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Top Docs: 5 facts about sinus infections

Dr. Louis Rosner, director of the Department of

Dr. Louis Rosner, director of the Department of Otolaryngology at South Nassau Communities Hospital, demonstrates how to use a nasal spray at South Shore Otolaryngology P.C. in Rockville Centre. (Nov. 5, 2012) Credit: Barry Sloan

Talk about pressure. A sinus infection can make your head feel like it's going to burst open. But the wide array of possible treatments -- from neti pots and decongestants to nasal sprays and antibiotics -- can be mighty complicated.

Here's what you need to know:





How do you know if you're suffering from a cold or a sinus infection? Pay attention to symptoms. "Colds tend to be briefer and less intense and involve the nose, not the sinuses," said Dr. Raymond Soletic, an otolaryngologist, or ear, nose and throat specialist, based in Manhasset, and an attending physician at St. Francis Hospital Heart Center.

"People with sinus infections have more pain and pressure, more nasal secretions," Soletic said. "And instead of lasting for a few days, a sinus infection can last from days to weeks to months."

There are other signs, too. They can include swelling, a runny nose with yellow or green mucus and perhaps a fever or headache, said Dr. Louis M. Rosner, an otolaryngologist in Rockville Centre and director of the department of otolaryngology at South Nassau Communities Hospital in Oceanside.

Anyone who has these symptoms longer than 10 days should see a doctor, he said.





Drugstores sell "neti pots" and other inexpensive nasal-irrigation devices that are used to flush the sinuses -- not just the nose -- with salt water. Both Rosner and Soletic recommend flushing.

"It's a cleansing process that washes out mucus," Soletic said. "It can cleanse the nose, reduce the intensity of the infection and also hopefully shorten the duration."

Make sure the water is warm, around room temperature, and use the saline packets that come with the devices to avoid irritating the nose, he said.

Soletic advises patients to use only an eighth of an ounce, or three-quarters of a teaspoon of water. Many people prefer that because "they don't feel like they're sticking their head underwater," he said. And he suggests using a nasal aspirator, a kind of syringe designed for infants and sold over-the-counter.

Two Louisiana residents died last year after developing a rare brain infection caused by an amoeba that entered the body through the nose after they used neti pots filled with tap water. Jonathan Yoder, coordinator of waterborne diseases and outbreak surveillance with the U.S. Centers for Disease Control and Prevention, recommends that only boiled or filtered water be used in neti pots.





Over-the-counter decongestant sprays can clear the sinuses, but doctors advise that they be used only briefly. "They'll help you over the worst part, but over two to three days, your nose will become addicted to them," Rosner said.

The decongestants constrict blood vessels, which reduces fluid in the nasal passages and makes breathing easier on a temporary basis, he said. But if you use a decongestant for more than a day, the nasal tissues develop tolerance to the decongestants and need a bigger dose to get the same effect. "You're forced to keep using the spray throughout the day," he said.





Though decongestant nasal sprays can spell trouble, saline nasal sprays are innocuous, said Rosner, who added that people can use them frequently to flush their nasal passages and keep them moist.

"You want to keep the mucus flowing. You don't want to shut down," he said. "Sometimes, people say you have to stop the mucus completely. But remember that the body is trying to clear itself of whatever toxins are getting into the nose. There has to be some flow."

Rosner also recommends the cold-and-sinus products by Tylenol and Advil because they don't cause addiction or the rebound effects that nasal decongestants can.





"The body has an amazing capability to fight off an infection, so you don't always need an antibiotic," Rosner said. "Most cases of acute sinus infections will resolve with simple hydration, nasal sprays or irrigation and just taking care of yourself." But he said that antibiotics are needed if the infection lasts beyond 10 days.

However, antibiotics can cause side effects. Soletic warns that people taking antibiotics should stop taking them and contact a doctor if they start having headaches, stomach discomfort or diarrhea, or muscle or joint pain.





Dr. Anthony J. Durante

134 Mineola Blvd.

Ste. 201



Dr. Douglas K. Frank

430 Lakeville Rd.

New Hyde Park


Dr. Robert M. Gargano

375 E. Main St., Rm. 17

Bay Shore


Dr. Michael A. Gordon

990 Stewart Ave., Ste. 610

Garden City


Dr. John Grosso

875 Old Country Rd.

Ste. 200



Dr. Andrew A. Jacono

440 Northern Blvd.

Great Neck


Dr. Richard Litman

251 E. Oakland Ave.

Port Jefferson


Dr. Kenneth Mattucci

29 Barstow Rd., Ste. 203

Great Neck


Dr. Idel Moisa

3 School St., Rm. 304

Glen Cove


Dr. Philip W. Perlman

Progressive Ear, Nose & Throat Assocs.

333 E. Shore Rd., Ste. 102



Dr. Louis M. Rosner

176 N. Village Ave., Ste. 1A

Rockville Centre


Dr. Michael Setzen

600 Northern Blvd., Ste. 312

Great Neck


Dr. Mark J. Shikowitz

Hearing & Speech Bldg.

430 Lakeville Rd.

New Hyde Park


Dr. Raymond Soletic

1615 Northern Blvd., Ste. 201



Dr. Bernard Tawfik

3 School St., Ste. 304

Glen Cove


Dr. Andrea Vambutas

Hearing and Speech Ctr.

430 Lakeville Rd.

New Hyde Park


Dr. Jay Youngerman

875 Old Country Rd.

Ste. 200



Dr. Gerald Zahtz

430 Lakeville Rd.

New Hyde Park


Dr. Warren H. Zelman

990 Stewart Ave.

Ste. 610

Garden City




How they were picked


Castle Connolly Medical Ltd. is a health-care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and top hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of top doctors and the medical leadership of leading hospitals.

Castle Connolly's physician-led team of researchers follows a rigorous screening process to select top doctors on both the national and regional levels. Its online nominations process -- located at nominations -- is open to all licensed physicians in America who are able to nominate physicians in any medical specialty and in any part of the country, as well as indicate whether the nominated physician is, in their opinion, among the best in their region in their medical specialty or among the best in the nation in their medical specialty.

Careful screening of doctors' educational and professional experience is essential before final selection is made among those physicians most highly regarded by their peers. The result -- Castle Connolly identifies the top doctors in America and provides the consumer with detailed information about their education, training and special expertise in its paperback guides, national and regional magazine Top Doctors features and online directories. Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors. (Newsday is not part of the selection process.)

Physicians selected for inclusion in this Top Doctors feature may also appear as Regional Top Doctors online at, or in one of Castle Connolly's Top Doctors guides, such as America's Top Doctors® or America's Top Doctors® for Cancer.



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