Sinusitis and Biofllm

Why do You Have Chronic Sinusitis?

I typically see a patient who has a history of three or more bouts of sinusitis a year–a form of Chronic Sinusitis. She gets well with the antibiotic, but three months later she gets another bout and soon requires antibiotic again.

Six Weeks Antibiotic
Recently I saw R.T. with this history; just after six weeks of a powerful antibiotic, not only does she have a vaginal thrush, but her sinusitis is back! Why does this happen?
In this person’s case the diagnosis is easy. Yes, the antibiotic did kill the bacteria; but because the nasal cilia failed to recover, they were not moving the bacteria out of the nasal cavity. Normally you stay healthy because your nasal cilia act as sweepers to remove harmful bacteria. When they fail to do so, infection can be caused when the bacteria multiply. Therefore, even though you eliminate the bacteria successfully, without cilia action, another infection may occur.
For R.T., the solution is NOT sinus surgery; it is NOT more antibiotics; it is NOT cortisone spray. The solution is to restore nasal cilia activity with tea, pulse wave irrigation, humming and good sleep. This worked for R.T.’s recurrent sinusitis.

Biofilm
Another frequent cause of repeated sinus infection is biofilm. We know that the bacteria in a certain class can specialize. One forms a means of attaching to nasal membrane; another builds a perfect environment for bacteria to flourish; another builds a shield or cover that prevents healing elements and natural defense cells from getting to the bacteria. This shield or cover also prevents antibiotics from killing the bacteria that are protected by this protective shield. When there is biofilm, the concentration of antibiotic needed to effect the shielded bacteria is much greater than is reached in
Unfortunately the needed concentration to penetrate the biofilm shield is seldom reached in standard care. Simple irrigation with pots and squeeze bottles may not be adequate–which is what I see in my practice. What works is using pulse wave irrigation at the proper wave frequency to dislodge these biofilm colonies.

Pulse Wave Irrigation
Daily we read about who wave action is effecting beach erosion, taking out bluffs and buildings. The wave action is powerful enough to move rocks. A similar principle is used for the pulsating stream of the Hydro Pulse® Nasal/Sinus Irrigator. The wave action is about 100x more effective in removing the biofilm products than simple wash.

Don’t Need to Kill 100% of Bacteria
A common misconception in sinus therapy is that you must remove 100% of the infecting bacteria. In one sense, we are not sure this can be done. However, the name of the game is to reduce the concentration and bacterial numbers suffeiciently so that the natural immune factors can take over. Think of it this way: you have only ten cowboys available to move cattle from one area to another. If you have 10,000 cattle to move, that is an almost insurmountable number for the ten cowboys. But, if you remove 9900, and leave only 100, then the ten cowboys can do the job well.
Similarly, anything you do to reduce the total number of bacteria, can be crucial to good health. Since pulse wave irrigation is more effective in removing bacteria, it is preferred by otolaryngologists concerned with getting sinusitis cleared without excess drugs or surgery.

Balloon Sinuplasty
We read a great deal today re balloon sinuplasty. If we have a sinus opening closed, placing a balloon into the opening and squeezing it open by spreading the balloon can open the ostia. Then the infected material can exit and the opening may remain open. This method is particularly of value in Frontal Sinus Disease. However, at Tower ENT we have concentrated on restoring nasal cilia function first because often restoring nasal cilia that sweeps out the bacteria can be effective in restoring the sinus opening.

Conclusion
In recurrent sinusitis that returns despite the antibiotic, be sure to take measures to restore cilia funtion, and use pulse wave irrigation to remove biofilm.

After any antibiotic, I recommend taking yogurt and probiotics for three months. This is needed to restore the good bacteria that are critical for full immunity.