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SINUSITIS2008-04-27 18:04:15 Dr Rahees K Kokkallur

SINUSITIS

Sinuses are hollow air spaces within the bones surrounding the nose. They producemucus, which drains into the nose. If your nose is swollen, this can block thesinuses and cause pain and infection. Infection of sinuses is known as Sinusitis.Sinusitis is one of the more common conditions that can afflict people throughouttheir lives. Sinusitis commonly occurs when environmental pollens irritate the nasalpassages, such as with hay fever. Sinusitis can also result from irritants, such as

chemicals or the use and/or abuse of over-the-counter nasal sprays and illegalsubstances that may be snorted through the nose. Sinusitis can also be caused byinfection (by viruses or bacteria).

Sinusitis can be acute, lasting for less than four weeks, or chronic, lasting muchlonger. Acute sinusitis often starts as a cold, which then turns into a bacterialinfection. Allergies, pollutants, nasal problems and certain diseases can also causesinusitis.

Symptoms of sinusitis can include fever, weakness, fatigue, cough and congestion.There may also be mucus drainage in the back of the throat, called postnasal drip.Treatments include antibiotics, decongestants and pain relievers. Using heat padson the inflamed area, saline nasal sprays and vaporizers can also help.
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CAUSES

Anything that causes swelling in your sinuses or keeps the cilia from moving mucuscan cause sinusitis. This can occur because of changes in temperature or airpressure. Using decongestant nasal sprays too much, smoking, and swimming ordiving can also increase your risk of getting sinusitis. Some people have growthscalled polyps (say: pawl-ips) that block their sinus passages.

When sinusitis is caused by a bacterial or viral infection, you get a sinus infection.Sinus infections sometimes occurs after youve had a cold. The cold virus attacksthe lining of your sinuses, causing them to swell and become narrow. Your bodyresponds to the virus by producing more mucus, but it gets blocked in your swollensinuses. This built-up mucus makes a good place for bacteria to grow. The bacteriacan cause a sinus infection.

Sinuses can also become obstructed by tumors or growths which are in the

proximity of the sinus ostia. The drainage of mucous from the sinuses can beimpaired by thickening of the mucous secretions, by decrease in hydration (watercontent) of the mucous brought on by disease (cystic fibrosis), drying medications(antihistamines), and lack of sufficient humidity in the air. The mucous producingcells have small hairlike fibers, called cilia, which move back and forth to help themucous move out of the sinuses. These small cilia may be damaged by manyirritants, especially smoke, which then prevents them from assisting the mucousfrom draining from the sinuses. Stagnated mucous then provides a perfectenvironment for bacteria and in some circumstances (i.e.: AIDS) fungus to grow inthe sinus cavities.

CLASSIFICATION

Sinus infection may be classified in at least two ways, based on the time span of theproblem (acute, subacute, or chronic ) and the type of inflammation (eitherinfectious or noninfectious). Acute sinus infection is usually defined as being of lessthan 30 days duration; subacute sinus infection as being over 1 month but lessthan 3 months; and chronic sinus infection as being greater than 3 months duration.Infected sinusitis is usually caused by uncomplicated virus infection. Far less

frequently bacterial growth causes sinus infection. Noninfectious sinusitis can becaused by irritants and allergic conditions. Subacute and chronic forms of sinusinfection usually are the result of incomplete treatment of an acute sinus infection.

SIGNS AND SYMPTOMS

Commonly the symptoms of sinus infection are headache, facial tenderness orpain, and fever. However, as few as 25% of patients may have fever associated withacute sinus infection. Other common symptoms include cloudy, discolored nasaldrainage, a feeling of nasal stuffiness, a sore throat, and a cough. Some peoplenotice an increased sensitivity or headache when they lean forward. In allergicsinusitis other associated allergy symptoms of itching eyes and sneezing may becommon.


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Some of the signs that a person may have bacterial sinusitis are:

a stuffy or runny nose with a daytime cough that lasts for 10 to 14 dayswithout improvementmucus discharge from the nose (this can occur with both viral and bacterialsinusitis but continuous thick discharge is more likely to be from bacterialsinusitis)

persistent dull pain or swelling around the eyestenderness or pain in or around the cheekbonesa feeling of pressure in your heada headache when you wake up in the morning or when bending overbad breath, even after brushing your teethpain in the upper teetha fever greater than 102 degrees Fahrenheit (39 degrees Celsius)

Some people also have dry coughs and find it hard to sleep. Others have upset

stomachs or feel nausea.

Although many of these symptoms are similar to those you can get from viralsinusitis or allergic rhinitis (inflammation of the nose and sinuses due to allergy), itsa good idea to see your doctor just in case. Viral sinusitis and allergic rhinitis aremore common, but bacterial sinusitis often needs to be treated with antibiotics, andyou can only get these with a doctors prescription.

PREVENTION

You can lower your risk of getting sinusitis by making some simple changes in yourhome environment. Try using a humidifier during cold weather to stop dry, heated airfrom irritating your sinuses, which can make them more susceptible to infection.Clean the humidifier regularly because mold, which can trigger allergies in somepeople, forms easily in moist environments.

If you have allergies, make an extra effort to keep them under control because theycan make a person more prone to developing a sinus infection.

Although sinusitis itself isnot

contagious, it is often preceded by a cold, which canbe spread to family members and friends. The most effective way to prevent thespread of germs is to wash your hands frequently and thoroughly. Steer clear ofused tissues, and try to stay out of the line of fire when someone sneezes.

TIPS ON TAKING CARE OF SINUSITIS

Get plenty of rest. Lying down can make your sinuses feel more stopped-up,so try lying on the side that lets you breathe the best.Sip hot liquids and drink plenty of fluids.

Apply moist heat by holding a warm, wet towel against your face or breathingin steam through a cloth or towel.Talk with your doctor before using an over-the-counter cold medicine. Somecold medicines can make your symptoms worse or cause other problems.


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