Do I Need a Sinus Specialist?

In addition to being trained as standard ear, nose, and throat (ENT) doctors -- who treat more general ENT issues -- sinus specialists (also called rhinologists) have completed advanced subspecialty fellowship training, which is the highest level of instruction available. This means they are equipped to treat serious sinus and nasal problems with medication and surgery, and they may be able to offer treatments that your ENT or primary care doctor haven't considered.

Duke’s David Jang, MD, often meets people who are surprised to discover that there are additional options. He explained that people should make an appointment with a sinus specialist if they fall into one of these categories:

• It’s gone on too long -- You are congested more often than not, you have trouble breathing through your nose, you've had consistent sinus symptoms for three months or longer, or repeat sinus symptoms or infections that occur three or more times in a year.
• I’ve tried everything -- Your sinus symptoms have not improved enough, despite over-the-counter or prescription medications, nasal sprays, or multiple courses of antibiotics.
• It’s complicated -- You have underlying conditions that cause severe sinus symptoms, including sarcoidosis, recurrent nasal polyps, or cystic fibrosis.
• I need surgery again -- You’ve had sinus surgery before, but you’re still experiencing symptoms.
• I want an expert -- Maybe you’ve been seeing an ENT doctor for a while and you don’t even know whether you need to see a sinus specialist, but you want to talk to someone who may have other ideas or treatment options.

Yes! And they are specifically trained to perform procedures that can improve or eliminate troublesome sinus symptoms. Many of these surgeries are performed endoscopically, which means they can be done without an external incision. Instead, sinus specialists can operate through the nostrils, which reduces risk and recovery time.

These surgeries must be precise, because the sinuses are close to the eyes, brain, and important nerves. Sinus surgeons must work in very small areas and avoid these vital structures while also being as thorough as possible. This expertise allows sinus specialists to perform procedures ranging from the routine (like septoplasty, which corrects a deviated septum) to the extremely complex (for example, anterior skull base tumors, revision sinus or nasal surgeries that can have an increased risk of bleeding or other complications, or clearing out the sinus cavities of people with cystic fibrosis or antibiotic-resistant bacteria).

“We see a lot of cases like this,” Dr. Jang said. “Giving people a practical solution for problems that they’ve had for a long time, that others could not help them with, that’s what I find most rewarding.”