Sinuses refer to hollow cavities within the skull, located in the forehead, cheeks, between and behind the eyes. They connect to the nose through small tunnels, a little wider than a pinhead. Sinuses located in the area near the eyebrows are called frontal sinuses. Those located inside the cheekbones are called maxillary sinuses. Ethmoid sinuses refer to those located between the eyes. Sphenoid sinuses, meanwhile, sit behind the ethmoid sinuses.
Sinuses are normally filled with air. It makes our facial bones less dense and lighter in weight. They function to warm and dampen the air as we breathe in. This prevents the air from getting too cold and dry for the lungs. Cells that produce mucus line the sinuses. Mucus helps traps particles of dirt and bacteria to protect against infection.
If these tunnels are blocked due to allergy, colds, or polyps, it causes pain in the face. Blocked sinuses create an environment, which can harbour bacteria overgrowth, just like the growth of bacteria in stagnant water.
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Viral sinusitis refers to inflammation of the sinuses due to colds or allergy. However, when common cold and allergies cause nasal congestion and the sinuses do not properly, bacteria may become trapped inside the sinuses, leading to bacterial sinusitis. Bacterial sinusitis causes more facial pain and swelling than viral sinusitis. It also causes fever to develop.
Doctors commonly prescribe antibiotics for sinus infections. However, numerous problems arise with taking antibiotics for sinus infections. Since antibiotics make us feel better fast, patients commonly stop taking the prescription before using it all. This creates more problems than benefits. Moreover, if the sinus infection is caused by virus, antibiotics will absolutely have no effect on the condition. It only provides relief of symptoms but it does not treat the root cause of the problem. Therefore, it may lead to repeat infections, a condition known as chronic sinusitis.
Chronic sinusitis will benefit more from homeopathic, herbal and natural remedies because antibiotics cannot be taken all the time. Yes, they may take a little longer to work than antibiotics but it will do a better job of cleansing the body to help prevent future infection.
Sinus infection or sinusitis refers to an inflammation of the sinuses and nasal passages. The infection can cause headache, pressure in the eyes, cheeks, nose, and on one side of the head. It may also be accompanied by cough, fever, bad breath and nasal congestion. It may be either acute or chronic. Chronic sinusitis usually lasts for eight weeks or more.
Types of Sinusitis
The infection usually lasts for up to three weeks. Bacteria cause the infection in most cases. It occurs as a late (secondary) complication of a viral respiratory infection such as a common cold or untreated allergies.
Chronic sinusitis lasts for more than three weeks. It is often a chronic inflammatory disorder just like bronchial asthma. It may also be caused by bacterial infection. If not treated properly, it can last for months or even years. Immunological problems, structural problems and allergies may lead to chronic sinusitis.
Bacteria, viruses or fungi may cause sinusitis. Viral sinusitis refers to the inflammation of the sinus cavities usually due to cold. The swelling blocks the normal drainage of fluid from the sinuses and into the nose and throat. If the fluids fail to drain, it builds up over time. It causes bacteria and fungi to start growing. Bacterial or fungal infection causes further swelling and pain. Nasal allergies, pollutants and other conditions that cause blockage of nasal passages and fluid build-up can also lead to sinusitis.
Streptococcus pneumonia, Haemophilius influenza and Moraxella catarrhalis commonly cause bacterial sinusitis. These bacteria, together with Staphylococcus aureus and other anaerobes cause chronic sinusitis.
People with a weakened immune system such as AIDS, leukaemia and diabetic patients, often have chronic sinusitis caused by fungi.
Signs and symptoms depend upon the sinus involved and whether the condition is acute or chronic.
The main symptoms of sinusitis involves runny or stuffy nose with daytime cough. It usually lasts for 10 to 14 days or longer without improvement. There may also be headache and pressure on the head and face. Other symptoms may include the following:
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White nasal mucus, it may thicken and darken to yellow or green
Congestion with excruciating sinus pressure
Frontal headache, especially upon waking up in the morning
Puffiness around the cheeks and eyes
Pain in the face, jaw, brow, upper teeth when touched or throbbing pain on the said areas
Thick post-nasal drip, this may result to morning sore throat, nausea, swelling of the uvula
A feeling that something is â€œstuckâ€Â in the nasal passages
Heavy feeling head especially when bending forward
Stuffy ears and ear aches, which can progress to vertigo (imbalance)
Possible fever, greater than 102F (39C)
Bad breath even after brushing your teeth
Your doctor will ask questions about your past health. He will also perform a physical exam. Most sinusitis patients do not need any to undergo any tests. A family medicine doctor, paediatrician, internist, nurse practitioner or physician assistant may diagnose the condition.
An eye, nose and throat (ENT) specialist, also known as otolaryngologist can provide a more specialized examination of the area affected. If the sinus infection is caused by nasal polyps or other conditions that cause nasal cavity blockage, referral to en ENT specialist proves beneficial. In cases of chronic or complicated sinusitis, an ENT specialist can do diagnosis and surgical treatment. An ENT specialist uses a nasopharyngoscope or sino-nasal endoscope to check the nasal passages and the connection to the sinuses. This may come in the form of a fiberoptic, flexible instrument or a rigid tube that inserts through the nose. It enables the doctor to view the passages and see if the sinuses remain open and are draining correctly. Amore invasive test include inserting a needle into the sinus through the skin, gum and bone in order to withdraw fluid. The fluid will be tested for any organisms in a lab. The lab can identify any bacteria present within two days.
In cases when the doctor will require tests, CT scan and ultrasound may suffice for the diagnosis of sinusitis.
CT scan can clearly depict all of the paranasal sinuses, the nasal passages and the structures surrounding the area.
A CT scan can confirm the presence of sinus infection due to the following conditions:
Air-fluid levels in one or more of the sinuses
Total blockage in one or more sinuses
Thickening of the inner lining of the sinuses
Ultrasound offers fast, reliable, and less expensive diagnostic procedure than CT scan. However, it may not give detailed results. Not all medical specialists accept ultrasound for diagnosing sinus infection.
Surgical Options for Sinus Infection
Surgery is usually the last option when medications and natural remedies fail to control sinusitis. The spread of infection to the bone or inside the brain and other complications will also require surgery. Surgery aims to create a better drainage of the sinuses. This usually requires removal of the blockage as well as draining of the mucus. It may mean removal of infected, swollen or damaged tissue; bone; growths inside the nose or sinuses such as nasal polyps; and any foreign object blocking the nasal or sinus passage.
Key Points to Consider before getting a Surgery
Very few people need surgery for sinusitis. In most cases, home care or medicines can treat sinus infection.
People who have chronic or long-term sinusitis may want to consider surgery. People with chronic infection often get recurring infection due to blockage of the flow of mucus from the sinuses or due to another problem. Surgery can help drain the sinuses by making the openings bigger.
After maximum medical treatment for four to six weeks without any positive result, your doctor may require a CT scan to find out if surgery can help your condition. It will help your doctor see what is causing the infection.
About 20 out of 100 people who underwent surgery need a second operation.
Post-surgery treatment may require you to take medicines and follow home treatment for a long period.
If allergies cause your chronic sinusitis, get that problem under control before deciding to have a surgery.
Conditions that necessitate surgery
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Lack of improvement after using two or more antibiotics for four to six weeks (or two to three months in paediatric patients)
Symptoms persist due to thickened mucus membranes, growths inside the nose and other conditions that cause blockage
CT scan results show a blocked drainage opening for a sinus or it establishes the presence of long-term sinus infection
Fungus causes the infection
Serious complications of sinusitis develop such as infection of the facial bones (osteomyelitis), infection of the lining of the brain (meningitis), development of a pocket of pus (abscess) in the eye socket, brain, facial bones and soft tissues of the face
Endoscopic surgery is more commonly done than traditional surgery. It involves insertion of a thin, lighted tool called an endoscope inside the nose. The instrument helps remove small amounts of bone or tissue that creates blockage in the sinus openings.
Traditional surgery involves opening the sinus from the inside the mouth or through the facial skin. The development of pus in the sinus, infection of the facial bones and brain abscess may require the performance of traditional surgery.
Sinus surgery involves removal of diseased sinus tissue. This aims to improve the natural drainage channels through the creation of a pathway for infected material to drain from the sinuses. Endoscopic techniques help your doctor visualize the sinus cavities better without the need for external incisions. This technique offers less bleeding, discomfort and swelling. It leads to faster recovery compared to conventional external surgery.
Sinus surgery differs from other types of surgery. It involves re-routing of existing sinus pathways. In order to prevent or minimize failure, post-operative care and follow up must be given equal importance as the surgery itself.