Research does demonstrate that in children, CT scans can lead to a small, but measurable increase in the risk of cancer. How does one protect your child, yet obtain the x-rays that will give the proper diagnosis and are clinically indicated?
I am of course referring to a CT (coronal) scan of sinuses used to diagnosis infection or anatomical nasal obstruction. Many patients need CT of sinuses because the underlying cause of their runny nose has never been identified.
Fortunately, coronal CT of sinuses exposes children to very little radiation because the area that is examined is very small (just the face)
Coronal CT of sinuses does not require repeated examinations. Once is usually enough!
Usefulness of a plain sinus x-ray is questionable. False negative rates (study is normal, but wrong) can be as high as 30-40% with a plain radiograph. Take home message: benefit isn’t worth the risk.
Read the article below, but you probably don’t need to worry about CTs of the sinuses.
You won’t sleep well if you can’t breathe! Unfortunately, sinusitis is quite common during the Christmas Holidays.
Often patients don’t know what can be done about it. But let’s start from the very beginning…..
What are the signs and symptoms of chronic sinus infection?
1. Nasal congestion (can’t breathe through my nose) is always present during chronic sinusitis. No exceptions. I can hear this when you talk to me in the exam room–if you’ve had sinus infections for any length of time, you become accustomed to hyponasal speech. You can’t hear it, but I can (and ask your spouse or mother).
2. Repeated courses of antibiotics that just DON”T work after 10 days.
3. If the nasal drainage is clear…can you still have a sinus infection? YES. The color of nasal drainage doesn’t predict if you will have chronic sinus infection. Only a CT scan of your sinuses can show you any inflammation or mucous thickening in the sinuses
4. Don’t forget that many asthma patients have a flare sending them to the ER because of Sinus infection.
OK….so now I know what’s going on, but how do I get rid of it?
1. Remember, the engine that drives movement of mucous in the sinuses is nasal airflow. Without nasal airflow, secretions accumulate and you can’t blow your nose enough to get rid of the SNOT. I know it’s gross, but this is the key to keeping your sinuses open.
2. The purpose of nasal sprays (steroids/antihistamines) is to reduce the size of enlarged turbinates and allow nasal airflow.
3. Don’t worry about the side effects of nasal steroids. Exposure is very low and often not detectable in the bloodstream. And besides, the clinical researchers trying to find side effects of nasal steroids put themselves and their own kids on this type of medicine.
4. Persistence is the key! Use at least one spray in each nostril per day (the rest is gravy)….up to 4 sprays per day may be needed during colds or upper respiratory infections.
5. Tilt your head forward to use the spray and avoid “snorting” the spray down the back of your throat.
6. If nasal sprays don’t work because of your congestion, I recommend using NasoNeb II from ASL pharmacy. Any nose spray works better if you “pretreat” with Afrin™ or other 4-way spray, simply because you open the nose for better penetration. Your limit on use of Afrin or similar OTC nose spray is < 1 week per month–don’t worry about addiction if you stay within these boundaries.
So there you have it….no one should suffer from sinus headaches during the Christmas holidays if you follow some simple steps:
Find out if you have sinus infection–CT is best
Use your nasal spray (from the doctor, not OTC) everyday as prescribed!
Put your money where your mouth is and use correct technique with any nasal inhaler…what goes down the back of your throat can’t help.
Want to know more on this subject? The link below will take you to the most recent guidelines on treatment and management of sinusitis. In the meantime, sleep tight and enjoy the Holidays!
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