What are the sinuses?  

The sinuses are four pairs of cavities in the head which are connected by narrow channels. They are part of the upper respiratory tract. The sinuses make thin mucus that drains out of the channels into the nose (nasal cavity). 

The sinuses are named according to the facial bones in which they are located - maxillary, frontal, sphenoid and ethmoid. The largest sinus cavities are about an inch across, and the others are much smaller.

What's in the sinuses?

The sinuses are air filled, and have a mucosal lining which is packed with steadily beating tiny cilia. The cilia beat 700 to 800 times a minute, and help mucus move into the nasal cavity. Microbes live in the mucosal lining of the sinuses.

What is the sinus microbiome? 

The sinus microbiome is the hundreds of species of microbes (bacteria, fungi, viruses) living in complex communities in the mucosal lining of the sinuses. They are present in both healthy persons and those with sinusitis.

Microbes that we normally think of as harmful (pathogenic), benign, and good (beneficial) all coexist together in equilibrium. Potentially harmful species are kept in check by good (beneficial) microbes.

What is a sinus infection?

A sinus infection is an inflammation of the mucous lining of the sinuses. There is also an imbalanced sinus microbiome with some species (especially harmful species) increasing in numbers.

What is the difference between a sinus infection and sinusitis?  

A sinus infection and sinusitis are the same thing.

What are the symptoms of a sinus infection?

Sinus infection symptoms include post nasal drip (mucus that drips down the throat), thick yellow or green nasal mucus, facial pain, stuffy nose, headaches, loss of smell, aching teeth, clogged ears, cough, feeling ill, and sore throat.

What is the difference between acute and chronic sinusitis?

Acute sinusitis is short lasting and may resolve on its own (or it might not). Chronic sinusitis is when sinus symptoms last 12 weeks or more. Repeated sinus infections can lead to chronic sinusitis.

How do you treat a sinus infection?

The traditional medical treatment for a sinus infection involves a course of antibiotics, which kill bacteria (both harmful and good bacteria). The future is treating a sinus infection with probiotics that dominate over harmful bacteria, and which help rebalance the sinus microbiome.

Medical professionals also recommend the use of decongestants, allergy medications, saline nasal rinses, and nasal corticosteroid sprays (e.g., Flonase) to help with sinus symptoms.

(Lactobacillus sakei)

What causes a sinus infection?

Sinus infections are caused when the nasal passages become inflamed and mucus is blocked from draining from the sinuses and nasal passages. They frequently occur after an upper respiratory infection, such as a cold, sore throat, or flu virus. They can also occur from allergies, infections, air pollution, exposure to toxins, multiple courses of antibiotics, asthma, and cigarette smoke.

All of these can cause a disruption and imbalance in the sinus microbial community. This can result in increased numbers of harmful bacteria and sinusitis symptoms.

Can allergies cause a sinus infection?

Yes, allergies can cause a sinus infection if the nasal passages become inflamed and blocked.

Do fungi cause most sinus infections?

No, fungi do not cause most sinus infections. The view nowadays is that only a minority of cases are “fungal sinusitis”. We breathe in fungi (including mold) in the air every day, and normally we can handle it just fine. Some fungal species are part of our sinus microbiome. However, exposure to large amounts of ordinary mold can act as irritants and trigger an allergic and inflammatory response, and this can lead to sinusitis in some people.

Does salt water nasal irrigation (nasal saline rinses) treat sinus infection?

Salt water irrigation does not treat sinus infections, but it may help with sinus symptoms.

Do corticosteroid drugs (e.g., budesonide) or corticosteroid nasal sprays treat sinus infections?

Corticosteroid nasal sprays do not treat sinus infections, but they may help with inflammation and nasal polyps. Adding budesonide to a daily nasal saline rinse does not help symptoms any more than plain saline rinses.

Can a good or special diet treat or prevent sinusitis?

No diet has has been shown to prevent or treat sinusitis. However, eating a good diet rich in fruits, vegetables, whole grains, seeds, nuts, and legumes boosts the immune system and lowers chronic inflammation. This may (should) result in fewer upper respiratory infections and resulting sinus infections.

Is there a probiotic that can be used for sinus infections?

The probiotic bacteria Lactobacillus sakei (found in Lanto Sinus) is helpful during sinus infections. This good bacteria is found in the sinuses of healthy persons, but is diminished in persons with chronic sinusitis. Lactobacillus sakei dominates over harmful bacteria that are causing sinus symptoms and helps rebalance the sinus microbiome. It has had good results since it was first studied as a sinus treatment in 2012.

Can a probiotic prevent or treat a sinus infection without antibiotics?

Many persons have avoided the use of antibiotics for sinus infections by using a probiotic such as Lactobacillus sakei either at the start of an infection (minor symptoms) or a full-blown sinus infection. The probiotic Lactobacillus sakei (found in Lanto Sinus) should only be used when needed to rebalance the sinus microbiome.

Do nontraditional or alternative treatments treat sinus infection?

Alternative treatments include such things as grapefruit seed extract (xylitol), manuka honey, oil of oregano, herbal supplements, baby shampoo, and homeopathy.

Studies using alternative treatments have had generally disappointing results in treating sinus infections. Many alternative treatments try to kill or suppress bacteria, and do not address the underlying problem of a sinus microbiome that is imbalanced. Studies trying probiotic bacteria species that do not normally live in the sinuses have also not been effective.

Some examples of disappointing sinus treatments: Researchers found that xylitol, the probiotic Lactococcus lactis, and ordinary saline rinses do not improve sinusitis symptoms or the sinus microbiome. Similarly, manuka honey and honeybee Lactobacillus and Bifidobacterium species have no effect on sinus infection symptoms.

What is the future in sinusitis treatment?

The future of sinusitis treatment is wide-spread use of probiotics that are used directly – either applied in the nose or swished in the mouth, when there are sinus infection symptoms. There even is research looking at “snot transplants”, where the nasal or sinus microbiome from healthy persons is transplanted to persons with chronic sinusitis. It’s all very exciting!