Patients who undergo radiotherapy for nasopharyngeal carcinoma tend to suffer from sinusitis because irradiation causes damage to sinonasal tissue. When I had to deal with this problem I realized that there is very little information about the organisms causing sinusitis after radiation therapy. Two recent studies provided important information about the unique microbiology of sinusitis in these patients.
One study evaluated 25 patients with acute sinusitis and the other evaluated 30 with chronic sinusitis. Both studies found higher recovery of Staphylococcus aureus in irradiated individuals. Because of the high prevalence of methicillin resistant S. aureus (MRSA) these individuals may need to be treated with antimicrobials effective against these organisms.
These studies underscore the need to obtain appropriate cultures from patients with chronic sinusitis who were irradiated so that proper antimicrobials can be administered to them.
Itzhak Brook MD

Where (what areas) were these patients radiated?

[quote]One study evaluated 25 patients with acute sinusitis and the other evaluated 30 with chronic sinusitis. Both studies found higher recovery of Staphylococcus aureus in irradiated individuals. Because of the high prevalence of methicillin resistant S. aureus (MRSA) these individuals may need to be treated with antimicrobials effective against these organisms.
These studies underscore the need to obtain appropriate cultures from patients with chronic sinusitis who were irradiated so that proper antimicrobials can be administered to them. [/quote]

What are antimicrobials? Is this antibiotics or decongestants? Dribrook, when you post information about random topics, if possible can you make it easier to understand? Most of us here dont have medical backgrounds, we are mainly patients and caregivers. Unfortunately we have had to learn a great deal of medical information to help us deal with our illnesses.


I have sinusitis caused by radiation. Im not treated with antibiotics. I take singulair and nasonex nasal spray almost daily. My radiation was aimed at the tumor in the middle of my left cheek and the other tumor behind my top, left molar. Its very annoying, its like I always have a cold. I also suffer from problems with thick mucous that clogs my throat. If this is the worst thing I have to complain about then I am a very lucky person. In previous posts several other members mentioned the same problems. But this was never linked to anyone having MRSA. With only 55 people being part of the studies, they are pretty small.

I looked up the info and one of the studies was from Europe. It was mentioned on your website. I wish that there was more info available about this topic since its something that affects quite a few of us after radiation. I dont understand the link between MRSA and sinusitis. When I have more time I will look into this more. Thanks for bringing this topic up.


http://oralcancersupport.org/forums...ords=sinusitis&Search=true#Post79228

Here's more then you'll ever want to know about microbes and antimicrobials:

http://www.answers.com/topic/antimicrobial

It seems like a no brainer that the Dr. is refering to H&N RT since it's a sinus issue. Even RT scatter will affect the sinuses to some degree. But the definition of nasopharyngeal should clarify it.

http://www.cancer.gov/cancertopics/pdq/treatment/nasopharyngeal/Patient

After rads in my nasopharynx area (among others), I had problems with recurrent mild nose-nostril staph infections and nose bleeds for over a year (a few significant nose bleeds during rads).

The staph flare-ups were well controlled with a 'Double Antibiotic Ointment'.

My nose isn't the same, but isn't a big problem. It is often itchy, seems more susceptible to hay-fever irritations and at times can get drippy - ENT calls it old man nose

I would like to respond and explain the meaning of the studies I described.

Sinus irritation and inflammation after radiation treatment does not mean that there is a bacterial infection there. However there can also be a bacterial infection which than may require antibiotic treatment.

The studies I referred to describe the bacteria that caused the sinusitis. This new information offer information that can help in the choice of antibiotics. If anyone has sinus infection and had received radiation treatment in the past they may want to inform their doctors about these studies.

Itzhak Brook MD

Dr. Brook, if you have a link for these studies please pm me. I would like to forward them to my H&N Surgeon

You can get a link to these studies on my Blog at http://sinusitisunderstood.blogspot.com/2010/12/sinusitis-after-radiation-is-caused-by.html

Itzhak Brook MD

The patients received radiation to their head and neck as treatment of their cancer.
I Brook MD

questions have been asked and ignored so I am going to step in here and demystify a few points for non-medics which is most of us.

1 "itis" as in sinusitis or tonsillitis means swelling or inflammation. So Sinusitis is swelling of the sinuses. Most people immediately think of sinusitis as an infection but any asthmatic or person with allergies will tell you, inflamed or swollen sinuses is part of their condition and has nothing to do with infection.

2. An antibiotic is an antimicrobial. Antibiotics, fight microbes or bacteria which cause infection. Generally there are two types of infection - bacterial and viral. Antibiotics only work on bacteria although doctors often prescribe antibiotics for viral infections. The reason for this, is that one can't tell if it is viral or bacterial unless a swab is taken and tested (most don't do this they just guess)so it is treated in case it is bacteria. Sometimes it is worth giving antibiotics prophylactically (as a preventative)to stop the infection progressing to something really nasty.

3. The other kind of sinusitus is when the swelling is not caused by an infection but body itself (immune response). The drugs used by asthmatics and allergy sufferers keep the swelling or inflammation at bay. Basically they are called "anti-inflammatory" drugs and they work to calm down the immune system which is causing the inflammation.

4. Inflammation is a natural (and usually welcome) response to beasties. The immune system literally goes to war with invaders, be that infection or physical injury. Radiation is physical injury and your immune system is in there trying to control the damage. Scarring is the immune system's idea of a bandaid. Unfortunately, your immune system has got a little over excited and doesn't know when to quit. Your meds are taken to calm the immune system down to reduce the inflammation so you don't get so much pain

(There are three main types of infections, and the third is fungal)