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PARANASAL SINUSES AND SINUSITIS

Posted Mar 09 2010 12:00am
Mar
09

          Sinusitis simply means that your sinuses are infected or inflamed.  The most common symptoms are very uncomfortable – headaches, fever, severe pressure over the eyes, nose and/or cheeks, cough, congestion and viscous nasal secretions.  There is also a host of less common symptoms, which include bad breath, sore throat, decreased sense of smell, tiredness and a cough that may be worse at night.  In both acute chronic sinusitis patients experience not only pain, but they tend to have thick nasal secretions that are yellow, green or blood-tinged.  Sometimes these secretions (referred to as post-nasal drip) drain in the back of the throat and are difficult to clear.  Also, acute chronic sinusitis is strongly associated with a stuffy nose, in addition to a general feeling of fullness over the entire face.

          My oldest son has terrible allergies and he gets recurrent sinusitis each year; my best estimate is 5 times per year.  It seems that every time he comes home from college, he’s off to the doctor with script in hand.  He normally goes in to see his physician, the doctor will examine his face and forehead, listen as he describes the symptoms, check his vital signs and very rarely does a sinus x-ray.  His doctor always concludes that it is sinusitis.  I guess it is really not that uncommon at all.  The researchers tell us that approximately 37 million Americans suffer from at least one sinusitis attack each year.  The Centers for Disease Control and Prevention estimate that close to 31 million adults suffer from sinusitis every year.  So what is the difference between acute and chronic sinusitis?  Acute normally means sudden and short, while chronic refers to a long term condition.  Health experts actually divide sinusitis into four categories:

  • Acute, which lasts up to 4 weeks
  • Subacute, which lasts 4 – 12 weeks
  • Chronic, which lasts more than 12 weeks and can continue for months or even years
  • Recurrent, which is several acute attacks within one year

With my son, it is definitely the recurrent type.  Acute sinusitis often starts as a cold, which then turns into a bacterial infection.  Allergies (which my son has a ton of), pollutants, nasal problems and certain diseases can also cause sinusitis.

          Anything that causes a swelling in the nose – an infection, an allergic reaction or an inflammatory reaction to a chemical to which you may get exposed – can affect your sinuses.  Air trapped within a blocked sinus, along with pus or other secretions may cause pressure on the sinus wall that can cause the intense pain of a sinus attack.  Similarly, when air is prevented from entering a paranasal sinus by a swollen membrane at the opening, a vacuum can be created that also causes pain.  People who experience changes in atmospheric pressure, such as while flying, climbing to high altitudes or swimming, risk sinus blockage and therefore have an increased chance of developing sinusitis.  Air pollution from industrial chemicals, cigarette smoke or other pollutants can damage the cilia responsible for moving mucus through the sinuses.  Dental problems and procedures precipitate about 10% of cases of sinusitis due to anaerobic bacteria.

          There are certain medical conditions that can also put people at high risk for chronic sinusitis.  Yesterday I talked about GERD (gastroesophageal reflux disease) and this particular disease is one that could lead to chronic sinusitis.  Other illnesses having the same risk on individuals are: pregnancy, steroid use, septal deviation, nasal polyps, diabetes, hypothyroidism, cystic fibrosis and Kartagener’s syndrome.  Kartagener’s syndrome is a rare, genetic birth defect that results in a chronic lung disease where cilia are unable to move.  When cilia do not function properly, mucous is not properly cleared.  Cigarette smoke also slows down the sweeping action of the cilia.

          Just as there are four classifications of sinusitis, there are also four pairs of cavities, or sinuses, known as paranasal sinuses.  These cavities, located within the skull or bones of the head surrounding the nose, include:

  • Frontal sinuses, which are over the eyes in the brow area
  • Maxillary sinuses, which are located inside each cheekbone
  • Ethmoid sinuses, just behind the bridge of the nose, between the eyes
  • Sphenoid sinuses, tight behind the ethmoids in the upper region of the nose and behind the eyes

When people say, “my sinuses are killing me,” they usually are referring to symptoms of congestion and achiness in one or more of these four pairs of cavities.  Each sinus has an opening into the nose for the free exchange of air and mucus, and each is joined with the nasal passages by a continuous mucous membrane lining.

          If you have acute sinusitis, your healthcare provider may recommend antibiotics to control a bacterial infection, pain relievers to reduce any pain and decongestants to reduce congestion.  For chronic cases, some of the following ideas may help you: eating spicy foods (garlic, horseradish and Cajun spices may reduce the pain), using warm, moist steam (such as a small vaporizer to ease congestion), consuming extra fluids, trying nasal irrigators with a saline solution, applying warm compresses between your eyes a few times a day and using over-the-counter decongestants such as Afrin.

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