PHX Reporter

• Research has found that inflammation, which comes with chronic sinusitis, can alter brain activity.
• This can cause symptoms such as difficulty concentrating and depression.
• In older patients, chronic sinusitis has been linked to dementia.

Dr. John Stewart of Arizona Breathe Free Sinus & Allergy Centers warns his chronic sinusitis patients that they could experience problematic cognitive symptoms, such as trouble focusing or remembering things, all due to their sinus troubles.

"For most of us (ENT doctors) who do sinus work full-time, there's a questionnaire. It's sort of humorously called the snot-20 score," Stewart told PHX Reporter. "Memory and concentration issues are on there. (Patients) will often circle those issues, and that comes full-circle to their immune system being attacked. They're not breathing and sleeping like they should, and those are the untold, long-term manifestations that a lot of patients don't put together. If you do this job long enough and you look at those scores and how many people circle that, you understand very quickly that it ties directly into that. So that's listed on one of our grading scales for how severe their disease is, at least on a clinical basis."

A study conducted by University of Washington School of Medicine found that chronic sinusitis, which affects approximately 11% of adults across the U.S., also causes inflammation, which can be linked to changes in brain activity. These changes can cause patients to experience depression and have difficulty concentrating.

Dr. Kristina Simonyan, a coauthor of the study, said examining brain scans of patients revealed that "subjective feelings of attention decline, difficulties (in focusing) or sleep disturbances that a person with sinus inflammation experiences might be associated with subtle changes in how brain regions controlling these functions communicate with one another. It is also possible that we might have detected the early markers of a cognitive decline where sinus inflammation acts as a predisposing trigger or predictive factor."

In addition to physical symptoms -- such as congestion, facial pain and headaches -- some studies have found a link between sinusitis and neurodegeneration in older patients, according to a report by the International Journal of Molecular Sciences. Research also showed that cognitive impairment caused by sinusitis could perpetuate the onset of Alzheimer's disease, the leading cause of dementia, which can also cause progressive memory loss and personality changes.

"I used to help train residents and fellows, and I used to tell them that we don't treat X-rays, we treat people," Stewart said. "We use X-rays to help guide us. What the patient says and how they feel are more important than what the X-rays look like. Those are useful grading scales for how it's impacting their lives in general. It's right there on the scale sheet itself: memory and concentration, lack of sleep, and feeling tired and run-down. All of that is on there, and that can be linked to chronic disease."

One surgical treatment option for chronic sinusitis sufferers is balloon sinuplasty, a minimally invasive procedure that takes only 10 to 15 minutes, and patients typically recover within one to two days. According to Eisemann Plastic Surgery Center, most patients can resume their normal activities during that time, although they may experience some swelling for up to a week.

For more information on sinusitis and allergy symptoms, take this Sinus Self-Assessment Quiz.