Subacute Sinusitis Seattle

Sinusitis can appear in many forms. It can infect any of the four sinus cavities: maxillary, frontal, ethmoid, and sphenoid sinuses. Sinus infections can also be caused by multiple microorganisms including viruses, bacteria, and fungi. These variations make sinusitis treatment an intricate and careful art that requires an expert. Along with the different locations and types of infections, the duration of sinusitis can differ as well. Dr. David Santos at Sinusitis In Seattle has decades of experience treating all types of sinusitis. Dr. Santos provides the best treatment of subacute sinusitis Seattle offers.


Subacute sinusitis refers to sinus symptoms that last longer than four weeks. If symptoms continue for more than eight to twelve weeks with no improvement, you may have chronic sinusitis. Subacute sinus infections can infect one or multiple sinuses. It also has many of the same symptoms as acute and chronic sinusitis

Like with chronic sinusitis, subacute sinusitis may appear to have duller symptoms that last longer. You may also exhibit severe symptoms without a fever. Constant fevers are rare in cases of subacute and chronic sinusitis. Patients with subacute sinusitis may experience daily facial pain and swelling, congestion, headaches, and sore throat. The symptoms of subacute sinusitis can affect breathing and daily activities. 

Also, every patient who develops chronic sinusitis first has subacute sinusitis. Once the patient shows symptoms for two to three months, Dr. Santos may determine you have chronic sinusitis. Chronic sinusitis can have a variety of causes. It is also more common in people with certain anatomical structures or respiratory issues like asthma. Therefore, these also influence subacute sinusitis.

History of Subacute Sinusitis Treatment

Countless doctors and scientists throughout history observed and studied the sinuses. Even in the writing of Hippocrates, non-surgical therapies for nasal polyps are mentioned. Academics generally understand that the sinuses were air filled and could become congested. However, it was not until the 18th century that doctors recorded surgical procedures to drain the sinuses.

The first recorded sinus surgeries took place in the mid to late 1700s. At first, they began as explorations into the anatomy and experimentation on how to best reach the sinuses. Eventually, this led to the first sinus surgeries designed to relieve chronic sinus conditions. 

The first modern sinus surgery most similar to today’s endoscopic technique took place in 1910. This surgery allowed for surgeons to use less invasive techniques, small incisions, and access the sinuses easier. Over a quarter of a million sinus surgeries are performed every year, making it one of the most frequently performed surgeries.

Causes Of Subacute Sinusitis


Subacute sinusitis–like the other forms of the condition–is usually caused by a virus, bacteria, or fungus. However, other environments and conditions can worsen or prolong sinus symptoms such as smoking, cystic fibrosis, asthma, and living in a place with a high amount of pollution. This may cause sinus symptoms to become subacute and last longer than acute sinusitis.

Sinusitis can be influenced and worsened by these factors. These factors also put patients at a higher risk for chronic sinusitis. Often when subacute sinusitis transitions into chronic sinusitis, there is a larger problem. This may require either sinus surgery or more extensive treatment.

Bacterial sinusitis is more likely to develop into subacute sinusitis because antibiotics are not prescribed until ruling out viral infection. Usually, once antibiotics are given, the infection will clear before it becomes subacute. Occasionally, patients will receive a misdiagnosis or have a particularly bad infection that may cause an acute sinus infection to become subacute sinusitis.


Within the face, you have four major sinuses. The largest one, the maxillary sinus, is located below the eyes and behind the cheekbone. Next, the frontal sinus is located about the center in the forehead and fan out along each side. The sphenoid sinuses are in the sphenoid bone which makes up part of the eye socket. Finally, the ethmoid sinuses are along either side of the nose.

A sinus infection–whether acute, subacute, or chronic–can afflict one or multiple sinuses. When this occurs, the sinuses will become filled, not drain properly, and inflamed. The most common sinuses that tend to be involved in the most sinusitis cases are the maxillary sinus and ethmoid sinuses.


When you first come to a sinus specialist  Dr. Santos, your Seattle ENT will want to start with non-surgical treatments. These treatments aim to improve the environment of your sinuses, drain and promote draining without surgery, and provide relief from symptoms. 

Sometimes these treatments will alleviate sinusitis, other times they may just treat the symptoms, and rarely they may show no improvement. Not only will these likely provide some relief, but they also help Dr. Santos gauge the severity and cause of your subacute sinusitis in Seattle.

Nasal Irrigation

Nasal irrigation, or rinsing your sinuses, can promote draining of your nose and sinuses. Using a neti pot or similar device, rinse the nasal cavities and sinuses with saline solution. This is usually performed once every 2-3 days. In some cases, Dr. Santos may recommend rinsing once a day or more.

Performing nasal irrigation regularly can reduce inflammation in the sinuses, improve breathing, and may prevent an infection from worsening. Nasal irrigation is often recommended in the treatment of the common cold and allergies, both to relieve symptoms and to prevent sinus infections.

Nose Spray

Nose spray–prescription and non-prescription varieties–can reduce swelling in the nasal passages and sinuses. Generally, nose spray is used in conjunction with other treatments or medications. Some nasal sprays may also contain steroids that can treat inflamed sinuses to promote drainage. 

If you have allergies or a similar condition that causes constant or frequent congestion, Dr. Santos may recommend daily or weekly use of a nose spray. This can prevent sinus and ear infections from forming.


Various medications can aid in the treatment of subacute sinusitis. First off, if you have not already, Dr. Santos may place you on antibiotics. He may also try a different antibiotic than before. This is to ensure that you do not have a bacterial sinus infection easily treated with antibiotic therapies. 

Dr. Santos may also prescribe decongestants or allergy medications. If you have year-round allergies, a daily allergy medication may reduce your risk for sinusitis and alleviate some symptoms. In more severe cases, Dr. Santos might recommend allergy shots.

Again, certain steroidal medications may reduce the inflammation present in your sinuses. This can promote the sinuses to drainage and for the infection to clear. All of these medications can be supplemented with occasional over-the-counter painkillers for your symptoms. 

Unless a larger, longer term issue like allergies, asthma, or cystic fibrosis is present, medications for subacute sinusitis are generally temporary. They should only be taken as directed and until subacute sinusitis clears.

Other Home Remedies

There are countless home remedies for subacute sinusitis that Dr. Santos may recommend during treatment. Usually, these remedies will not treat or cure an infection. However, they can make you more comfortable and aid other treatments. Examples of home remedies for subacute sinusitis include:

  • Breathe in steam
  • Use a humidifier
  • Warm compresses
  • Stay hydrated
  • Rest





Before Dr. Santos performs sinus surgery, he will want to meet with you for a consultation. This allows him to determine the best treatment for your Seattle subacute sinusitis. At first, this may include a conversation to discuss your symptoms and their duration. Dr. Santos will also review your medical history to determine possible causes and if you may be a surgery candidate. 

Next, Dr. Santos will want to know any medications you take (even if they aren’t related to sinusitis). As well as what other treatments you have tried. Finally, Dr. Santos will conduct a physical examination. As part of his evaluation, he may want to do certain tests. This can include imaging such as CT scans or an MRI. Dr. Santos may also order allergy testing or nasal endoscopy.

At this point, Dr. Santos will put together a treatment plan to alleviate symptoms and fully treat your subacute sinusitis. This may involve various at-home remedies, non-surgical treatments, and the possibility of surgery.

Sinus Surgery

Sinus surgery can consist of various procedures depending on what is necessary to find relief as well as the probable cause. Endoscopic sinus surgery is the most common sinus surgery for draining and widening the sinuses. However, balloon sinuplasty and stealth sinus surgery are often options. 

Surprisingly, a septoplasty or similar procedure to correct a structural problem within the nose may also relieve your sinus problems. Dr. Santos can determine this during a consultation and initial appointments.

If Dr. Santos believes that you would benefit from sinus surgery, he will first ensure that you are a good candidate. Next, he will describe your specific sinus surgery to you in detail and the expected outcome. Finally, he provide instructions for before and after surgery. 

During endoscopic sinus surgery, Dr. Santos uses a small camera with a light on the end called an endoscope. The endoscope provides a magnified view of the inside of the nasal passages and sinuses. This encourages a more precise and effective surgery. Dr. Santos will then use specialized tools along with the endoscope to remove blockage from the sinus. This can include physical barriers like scar tissue or nasal polyps. 


The procedure can take between a half hour to hour and a half. Dr. Santos performs endoscopic sinus surgery in Seattle on an outpatient basis which means you will go home the same day. Patients can expect around a week off work for their comfort and healing.

During the first couple of weeks, patients can expect to feel some sinus pressure, bleeding, drainage. Dr. Santos will give you post-operative instructions such as:

  • Perform nasal irrigation at specified intervals to remove dried blood and mucus
  • Take antibiotics or prescribed medications
  • Use pain medication only as needed
  • Avoid exercise, bending over, and blowing your nose for at least a few days
  • Use the prescribed nose spray as directed



Millions of patients every year will visit their doctor’s offices with concerns about sinus problems. For patients who need specialized care and do not see their symptoms cease after four weeks, Dr. Santos provides the best care for chronic and subacute sinusitis Seattle offers.

Sinusitis In Seattle offers comprehensive sinus care for patients in and outside of the Greater Seattle area. Dr. David Santos is a board certified surgeon in otolaryngology and facial plastic surgery. He holds a deep and fundamental knowledge of the facial structures that lets him to perform the best non-invasive sinus procedures, providing a better quality of life to sinusitis patients.

To learn more about subacute sinusitis and to schedule a consultation, call us at (206) 242-3696 or contact us online.

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