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| Sinuses
are air-filled cavities in the bones of your face.
These cavities are lined with mucus membranes. Sinusitis
is the condition in which these membranes swell
and become inflamed or the cavity becomes filled
with infected material. |
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You're
coughing and sneezing and tired and achy. You think that you might
be getting a cold. Later, when the medicines are not working and
you've now got a terrible headache, you finally drag yourself to
the doctor. After listening to your history of symptoms, examining
your face and forehead, the doctor says you have sinusitis.
What
is sinusitis?
Sinusitis
simply means inflammation of the sinuses, but this gives little
indication of the misery and pain this condition can cause. Americans
spend millions of dollars each year for medications that promise
relief from their sinus symptoms.
What
causes it?
When
people say, "I'm having a sinus attack," they usually are referring
to symptoms in one or more of four pairs of cavities.
Each
sinus has an opening into the nose for the exchange of air and mucus.
Therefore, anything that causes a swelling in the nose also can
affect the sinuses. Air trapped within an obstructed sinus, along
with pus or other secretions may cause pressure on the sinus wall.
The result is the sometimes-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.
Most
cases of sinusitis are preceded by a "cold." The nose reacts to
an invasion of viruses by producing mucus and sending white blood
cells to the lining of the nose, which congest and swell the nasal
passages, trapping air and mucus in the sinuses. As the sinus openings
become too narrow to permit drainage of the mucus, the bacteria
that may have been living harmlessly in the nose or throat multiply
and cause an acute sinus infection.
What
are the symptoms?
Pain
when the forehead is touched may indicate inflammation of the frontal
sinuses. Infection in the maxillary sinuses can cause the upper
jaw and teeth to ache and the cheeks to become tender to the touch.
Since the ethmoid sinuses are near the tear ducts in the corner
of the eyes, inflammation of these cavities often causes swelling
around the eyes, and pain between the eyes.
Ethmoid
inflammation also can cause tenderness when the sides of the nose
are touched, a loss of smell, and a stuffy nose. Although the sphenoid
sinuses are less frequently affected, infection in this area can
also cause earaches, neck pain, and deep aching at the top of the
head. However, most patients with sinusitis have pain or tenderness
in several locations, and symptoms usually do not clearly define
which sinuses are inflamed.
Other
symptoms of sinusitis include fever, a cough that may be more severe
at night, or nasal congestion. In addition, drainage of mucus down
the back of the throat (postnasal drip) can cause a sore throat
and can irritate the membranes lining the larynx (upper windpipe).
How
is it diagnosed?
Many
people confuse simple nasal congestion with sinusitis. A cold usually
lasts about 7 to 14 days and disappears without treatment. Acute
sinusitis often lasts longer and typically causes more symptoms
than just a cold. Sinusitis can be diagnosed by medical history,
physical examination, X-rays, and if necessary, magnetic resonance
imaging (MRI) or computed tomography (CT) scans.
How
is it treated?
Acute
sinusitis is treated by reestablishing drainage of the nasal passages,
controlling or eliminating the source of the inflammation, and relieving
the pain. Generally decongestants are used to reduce the congestion,
steroid nasal sprays to reduce swelling, antibiotics to control
a bacterial infection, if present, and pain relievers to reduce
the pain.
Although
home remedies cannot cure a sinus infection, you can use them to
lessen their discomfort. Inhaling steam from a vaporizer or drinking
a hot cup of water can soothe inflamed sinus cavities. Another treatment
is saline nasal spray, which can be purchased in a pharmacy. Applying
a hot water bottle; hot, wet compresses; or an electric heating
pad over the inflamed area also can be comforting.
When
medical treatment fails, surgery may be the only alternative for
treating chronic sinusitis. In children, problems often are eliminated
by removal of adenoids obstructing nasal-sinus passages. Adults
who have had allergic and infectious conditions over the years sometimes
develop nasal polyps that interfere with proper drainage.
Removal
of these polyps and/or repair of a deviated septum to ensure an
open airway often provides considerable relief from sinus symptoms.
The most common surgery done today is functional endoscopic sinus
surgery, in which the natural openings from the sinuses are enlarged
to allow drainage.
How
can sinusitis be prevented?
Although
you cannot prevent all sinus disorders - any more than you can avoid
all colds or bacterial infections - you can take certain measures
to reduce the number and severity of the attacks and possibly prevent
sinusitis from becoming chronic.
If
you are susceptible to sinus disorders, particularly if you also
have allergies, try to avoid cigarette smoke and other air pollutants.
Inflammation in the nose caused by allergies predisposes a patient
to a strong reaction to all irritants. Drinking alcohol also causes
the nasal-sinus membranes to swell.
Anyone
who suspects that their sinus inflammation may be related to dust,
mold, pollen, or food - or any of the hundreds of allergens that
can trigger a respiratory reaction - should speak to their doctor.
Various tests can determine the cause of the allergy and also help
the doctor recommend steps to reduce or limit allergy symptoms.
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