Dr. Thomas C. Spalla, MD

Ear-Nose and Throat Doctor (ENT)

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2799 W Grand Blvd 8th Floor - Otolaryn Detroit MI, 48202 Show map

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Dr. Thomas Spalla is an ear, nose and throat (ENT) doctor, also known as an otolaryngologist, practicing in Detroit, MI. Dr. Spalla specializes in diseases and disorders of the ear, nose and throat as well as other parts of the head and neck. Such structures an ENT may work on include the sinuses, larynx (voice box) and mouth in addition to the ear, nose and throat. There are seven areas of expertise that an ENT might specialize in, and these are: allergies; facial reconstructive surgery; head and neck; laryngology; otology/neurotology; pediatric otolaryngology; and rhinology.

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OtolaryngologyAmerican Board of OtolaryngologyABOto

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Dr. Thomas C. Spalla, MD

Dr. Thomas C. Spalla, MD's Expert Contributions

My Answers

How can I prevent a relapse of my tonsil infection?
Prevention of tonsillitis can be achieved through meticulous handwashing, the use of hand sanitizers, avoiding touching your nose/mouth/etc, and social distancing - especially around anyone who is ill. Despite this, some patients are colonized with bacteria in their tonsils and suffer from repeat bouts of tonsillitis. These patients often only find temporary relief with antibiotics and may be best served with removal of the tonsils. However, this decision should be a last resort as there are serious risks associated with tonsillectomy. READ MORE
Are there any home remedies to manage swallowing pain?
You should see your doctor to try and find the cause for what you are experiencing. In the meantime, warm salt water gargles are helpful in alleviating a sore throat. Drinking plenty of fluids and avoid alcohol and caffeine. It goes without saying, but there should be no smoking/vaping/etc. READ MORE
Are these crackling sounds in my ear from TMJ?
These sounds may be from your TM joint. The sounds could also be comes from the eustachian tube (that which connects your ear to the back of your nose). See an oral surgeon to accurately evaluate your TMJ since you've had issues with it in the past. If this isn't found to be the issue, see an ENT doctor. READ MORE
I just found red traces which seem like blood when coughing this morning. Is it serious?
It's likely that the capillaries in your nose and nasopharynx (back of nose) are inflamed from the infection and you ruptured one (or more) with coughing. It's also possible that one ruptured in your throat or even further down. If this persists, see your doctor for an examination and work-up to rule out more nefarious causes such as cancer. READ MORE
Why was I prescribed an antibiotic for an ear infection? Don't I need drops?
If you have "swimmer's ear" aka otitis externa, topical antibiotics (drops) are usually sufficient. If you have a middle ear infection (behind an intact eardrum), then oral antibiotics are warranted as the drops would have no way of reaching the infection in the face of an intact eardrum. READ MORE
I had a balloon sinuplasty and symptoms are coming back. Do I need it again?
This is a complicated situation. This certainly warrants an in-depth discussion with your ENT, or another one, if you wish, regarding your symptoms, alleviating and worsening factors, medication trials and imaging results. Balloon sinuplasty is not a one-size fits all and may or may not be appropriate for your situation. It's efficacy can be controversial for certain disease processes and is often over-utilized. READ MORE
A small blockage?
See an ENT doctor for an in-office endoscopy (very comfortable surprisingly) to ensure nothing is present in the throat (rule out a tumor). A thyroid examination is also warranted. That being said, this likely represents globus pharyngeus and is typically due to larygnopharyngeal reflux. Google these for further information and see if this sounds like what you're experiencing. READ MORE
Small amounts of blood in ear canal?
It's difficult to say exactly what caused this, but I would speculate that it was due to minor trauma from Q-tip usage. I've seen this numerous times. This is particularly common in patients who more aggressively clean their ears and those on medications or supplements which cause the blood to not coagulate as rapidly. READ MORE
I have a swollen and bitten tongue?
There does not appear to be a laceration to the tongue. Have him avoid spicy/hot/salty foods. Use warm salt water gargles to alleviate discomfort. Topical anesthetics are available over the counter (e.g., Anbesol) and can be used sparingly (helpful prior to eating). Eat soft foods in the meantime. The tongue is resilient and heals rapidly. READ MORE
Chesty cough?
This definitely warrants seeing your primary care physician for a lung examination. READ MORE
What's this crackling noise in my ear?
You could be hearing the eustachian tube opening (back of the nose connection to the ear) or this could be coming from your temporomandibular joint (TMJ). READ MORE
Annual flu shot?
I would recommend that you get the flu shot and the booster. You may elect to have them done separately. They, of course, cover different infectious entities and are thus both warranted. READ MORE
Is general anesthesia used for endoscopic sinus surgery?
In general, yes. Discuss this with your surgeon, but in my experience, endoscopic sinus surgery (not sinus procedures that are minor and done in the clinic) warrants general anesthesia. READ MORE
I have inner ear crystals repositioning?
Plain Language Summary: Benign Paroxysmal Positional Vertigo Show all authors Neil Bhattacharyya, MD, Deena B. Hollingsworth, MSN, FNP-BC, Kathryn Mahoney, ... First Published March 1, 2017 Research Article Find in PubMed https://doi.org/10.1177/0194599816689671 Article information Article has an altmetric score of 38 Free Access Abstract Objective. This plain language summary serves as an overview in explaining benign paroxysmal positional vertigo, abbreviated BPPV. This summary applies to patients ≥18 years old with a suspected or potential diagnosis of BPPV and is based on the 2017 “Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update).” The evidence-based guideline includes research to support more effective diagnosis and treatment of BPPV. The guideline was developed as a quality improvement opportunity for managing BPPV by creating clear recommendations to use in medical practice. Keywords benign paroxysmal positional vertigo, vertigo How Was This Summary Developed? This plain language summary is based on the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s (AAO-HNSF’s) “Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update),”1 which updates an earlier guideline developed in 2008 by the AAO-HNSF.2 The purpose of the summary is to convey key concepts and recommendations from the guideline in clear, understandable, patient-friendly language. It was developed by consumers, clinicians, and AAO-HNSF staff. The BPPV guideline was developed with the methods outlined in the third edition of the AAO-HNSF’s guideline development manual.3 A literature search through September 2015 was performed by an information specialist to identify research studies (systematic reviews, clinical practice guidelines, and randomized controlled trials) published since the prior guideline. The AAO-HNSF assembled a guideline update group representing the disciplines of otolaryngology–head and neck surgery, otology, neurotology, family medicine, audiology, emergency medicine, neurology, physical therapy, advanced practice nursing, and consumer advocacy. The group also included a staff member from the AAO-HNSF. Prior to publication, the guideline underwent extensive peer review, including open public comment. What Is BPPV? Benign paroxysmal positional vertigo, abbreviated BPPV, is the most common inner ear problem and cause of vertigo (vertigo is a false sense of spinning). It is more common in older people. Many of us will experience BPPV at some time in our lives. BPPV is a specific diagnosis, and each word describes the condition: Benign (pronounce bi-NYN)—it is not life-threatening, even though the symptoms can be very intense and upsetting. Paroxysmal (pronounced par-ek-SIZZ-muhl)—it comes in sudden, short spells. Positional (pronounced puh-ZI-shun-uhl—certain head positions or movements can trigger a spell. Vertigo (pronounced VER-ti-goh)—feeling like you are spinning or the world around you is spinning.4 See Table 1 for a summary of evidence-based statements and recommendations of diagnosis and treatment. Table Table 1. Summary of Guideline Key Action Statements. Table 1. Summary of Guideline Key Action Statements. View larger version What Causes BPPV? Most cases of BPPV happen for no reason. Anyone can have episodes of BPPV, but it happens more often in seniors. It can sometimes be associated with trauma, migraine, other inner ear problems, diabetes, osteoporosis, and lying in bed for long periods of time (preferred sleep side, surgical procedures, illness). We have crystals of calcium carbonate in our inner ear that help us with our balance and body motion. These tiny rocklike crystals, or “otoconia” (oh-toe-CONE-ee-uh), are settled in the center “pouch” of our inner ear. BPPV is caused by the crystals becoming “unglued” from their normal place. As they float around, they can get stuck on sensors in the wrong part or wrong canal of the inner ear. BPPV symptoms are caused by the crystals being out of position. The most intense part of BPPV symptoms relate to how long it takes the crystals or sensors to settle down after you move or change your head or body position. As the crystals move and settle in your inner ear, your brain is getting these powerful (false) messages telling you that you are violently spinning when all you may have done is lie down or roll over in bed. What Are the Common Symptoms of BPPV? Everyone will experience BPPV differently, but there are common symptoms: Distinct triggered spells of vertigo or spinning sensations Nausea (sometimes vomiting) Severe feeling of disorientation in space or instability These symptoms will be intense for seconds to minutes. You can have lasting feelings of dizziness and instability but at a lesser level, once the episode has passed. In some people, especially seniors, BPPV can seem more like an isolated feeling of instability that happens when changing body or head position. Sitting up, looking up, bending over, and reaching can trigger this feeling. BPPV does not cause constant severe dizziness and is usually triggered by movement. BPPV does not affect your hearing or cause you to faint. The dizziness episodes related to BPPV can increase your risk of falling. How Is BPPV Diagnosed? Health care providers diagnose BPPV through a physical examination and review of your medical history. Normal medical imaging, such as scans and x-rays, or medical laboratory testing cannot confirm BPPV. Your health care provider or examiner will complete simple bedside testing to help to confirm your diagnosis. The bedside testing requires the examiner to move your head into a position that makes the crystals move, and it will make you dizzy. The testing may include hanging your head a little off the edge of the bed or rolling your head left and right while lying in bed. The examiner will be watching you for a certain eye movement to confirm your diagnosis. The most common tests are called the Dix-Hallpike test and supine roll test. What Treatments Are Available? Medications may be used for the relief of immediate distress, such as nausea, but not for BPPV itself. Most BPPV cases can be corrected with repositioning procedures that will be performed bedside by your provider. These treatments usually take only a few minutes to complete. They have high success rates (around 80%), although sometimes the treatment needs to be repeated a few times. Examples of these treatments are the Epley maneuver (Figure 1) and the Lempert 360° roll maneuver (Figure 2). figure Figure 1. Depiction of the canalith repositioning maneuver (Epley maneuver) for right ear posterior semicircular canal benign paroxysmal positional vertigo. Adapted and reproduced with permission from Fife et al.5 © 2008 Barrow Neurological Institute, Phoenix, Arizona. figure Figure 2. The Lempert 360° roll maneuver (sometimes referred to as the barbecue roll maneuver) for the treatment of right lateral semicircular canal benign paroxysmal positional vertigo—geotropic type. Adapted and reproduced with permission from Fife et al.5 © 2008 Barrow Neurological Institute, Phoenix, Arizona. These repositioning treatments (referred to as “maneuvers”) are designed to guide the crystals back to their original location in your inner ear. You may be treated during the same office visit when the diagnosis testing is performed. You might be sent to a health professional (medical provider, audiologist, or physical therapist) who can perform these maneuvers, especially if any of the following apply: You have severe disabling symptoms. You are a senior with history of past falls or fear of falling. You have difficulty moving around, such as joint stiffness (especially in your neck and back) and/or weakness. You can also be taught to perform these maneuvers by yourself with supervision, which is called “self-repositioning.” Discuss learning these maneuvers with your health care provider. Does BPPV Go Away on Its Own? There is evidence that if BPPV is left untreated, it can go away within weeks. The natural course of BPPV is to become less severe over time. People will often report that their very first BPPV spinning episode was the worst and the following episodes were not as bad. However, remember that while the crystal is out of place, in addition to feeling sick and sensitive to motion, your unsteadiness can increase your risk for falling. You will need to take precautions not to fall. You are at a higher risk for injury if you are a senior or have another balance issue. Seniors are encouraged to seek professional help quickly to resolve symptoms. How Long Will It Take before I Feel Better? During the BPPV treatment, you may experience brief distress from vertigo, nausea, and feelings of disorientation. After treatment, some people report that their symptoms start to clear right away. Others report that they have continuing motion sickness–type symptoms and mild instability. You can still feel a little bit sensitive to movement even after successful treatments for BPPV. These symptoms can take a few days to a few weeks to slowly go away. Once your symptoms are slowly going away, it is important to return to normal activities that you can do safely. Exposure to motion and movement will help to speed your healing. You should discuss these activities with your provider. Seniors with a history of falls or fear of falling may need further exercises or balance therapy to clear BPPV completely. Can BPPV Come Back? Can I Prevent It? Unfortunately, BPPV is a condition that can sometimes return. Your risk for BPPV returning can shift from low risk (few experiences in your lifetime) to a higher risk, which is often caused by some other factor, such as trauma (physical injury), other inner ear or medical conditions, or aging. Medical research has not found any way to stop BPPV from coming back, but it can be treated with a high rate of success. It is very important to follow-up with your health care provider if you continue to have symptoms. You may be sent for further testing to confirm your diagnosis and/or discuss other treatment options. Where Can I Get More Information? Health care providers should discuss all treatment options and find the best approach for you. There is a printable patient handout of frequently asked questions (Figure 3) and other resources that further explain BPPV and can help with decisions about care options. For more information on BPPV, go to http://www.entnet.org/BPPVCPG . Additional information can be found by visiting the Vestibular Disorders Association, at http://vestibular.org/. figure Figure 3. Patient information: “Frequently Asked Questions: Benign Paroxysmal Positional Vertigo (BPPV).” About the AAO-HNS The American Academy of Otolaryngology—Head and Neck Surgery (www.entnet.org), one of the oldest medical associations in the nation, represents about 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The AAO-HNS Foundation works to advance the art, science, and ethical practice of otolaryngology–head and neck surgery through education, research, and lifelong learning. The organization’s vision: “Empowering otolaryngologist–head and neck surgeons to deliver the best patient care.” Author Contributions Neil Bhattacharyya, writer, chair; Deena B. Hollingsworth, writer, panel member; Kathryn Mahoney, writer, panel member; Sarah O’Connor, writer, AAO-HNSF staff. Disclosures Competing interests: Neil Bhattacharyya, Intersect ENT, Entellus, Sanofi—consultant; Sarah O’Connor, salaried employee of American Academy of Otolaryngology—Head and Neck Surgery Foundation. Sponsorships: American Academy of Otolaryngology—Head and Neck Surgery Foundation. Funding source: American Academy of Otolaryngology—Head and Neck Surgery Foundation. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. References 1. Bhattacharyya, N, Gubbels, SP, Schwartz, SR. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017;156(3_Suppl):S1-S47. Google Scholar | SAGE Journals | ISI 2. Bhattacharyya, N, Baugh, RF, Orvidas, L. Clinical practice guideline: benign paroxysmal positional vertigo. Otol Head Neck Surg. 2008;129:S47-S81. Google Scholar | SAGE Journals | ISI 3. Rosenfeld, RM, Shiffman, RN, Robertson, P. Clinical practice guideline development manual, 3rd edition: a quality-driven approach for translating evidence into action. Otolaryngol Head Neck Surg. 2013;148(suppl 1):S1-S55. Google Scholar | SAGE Journals | ISI 4. Woodhouse, S. Benign paroxysmal positional vertigo (BPPV). https://vestibular.org/understanding-vestibular-disorders/types-vestibular-disorders/benign-paroxysmal-positional-vertigo. Accessed January 2017. Google Scholar 5. Fife, TD, Iverson, DJ, Lempert, T. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2008;70:2067-2074. Google Scholar | Crossref | Medline | ISI View Abstract Article available in: Vol 156, Issue 3, 2017 Guidelines and Quality Improvement Related Articles Similar Articles: View all > Plain Language Summary: Ménière’s Disease Free Access Show details Plain Language Summary: Earwax (Cerumen Impaction) Free Access Show details Plain Language Summary: Evaluation of the Neck Mass in Adults Free Access Show details Articles Citing this One: 1 Downregulation of VDR in benign paroxysmal positional vertigo patients... Crossref Show details Articles In the Same Collection(s): Collection: Guidelines and Quality Improvement Executive Summary: “Evidence-Based Performance Measures for Rhinoplast... No AccessShow details Adverse Events Associated With Laser Use in the Upper Airway No AccessShow details Assessing the Practice Characteristics of Otolaryngology Same-Day Appo... No AccessShow details READ MORE
Ear pain and throat pain?
It's not unusual that your ear hurts at the same time as your throat. The nerves that give sensation to the throat also provide sensation to the ear, so the pain can radiate to your ear; we call that referred otalgia. Without knowing more, it's difficult to say what you have, but some possibilities include: sinusitis, tonsillitis, adenoiditis. There are, of course, a host of other things this could represent, but these would be more likely with the information you provided. If you aren't better in 7 days from the onset, or if you become sicker, seek medical help. READ MORE
Sore throat?
It sounds like you have pharyngitis or tonsillitis. If you are running a fever or if this has persisted for several days, seek medical help. A rapid strep test can be very helpful. It can be difficult though to determine if the infection is viral or bacterial. A throat culture which takes a few days to return results, can be useful. READ MORE
I got my nose pierced and now there are bumps on the inside. What can I do?
Based on the limited information, this is difficult to answer. The bumps could represent scar tissue or skin that was everted into the nose. Have an ENT doctor take a look; the answer should be readily evident to that doctor. READ MORE
Can mold exposure cause an ear infection?
Cause and effect can be difficult to prove. Mold exposure can result in an allergic response (to varying degrees in people) and allergies are a risk factor for ear infections. READ MORE
What causes sinus infections in some people?
Plain Language Summary: Adult Sinusitis (Sinus Infection) Show all authors Leslie A. Caspersen, MBA Leslie A. Caspersen American Academy of Otolaryngology—Head and Neck, Alexandria, Virginia, USA See all articles by this author Search Google Scholar for this author , Lindsey M. Walter, Sandra A. Walsh, ... First Published July 21, 2015 Research Article Find in PubMed https://doi.org/10.1177/0194599815587677 Article information Article has an altmetric score of 5 Full Access Abstract Objective. This plain language summary serves as an overview in explaining sinusitis (pronounced sign-you-side-tis). The purpose of this plain language summary is to provide patients with standard language explaining their condition in an easy-to-read format. This summary applies to those 18 years of age or older with sinusitis. The summary is featured as an FAQ (frequently asked question) format. The summary addresses how to manage and treat sinusitis symptoms. Adult sinusitis is often called a sinus infection. A healthcare provider may refer to a sinus infection as rhinosinusitis (pronounced rhi-no-sign-you-side-tis). This includes the nose as well as the sinuses in the name. A sinus infection is the swelling of the sinuses and nasal cavity. The summary is based on the published 2015 “Clinical Practice Guideline: Adult Sinusitis.” The evidence-based guideline includes research to support more effective diagnosis and treatment of adult sinus infections. The guideline was developed as a quality improvement opportunity for managing sinus infections by creating clear recommendations to use in medical practice. Keywords sinusitis, sinus infection, rhinosinusitis What Is Sinusitis? Sinus infections are one of the common conditions with which adults may be diagnosed. Sinus infections affect millions of adults in the United States each year.1,2 The sinuses are a group of hollow spaces that surround the nose and are also found above and between the eyes. Sinus infections include cloudy or colored runny nose with nasal blockage or clogging, facial pain/pressure, or both. Other symptoms include fever, cough, loss of energy, lack of or reduced sense of smell, tooth pain, and ear fullness. The symptoms can be severe enough to disturb your quality of life or general well-being. See Table 1 for a summary of evidence-based statements and recommendations of diagnosis and treatment. Table Table 1. Summary of Evidence-Based Statements. Table 1. Summary of Evidence-Based Statements. View larger version Sinus infections can be caused by viruses, bacteria, or fungi. A viral sinus infection has similar symptoms as bacterial infections but improves within 10 days and does not get worse. A bacterial sinus infection is defined by how long the symptoms last. The 3 types are acute (short course), recurrent (repeated), or chronic (long lasting). An acute bacterial sinus infection is one that either fails to get better within 10 days or has suddenly gotten worse after an initial period of getting better. Acute bacterial sinus infection lasts less than 4 weeks. See Figure 1 for more information on acute sinus infections. Recurrent bacterial sinus infections are when an acute sinus infection occurs 4 or more times in a 1-year period. A chronic sinus infection is when 2 or more symptoms and swelling lasts for 12 weeks or longer. A fungal sinus infection is one that is linked with chronic symptoms. Fungal sinus infections usually occur with people who have weak immune systems. Fungal sinus infections can also occur with people who have used long-term antibiotics. figure Figure 1. Patient information sheet on diagnosis of acute sinusitis. What Causes Adult Sinusitis? A sinus infection is typically caused by a viral upper respiratory infection, like a cold. A viral infection does not get better from taking antibiotics. Acute bacterial sinus infections are caused by a bacterial infection. Some people with bacterial infections can benefit from the use of antibiotics, although antibiotics are not necessary for everyone. What Can You Do? You should see a healthcare provider soon after symptoms occur. Early diagnosis may help avoid misdiagnosis or delayed treatment and worse results. There are several types of sinus infections, so it is important to get the correct diagnosis for proper treatment. Treatment options should be discussed with the healthcare provider after diagnosis. Antibiotics do not work for viral sinus infections. Antibiotics are not recommended for all types of bacterial infections. How Is Adult Sinusitis Diagnosed? A healthcare provider can diagnose a sinus infection by reviewing the medical history and doing a physical exam. The exam should review and document the conditions in your medical record. A healthcare provider will take note of how long symptoms have been present. The healthcare provider should decide between acute bacterial sinus infection from viral sinus infection or noninfectious conditions. Your healthcare provider should diagnose an acute bacterial sinus infection when (1) symptoms (facial pain-pressure-fullness, nasal blockage) or signs (cloudy or colored nasal drainage) or both continue without getting better for at least 10 days after the onset of upper respiratory symptoms like a cold or (2) symptoms or signs of a sinus infection worsen within 10 days after getting better (double worsening). Other conditions can seem like a sinus infection. For instance, a headache alone may not mean a sinus infection. With a sinus infection, there is usually cloudy or colored nose drainage. An acute sinus infection is diagnosed when there are up to 4 weeks of colored or cloudy runny nose with nasal blockage, facial pain-pressure-fullness, or both. A healthcare provider should decide between chronic and recurrent sinus infections from single-incident of acute bacterial sinus infections and other causes of sinonasal (nose and sinus) symptoms. The healthcare provider cannot diagnose chronic sinus infection based on symptoms alone. The healthcare provider will also need to see nasal swelling or inflammation on exam. The healthcare provider may use tools such as cameras (an endoscope or rhinoscope). These types of tools can offer a better view of your sinuses. The healthcare provider may also order a special radiology test called a CT (CAT) scan to view sinonasal swelling. The CT scan may confirm a diagnosis of chronic sinus infections. For chronic sinus infections, the healthcare provider should confirm whether nasal polyps are present. Nasal polyps are harmless growths. Having nasal polyps will modify care of your symptoms. Instead of prescribing antibiotics right away for your acute bacterial sinus infection, your healthcare provider may suggest a treatment option known as watchful waiting. This option usually includes a 7-day waiting period without antibiotics to see if you get better on your own. You may be tested for allergies and immune function. This testing will help tell chronic or recurrent sinus infections from allergies. What Treatments Are Available? It is important to properly diagnose viral and bacterial sinusitis because antibiotics are not for a viral sinus infection. If you have heart, kidney, or liver disease, your healthcare provider may consider different treatment. For a viral sinus infection: Talking with your healthcare provider can help you make decisions about the treatment of symptoms. To relieve symptoms, pain relievers, nasal steroid sprays, and/or nasal saline rinse (irrigation) may be recommended. Nasal saline rinse can be purchased or homemade. Nasal saline rinse involves using a bulb, squeeze bottle, or Neti pot with a mixture of water, baking soda, and a noniodized salt. For an acute bacterial sinus infection: The healthcare provider should offer either watchful waiting without antibiotics or an antibiotic. If a decision is made to treat acute bacterial sinus infection with an antibiotic, amoxicillin will likely be prescribed. A combination of amoxicillin with clavulanate for 5 to 10 days may also be prescribed as a different treatment. If you feel worse or do not improve with the antibiotic treatment after 7 days, you should see your healthcare provider. The healthcare provider will review the diagnosis and will rule out other causes. The healthcare provider may also decide to change the antibiotic. To relieve your symptoms, your healthcare provider may recommend over-the-counter treatments. These treatments may include pain relievers, nasal steroid sprays, and/or nasal saline rinse. Nasal saline rinse can be purchased or homemade. Nasal saline rinse involves using a bulb, squeeze bottle, or Neti pot with a mixture of water, baking soda, and a noniodized salt. See Figure 2 for more information on acute bacterial sinus infections. figure Figure 2. Patient information sheet on treating acute bacterial rhinosinusitis (ABRS). For a chronic sinus infection: Your healthcare provider may recommend saline nasal rinse, topical intranasal corticosteroids, or both for symptom relief. Your healthcare provider should not prescribe antifungal therapy for chronic sinus infections. Your treatment will be modified if you have asthma, cystic fibrosis, a weakened immune system, or ciliary dyskinesia. Where Can I Find Help? Patients and healthcare providers should discuss the benefits and potential risks or harms of treatments. Engaging in shared decision making helps achieve better health outcomes. To learn more about sinus infections, there are a number of resources available. Go to http://www.entnet.org/AdultSinusitisCPG to see printable patient resources and tables. There are tables that will explain when to use home remedies, such as salt water rinses in the nose. The tables will also explain when it is ok to take an antibiotic and the side effects of antibiotics. How the Guideline Was Developed The adult sinusitis guideline was developed using the methods outlined in the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s (AAO-HNSF’s) “Otolaryngology–Head and Neck Surgery Guideline Development Manual, Third Edition.”3 A literature search was performed by an information specialist to identify research studies (systematic reviews, clinical practice guidelines, and randomized controlled trials) published since the prior guideline. The AAO-HNSF assembled a guideline update group from the fields of otolaryngology–head and neck surgery, infectious disease, family medicine, allergy and immunology, advanced practice nursing, and a consumer advocate. The group also included a staff member from the AAO-HNSF. Although radiology was represented on the original guideline development group, they were excluded from the update since the AAO-HNSF had recently published a clinical consensus statement on imaging for sinusitis. The group solicited feedback from radiology about important statements to ensure that they stayed valid and current. Prior to publication, the guideline underwent extensive peer review, including open public comment. This plain language summary was developed from the 2015 AAO-HNSF’s “Clinical Practice Guideline: Adult Sinusitis.”4 The multidisciplinary guideline development group represented the fields of otolaryngology–head and neck surgery, including, infectious disease, family medicine, allergy and immunology, advanced practice nursing, and a consumer advocate. Literature searches for the guideline were conducted up through March 2014. For more information on allergic sinusitis, visit http://www.entnet.org/AdultSinusitisCPG. About the American Academy of Otolaryngology—Head and Neck Surgery The American Academy of Otolaryngology—Head and Neck Surgery (www.entnet.org), one of the oldest medical associations in the nation, represents about 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The AAO-HNSF works to advance the art, science, and ethical practice of otolaryngology–head and neck surgery through education, research, and lifelong learning. The organization’s vision: “Empowering otolaryngologist–head and neck surgeons to deliver the best patient care.” Author Contributions Leslie A. Caspersen, writer, American Academy of Otolaryngology—Head and Neck Surgery Foundation staff liaison; Lindsey M. Walter, writer, American Academy of Otolaryngology— Head and Neck Surgery; Sandra A. Walsh, writer, panel member; Richard M. Rosenfeld, writer, chair; Jay F. Piccirillo, writer, assistant chair. Disclosures Competing interests: Leslie A. Caspersen, salaried employee of American Academy of Otolaryngology—Head and Neck Surgery Foundation; Lindsey M. Walter, salaried employee of American Academy of Otolaryngology—Head and Neck Surgery. Sponsorships: American Academy of Otolaryngology—Head and Neck Surgery Foundation. Funding source: American Academy of Otolaryngology—Head and Neck Surgery Foundation. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. References 1. Lethbridge-Cejku, M, Rose, D, Vickerie, J. Summary health statistics for US adults: National Health Interview Survey, 2004. Vital Health Stat. 2006;10(228):19-22. Google ScholarOpenURL Rowan University 2. Blackwell, DL, Lucas, JW, Clarke, TC. Summary health statistics for US adults: National Health Interview Survey, 2012. Vital Health Stat. 2014;10(260):1-171. Google ScholarOpenURL Rowan University 3. Rosenfeld, RM, Shiffman, RN, Robertson, P. Clinical practice guideline development manual, third edition: a quality-driven approach for translating evidence into action. Otolaryngol Head Neck Surg. 2013;148(suppl 1):S1-S55. Google Scholar | SAGE Journals | ISIOpenURL Rowan University 4. Rosenfeld, RM, Piccirillo, JF, Chandrasekhar, SS. Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(suppl 2):S1-S39. Google Scholar | SAGE Journals | ISIOpenURL Rowan University READ MORE
Why does my head hurt when I blow my nose?
When you blow your nose you are creating some slight increased venous pressure within your body, similar to what we refer to as a Valsalva technique. This increased venous pressure is transmitted to the veins and venous sinuses around the brain resulting in this temporary discomfort. READ MORE

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Case report: mediastinal hematoma secondary to hypertension, presenting as a retropharyngeal space abscess.

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Patient Experience with Dr. Spalla

5.0

Based on 1 reviews

Dr. Thomas C. Spalla, MD has a rating of 5 out of 5 stars based on the reviews from 1 patient. FindaTopDoc has aggregated the experiences from real patients to help give you more insights and information on how to choose the best Ear-Nose and Throat Doctor (ENT) in your area. These reviews do not reflect a providers level of clinical care, but are a compilation of quality indicators such as bedside manner, wait time, staff friendliness, ease of appointment, and knowledge of conditions and treatments.