Monthly Archives - September 2016

Should You Use Nasal Decongestants?

Although we recommend that you employ some self-medication and home remedies for sinus trouble, some remedies are safer and more effective than others.

Nasal decongestants including Afrin, Neo-Synephrine and others can be used to treat nasal congestion, sinus infection and allergies. In general, these sprays are safe and can offer relief when used as directed. Many of these sprays include a limitation warning – such as not to use more than twice in 24 hours, or more than 3 days in a row. Why do they include such warnings?

The answer lies in how these drugs work. The active ingredients in most nasal sprays – such as oxymetazoline hydrochloride, phenylephrine hydrochloride or xylometazoline – work by closing blood vessels in your nose. The constriction of blood flow helps to minimize the effects of congestion and lasts about 12 hours.

If you use nasal decongestants for an extended period of time, however, the continued suppression of blood flow can damage nasal tissues and lead to worse congestion.

This ongoing interference with the body’s natural function can have many negative consequences, including edema (swelling) and lasting damage. Your body may increase the production of mucous in order to increase the blood flow that’s restricted by the medicine, which actually worsens the condition you’re trying to help!

Steroid and other types of nasal decongestants (including Flonase, Nasocourt, or Rhinocort) are the ones which we prefer and recommend, because they do not have these negative potential effects. Del Rey Sinus & Allergy Institute is here for you to help you make the right decisions for the health of your sinuses. Whether it’s allergy, cold or flu season, we can help you to Breathe Better, Today!


Recovery From Our In-office Balloon Sinus Dilation Procedures

We often say that balloon sinus procedures (also called sinuplasty) has a “fast recovery,” but we would like to provide you with more specific information about the recovery from sinus surgery.

Balloon sinus dilation is performed in many cases in less than one hour. Patients often elect to take a mild sedative pill before the procedure but can also elect to have the procedure without any medication before hand. As soon as 10 or 15 minutes after surgery and resume your normal level of activity. We do recommend that you rest and recover in a quiet environment that same day. You will generally be able to go back to work or your everyday life the very next day.

The chart below depicts typical recovery time and events that most (but not all) patients can expect (source: Entellus):

There is a chance that you will have some minor pain related to the surgery. In general, patients who have a balloon sinus surgery will not need prescription pain medication, and if so, for only a day or less. This is much less that what is usually required for endoscopic sinus surgery.

When you schedule your surgery at Del Rey Sinus & Allergy Institute, we will provide you with comprehensive pre- and post-surgery instructions. On the day of your procedure, you may have some anxiety, so we may give you an oral sedative or anesthesia, but many patients do not need either.
After the procedure, you may experience light bleeding. There is almost never any nasal packing required. The common risks of our in-office nasal procedure include minor pain, nosebleeds, fainting, and fast heartbeat in the case of local anesthesia. This minimally invasive surgery involves the modification of delicate bones that separate the nose and sinuses from the brain and the eye, which is a very sensitive area. The significant experience of Dr. Farhad Sigari and the Del Rey Sinus & Allergy Institute team helps avoid any complications of surgery.

Thanks to our local our revolutionary local anesthetic protocol we can often perform even the more advanced sinus procedure all in the comfort of our office without the need of general anesthesia.

One of the most helpful factors in fast recovery is our use of the Propel sinus stent.

The stent holds nasal passages open while delivering medication to reduce inflammation and promote healing. The stent dissolves by itself after about 45 days.

And for the most advanced and revision cases we can implement Image Guided Computer Aided procedures. Del Rey Sinus and Allergy Institute is one of the first and few centers in the country that has Fiagon Image guided system available for in office use!

Once the procedure has been completed, our patients experience long-term relief from their sinus symptoms. You should not need to have another procedure for many years, if ever.


Home Remedies for Sinus Health

Your sinus health is important to us. Even though Del Rey Sinus & Allergy Institute specializes in the medical treatment of sinus symptoms, we would really like for you to breathe freely all the time, without needing our help!

Here are some simple steps you can take yourself to ensure healthy sinuses, nasal passages and free breathing:

  1. Rest. It’s a very simple remedy but sleep is a great healer. When you sleep, your body produces more human growth hormone (HGH), which can help you fight infections and recover faster.
  2. Hydrate. The more you drink, the more your mucous can dilute and drain. Drinks with caffeine or alcohol have a dehydrating effect, which can make your symptoms worse.
  3. Keep sinus cavities moist. If you inhale while taking a hot shower, or cover your head with a towel as you breathe over a bowl of hot water, you can ease sinus pain and help your sinuses drain better.
  4. Rinse your nasal passages. Commercially available squeeze bottles or a neti pot can help keep your sinuses flushed and clear. It may take some practice to get proficient at irrigating the sinus cavity. Make sure to use water that is free of contaminants: distilled, boiled and/or filtered.
  5. Warm compresses. Placing warm and damp (but not wet) towels around the affected areas of your nose, eyes, and cheeks can help relieve pain.
  6. Elevate your head when you sleep. Keeping your sinuses drained is key to comfort, and this will help with drainage.
  7. Stay well. Easier said than done, but you want to avoid getting a cold. Avoid people who have colds and wash your hands with soap and warm water often.
  8. Avoid cigarette smoke and pollution. Any type of tobacco smoke (including that from e-cigs and vape pens) can irritate your nasal and sinus passages.
  9. Use a humidifier. Especially in the fall and winter months, when the air is particularly dry, a humidifier can help you keep your nasal and sinus passages moist while you sleep or go about your daily life.
  10. Consider over the counter medication such as antihistamines (claritin, zyrtec, allerga) and/or nasal steroids (Flonase, Nasocourt, or Rhinocort).

For overall ear, nose, throat and sinus health, we are here to help! Check back here and at for more info.


What is sinusitis and what can I do about it?

We know you have questions. Dr. Farhad Sigari and the staff of Del Rey Sinus Institute are expert in the treatment of sinus conditions, and we can help. Over the years we have encountered countless cases of sinusitis, including ones just like yours.

What is sinusitis?

Like all medical terms ending in “itis,” sinusitis is an inflammation or swelling of tissues, in this case in the sinus cavity. There are two kinds, acute (or acute bacterial) and chronic, which are similar in some but not all aspects:

  • Acute sinusitis is a sudden onset of cold symptoms such as a runny nose, congestion or facial pain.
  • Chronic sinusitis is an ongoing condition that may include nasal congestion, post-nasal drip and facial pain. Symptoms last for 12 weeks or more.

What are the symptoms of sinusitis?

Symptoms include:

  • Drainage of a thick, yellow or greenish discharge from the nose or down the back of the throat (post-nasal drip)
  • Nasal obstruction or congestion, causing difficulty breathing through your nose
  • Pain, pressure or swelling around your eyes, cheeks, nose or forehead

Other signs and symptoms can include:

  • Headaches
  • Sinus pain or pressure
  • Jaw or tooth pain
  • Reduced sense of smell and taste
  • Cough
  • Bad breath (halitosis)
  • Fatigue
  • Fever

In addition to inflammation, chronic sinusitis may include one or more of the following symptoms:

  • Thick, discolored discharge from the nose or drainage down the back of the throat (post-nasal drip)
  • Nasal obstruction or congestion, causing difficulty breathing through your nose
  • Pain and swelling around your eyes, cheeks, nose or forehead
  • Reduced sense of smell and taste in adults or cough in children

Other signs and symptoms can include:

  • Ear pain
  • Sore throat
  • Cough, especially at night
  • Bad breath (halitosis)
  • Fatigue
  • Nausea

As you can see, chronic and acute sinusitis may be similar and have some of the same symptoms, but acute sinusitis is a temporary infection of the sinuses, mostly from the common cold. The symptoms of chronic sinusitis last longer, and because sleep may be disturbed, fatigue is a bigger factor. Fever isn’t a common sign of chronic sinusitis, but you might have one with acute sinusitis.

How do you diagnose sinusitis?

The exam is basically the same, whether it’s acute or chronic. The doctor will feel for tenderness in your nose and face and look inside your nose.

Other methods that might be used include:

  • Nasal endoscopy. A thin, flexible tube (endoscope) with a fiber-optic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses.
  • Imaging studies. We have an in-house CT scanner that can show details of your sinuses. This can help us identify abnormalities or suspected complications, particularly for chronic sinusitis.
  • Nasal and sinus cultures. Laboratory tests are generally unnecessary for diagnosing acute sinusitis. However, when the condition fails to respond to treatment or is worsening, tissue cultures might help determine the cause, such as a bacterial infection.
  • Allergy testing. If allergies may have triggered your acute sinusitis, we may recommend an allergy skin test. A skin test is safe and quick, and can help pinpoint the allergen that’s responsible for your nasal symptoms.

What are the treatment options?

For acute sinusitis, believe it or not we advise you to self-treat. Most cases will resolve on their own.

You may use one of the following, which we can recommend on examination:

  • Saline nasal spray.
  • Nasal corticosteroids. These nasal sprays help prevent and treat inflammation and include Flonase, Veramyst, budesonide (Rhinocort), mometasone (Nasonex) and others.
  • Decongestants, either over the counter or prescription. These are to be used for a limited time.
  • Over-the-counter pain relievers, such as aspirin, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin IB, others).
  • Antibiotics usually aren’t needed to treat acute sinusitis, unless symptoms get progressively worse. If we prescribe antibiotics, you must take the entire course or your symptoms could recur.
  • Immunotherapy drops. If allergies are contributing to your sinusitis, allergy drops that help reduce the body’s reaction to specific allergens may help treat your symptoms.

For chronic sinusitis, the treatments are designed to reduce inflammation, drain sinuses, and control the causes and number of occurrences. Treatments are similar to those for acute sinusitis, including:

  • Saline nasal spray.
  • Nasal corticosteroids.
  • Oral or injected corticosteroids. These are stronger medications that can relieve inflammation, especially in cases of nasal polyps.
  • Antibiotics. These can be needed if you have a bacterial infection. We may recommend antibiotics, sometimes in combination with other medications.
  • Immunotherapy drops.
  • Endoscopic sinus surgery. When you feel you have tried everything, and treatment and medications are just not working, you may opt for sinus surgery. We use a thin, flexible tube with an attached light (endoscope) to explore your sinus passages. We may also remove tissue or shave away obstructions causing nasal blockage.
  • Minimally invasive sinus surgery. We are specialists in balloon sinus dilation, where a balloon will open your sinus passages. In one simple treatment, many people gain a lifetime of relief.

Take care of your sinuses and breathe better today! See our Facebook page and Twitter feeds for more tips on keeping sinuses healthy and happy. If you need us, just call at (310) 823-4444