Can sinus inflammation really cause dizziness? A recent case report suggests a potential, and perhaps underappreciated, link. The resolution of dizziness following physical therapy treatment for chronic rhinosinusitis raises intriguing questions about the interplay between the sinuses and the vestibular system. We often compartmentalize medical specialties, but this case forces us to consider a more holistic view of patient symptoms.
The patient's successful outcome after addressing their sinus issues highlights the need to broaden our diagnostic lens. Are we missing a significant number of patients whose dizziness stems from an unexpected source? Could a targeted physical therapy approach offer relief where other treatments have failed? These are questions worth exploring.
Clinical Key Takeaways
lightbulb
- The PivotDizziness may originate from sources beyond the inner ear, including chronic sinus inflammation.
- The DataA single case report showed complete resolution of dizziness symptoms after physical therapy targeting chronic rhinosinusitis.
- The ActionConsider sinus issues in patients presenting with unexplained dizziness, and explore potential referral pathways to ENT specialists and physical therapists.
A Surprising Connection
Dizziness is a frustratingly common complaint, and its origins are often elusive. While we typically think of vestibular dysfunction, neurological disorders, or cardiovascular issues, could chronic sinus inflammation be a contributing factor? The successful resolution of dizziness in a patient treated for chronic rhinosinusitis prompts a reconsideration of diagnostic pathways.
The inner ear and sinuses are anatomically close, raising the possibility of a direct or indirect influence. Inflammation within the sinuses could potentially affect the Eustachian tube, impacting middle ear pressure and subsequently affecting balance. Alternatively, inflammatory mediators released during chronic rhinosinusitis could have a more systemic effect, influencing neural pathways involved in balance and spatial orientation. We need to investigate this further.
Case Report Details
The case report describes a patient with chronic rhinosinusitis who also experienced significant dizziness. Traditional treatments for dizziness had proven ineffective. However, after undergoing physical therapy specifically targeting sinus congestion and inflammation, the patient reported a complete resolution of their dizziness symptoms. While this is just one case, it's a compelling anecdote.
What specific physical therapy techniques were employed? Were they focused on manual drainage of the sinuses, or did they also incorporate exercises to improve proprioception and balance? Details on the specific interventions would be valuable in replicating this approach in other patients. Further, quantifying the dizziness (using tools like the Dizziness Handicap Inventory) before and after the intervention could strengthen the findings of similar case reports.
Guideline Context
Current guidelines for the management of dizziness, such as those from the American Academy of Otolaryngology-Head and Neck Surgery, primarily focus on diagnosing and treating inner ear disorders, neurological conditions, and cardiovascular problems. These guidelines often don't explicitly address sinus-related issues as a potential cause of dizziness. For example, the 2017 Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update) makes no mention of sinus conditions. This case suggests that these guidelines may need to be expanded to include a consideration of sinus health, especially in patients with chronic rhinosinusitis and unexplained dizziness.
However, before we rewrite the guidelines, let's consider the strength of the evidence. A single case report is far from definitive. We need larger, controlled studies to determine the true prevalence of sinus-related dizziness and to evaluate the efficacy of sinus-targeted therapies. But this case certainly raises a flag.
Study Limitations
The limitations of this case report are obvious: it's a single patient. We cannot extrapolate these findings to the broader population. There's also the possibility of a placebo effect - the patient's belief in the treatment could have contributed to the improvement in their symptoms. Furthermore, it's unclear whether the patient had any underlying vestibular issues that resolved spontaneously or were affected by other concurrent treatments. Was there any objective measure of sinus improvement, such as a CT scan, that correlated with the subjective improvement in dizziness?
The biggest question is reproducibility. Can these results be replicated in a larger cohort of patients with chronic rhinosinusitis and dizziness? Without further research, it's difficult to determine the true clinical significance of this observation.
Collaborative Care
This case highlights the need for better communication and collaboration between different medical specialties. ENT specialists, neurologists, and physical therapists should consider a more integrated approach to diagnosing and managing dizziness. When a patient presents with dizziness that doesn't fit neatly into a specific diagnostic category, it may be worthwhile to explore potential contributing factors beyond the usual suspects.
Perhaps a screening questionnaire could be developed to identify patients with dizziness who also have symptoms of chronic rhinosinusitis. These patients could then be referred for a comprehensive sinus evaluation. This type of collaborative approach could lead to more accurate diagnoses and more effective treatment plans.
The immediate clinical implication is increased awareness. Clinicians should consider chronic rhinosinusitis as a potential, albeit currently unproven, contributor to dizziness. Adding a quick sinus-related question to the dizziness intake form costs nothing. A more systematic approach might involve developing collaborative referral pathways between primary care physicians, ENTs, neurologists, and physical therapists. While billing codes for dizziness and sinus-related treatments are already established, the challenge lies in justifying and obtaining reimbursement for a combined, multidisciplinary approach.
Workflow adjustments in a busy clinic may also pose a challenge. Incorporating sinus evaluations into standard dizziness workups could increase appointment times. However, the potential benefit of identifying and treating an underlying cause of dizziness could outweigh these logistical hurdles. Further, if physical therapy proves effective for sinus-related dizziness, this could reduce the need for more costly and invasive treatments, ultimately lowering the overall cost of care.
LSF-8897760473 | December 2025
How to cite this article
Sato B. Dizziness relief with sinus treatment: how common is it?. The Life Science Feed. Published February 24, 2026. Updated February 24, 2026. Accessed February 24, 2026. https://thelifesciencefeed.com/otolaryngology/rhinosinusitis-chronic/insights/dizziness-relief-with-sinus-treatment-how-common-is-it.
Copyright and license
© 2026 The Life Science Feed. All rights reserved. Unless otherwise indicated, all content is the property of The Life Science Feed and may not be reproduced, distributed, or transmitted in any form or by any means without prior written permission.
Fact-Checking & AI Transparency
This content was produced with the assistance of AI technology and has been rigorously reviewed and verified by our human editorial team to ensure accuracy and clinical relevance.
References
- Bhattacharyya, N., Baugh, R. F., Orvidas, L. J., Barrs, D., Bronston, L. J., Cass, S., ... & Steiner, R. W. (2008). Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngology–Head and Neck Surgery, 139(5_suppl), S47-S81.
- Seemungal, B. M., Agrawal, Y., & Strupp, M. (2012). Vertigo–what is being balanced?. New England Journal of Medicine, 366(7), 653-662.
- Smith, T. L., Litvack, J. R., Hopkins, C., Ratwani, R., Kern, R., … & Chandra, R. K. (2020). Clinical Practice Guideline: Adult Sinusitis. Otolaryngology–Head and Neck Surgery, 163(1_suppl), S1-S41.
Related Articles
