate individualized treatment plan, starting you on the road to relief. Recurring or moderate-to-severe sinus infection symptoms don’t need to keep you down.
Call us at (208) 593-4484 so we can help.

Acute and Chronic Rhinosinusitis Treatment

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The form of treatment you may expect at Treasure Valley Nasal and Sinus Center depends on the underlying cause of your sinusitis.

If you have:
  • Bacterial sinusitis, taking the proper course of antibiotics is often a first step. Determining whether a patient has a bacterial or a viral infection is key to prescribing the right kind of sinus infection treatment. Culture-directed antibiotic therapy is an excellent way to provide an accurate diagnosis and appropriate antibiotic selection when needed.
  • Viral sinusitis, staying hydrated and using a saline spray or sinus rinse to keep your sinuses moist is important. There may be other medical, non-invasive options to keep your sinuses clear and improve your immune response as your body fights the virus. Oral nasal decongestants such as Sudafed® (pseudoephedrine) or phenylephrine are found in many over-the-counter cold medicines and can be helpful for a short period of time. Mucus-thinning agents such as Mucinex® (guaifenesin) can help promote sinus drainage. Antibiotics, however, do not treat viral sinusitis.
  • Fungal sinusitis, surgery is almost always required to remove the invasive or colonizing fungus (called a mycetoma), but thorough follow-up care is also essential to preventing repeated infection and nasal obstruction.
  • Allergic rhinitis, we can help with initial diagnosis and specific treatment of the nasal cavity and sinuses (see our page on nasal allergies, and also can provide a referral to an allergist who can further help with immunotherapy to reduce allergic responses. Many of the treatments we use to treat the chronic inflammatory processes in the nose are also helpful in significantly reducing symptoms of allergic rhinitis.
  • Nasal (nose) polyps, surgery is also a common solution, but it is not the exclusive option. See our Nasal and Sinus Surgery page to learn more.

There are many other possible underlying causes for nasal and sinus blockage. Dr. Killian and the team at Treasure Valley Nasal and Sinus Center can discuss these with you and help get to the root of your symptoms.

If you’re looking for sinus pressure, headache, and infection relief, Treasure Valley Nasal and Sinus Center is here for you.

In Boise, Meridian, Eagle, Nampa, and Caldwell, there is no better source for solutions to your acute and chronic sinus disease. Call (208) 593-4484 or contact us today to schedule an appointment to start feeling better soon!
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