Sinusitis

Sinusitis describes a condition where the membrane (the mucus lining) inside of a sinus cavity is swollen. This inflammation prevents the sinus cavity from performing its function resulting in discomforting symptoms, sinus pain, and sinus infection. If not corrected, the sinus infection can spread to other areas of the body such as the eyes or brain.

What are Sinuses?

A sinus is an empty air pocket in the body. In the skull, there are four pairs of air cavities referred to as the paranasal sinuses because they all connect with the nasal cavity. There are eight bones that enclose the brain and make up the cranium. The names of the sinuses come from the bones in which they are located.

1. The Frontal Sinuses are located in the forehead and just over the eyes.
2. The Ethmoid Sinuses are located just behind the bridge of the nose, between the eyes, and just above the nasal cavity.
3. The Sphenoid Sinuses are located in the upper region of the nose behind the eyes and behind the ethmoids.
4. The Maxillary Sinuses are located in the cheekbones on each side of the nose and just under the eyes. It is the largest of the paranasal sinuses.

These cavities are connected to the nasal passageway by a continuous mucus membrane lining. A small opening connects the sinuses to the nose. Fluid (mucus), produced by the sinus membrane, drains into the nose.

To learn more, read the article Sinus Problems by the Asthma and Allergy Foundation of America.

What is the Purpose of the Paranasal Sinuses?

There is a close relationship between the nose and the sinuses. The primary function of the sinuses is to assist the nose in warming the air that we breathe, aid in filtering it, and to help give the air some moisture. Furthermore, these air pockets lighten the skull which makes it easier to hold the head up and to balance it on the neck. The sinuses also contribute to the vocalization of certain sounds.

How does the Sinus Perform its Function?

The sinuses are lined with the same kind of membrane that lines the nose. This membrane produces mucus which helps filter the air. Tiny hairs (called cilia) move in a way that allows the mucus to drain into the nose. The mucus carries out with it the foreign airborne particles that it has collected.

What is Sinusitis?

Sinusitis is the inflammation (swelling) of the mucus membrane inside the sinuses. This results in the opening between the sinuses and the nose to become closed. When this passageway becomes closed, the sinuses cannot drain.

When the sinuses cannot drain, the mucus will start to build up. This will give a feeling of pressure in the affected area. Air pollutants and bacteria breathed in will now have no place to go. With the sinuses aiding in giving moisture to the air we breathe, it now creates a moist environment for the trapped bacteria. This condition provides an ideal environment for the bacteria to grow and multiply resulting in infection.

It is this blockage between the sinuses and the nasal passages that describes the condition of sinusitis. The opening itself can become closed due to swelling and the inflammation of the membrane. This blockage prevents the cilia from performing its function of moving the mucus out.

The Cause

Sinusitis can be caused by anything that would cause swelling of the membrane to close the opening to the nasal passageway or to prevent the cilia from moving out the mucus. Inflammation from allergies or the common cold is the most common way to develop sinusitis. A few other possible causes are listed below;

• infection
• viral
• bacteria
• fungal
• swelling due to allergies (allergic rhinitis)
• swelling due to colds or the flu
• airborne irritants (especially smoke)
• airborne environmental pollution from poor indoor air quality
• nasal polyps (small growths in the lining of the nose)
• conditions that thicken the mucus
• lack of fluids and water content in the mucus
• lack of humidity in the air
• antihistamines dry out the mucus
• using decongestant too long
• temperature (cold air)
• air pressure (air travel)
• swimming in polluted waters

Types of Sinusitis

• A) Acute Sinusitis
• 1 month or less
• B) Subacute Sinusits
• 1 to 2 months
• C) Chronic Sinusitis
• 2 months or longer

Symptoms

Without the sinuses being able to drain, sinus pain and sinus pressure can develop. Where and how the pain and pressure develops depends on which sinuses are affected.

Sphenoid Sinus: An aching deep inside at the top of your head. Pain can reach your neck and your ears can ache. Pain or pressure behind the eyes.

Frontal Sinus: Tenderness in your forehead above the eyes. Also pain or pressure behind the eyes.

Maxillary Sinus: Tenderness in your cheek bones. Pain can be in your upper jaw and teeth.

Ethmoid Sinus: Tenderness when you touch the sides of your nose. Pain can be around or behind your eyes with the ethmoid sinuses being so close to the eye ducts.

Symptoms that may be related are;

• a reduce sense of smell
• an increase of facial sensitivity
• facial pain and pressure
• a general feeling of facial discomfort
• fever
• cough
• headache
• head congestion
• post nasal drip
• nasal congestion (stuffiness)
• thick, green or yellow nasal discharge
• fatigue / tiredness / weakness
• nausea
• dental pain
• a feeling of a dull, aching pain

Diagnosing

If you suspect that you have sinusitis, you should see your health care provider as soon as possible. If left untreated, acute sinusitis can develop into chronic sinusitis. When the airflow into your sinuses has stopped and the mucus is not draining, infection will very likely develop.

Your health care provider can determine your condition based on the clinical findings of your examination and reviewing your symptom history.

At the disposal of your doctor is a tool called an endoscope. Nasal endoscopy is a way to look into your nose with a tool that is equipped with a special camera and lights. The endoscope will reveal if there is obstruction and will also reveal if the cause is a result of swelling or a growth.

Treatment

After determining the condition and cause of sinusitis, a doctor can prescribe the best course of action to improve your condition. Consulting with your health care provider is the most important step you can take.

Sinusitis is generally first treated with medicine. Taking the correct medication at the right dosage, for the correct length of time cannot be over emphasized. Because drugs have the potential for side effects, taking them should be done only under the supervision of your doctor.

Antibiotics will be prescribed if you have developed a bacterial infection. They are not helpful, however, if you have a viral or fungal infection. It is important to take the complete dose even if you start to feel better or the infection will resurface.

Decongestants may be prescribed for temporary relief. They will help reduce the congestion. Decongestants should not be taken for a long period of time. They may be helpful in draining the sinus infection.

Antihistamines may be prescribed if the condition is caused by hay fever. Antihistamines will be helpful reducing the swelling.

Pain relievers may be prescribed if your sinuses are closed off and there is a build up of mucus and puss in the sinuses. Your face may be very tender to the touch with a build up of mucus.

Nasal corticosteroids may be prescribed to treat the inflammation and reduce the sinus congestion.

To learn more read the article Sinusitis by the Asthma and Allergy Foundation of America.
The American Academy of Allergy Asthma & Immunology also provides a useful article on Tips to Remember.

Go to the nasal allergies home page.

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