Sinusitis

The moist hollow air spaces in the bones of the face around the nose are called sinuses. Normally these are filled with air, which makes the facial bones light weight and less dense. When one has nasal congestion (stuffiness) due to common cold or allergies these sinuses are unable to drain properly, and they get filled with fluid. This causes germs like bacteria, viruses, and fungi, to get trapped inside the sinuses, leading to sinusitis, which is a medical term for inflammation of the sinuses due to some infection.

 

Sinusitis can be caused due to viruses, bacteria or a combination of both. Bacterial sinusitis is usually accompanied with more facial swelling and pain and may also be accompanied with fever.

 

There are different types of sinusitis, including:

ยท         Acute sinusitis: A sudden onset of cold-like symptoms and facial pain that does not go away. This type typically lasts 4 weeks or less.

ยท         Subacute sinusitis: An inflammation lasting 4 to 8 weeks.

ยท         Chronic sinusitis: Inflammation symptoms lasting 8 weeks or longer.

ยท         Recurrent sinusitis: Several attacks within a year.

 

 

Causes

ยท         Fungi: Inhaled microscopic fungi affect your immune system and aggravate sinuses.

ยท         Bacteria: Blocked sinus openings create an ideal environment for bacterial growth preventing the cilia from functioning properly, causing the mucus membrane to swell.

ยท         Allergens: Air-borne particles, pet dander and certain food items can aggravate sinuses.

ยท         Viruses: A viral infection can destroy or paralyze cilia, causing mucus to build up.

ยท         Immune system problems: Immune deficiency can prevent cilia from functioning normally.

ยท         Structural problems: A deviated septum or very narrow sinus opening can make it difficult to when the mucus membranes swell.

ยท         Colds and Flu

ยท         Smoke, Dust and other air pollutants

ยท         Asthma

 

 

Risk Factors

Young Children and Sinusitis

Though true sinusitis is very rare in children under the age of nine years, all infants are susceptible to respiratory infections as their immune system is not mature. Young children, therefore, may have 8-12 bouts of cold every year.  Some doctors believe that sinusitis is greatly over-diagnosed in this population.

 

The Elderly and Sinusitis

For a lot of people their nasal passages tend to dry out with age and the cartilage supporting the nasal passages also weakens, causing airflow changes.

 

Hospitalization

ยท         People with Head injuries

ยท         Conditions requiring insertion of tubes through the nose

ยท         Breathing aided by mechanical ventilators

 

Other Medical Conditions Affecting the Sinuses

ยท         Diabetes

ยท         Nasal polyps

ยท         AIDS and other disorders of the immune system

ยท         Oral or intravenous steroid treatment

ยท         Hypothyroidism

ยท         Cystic fibrosis

ยท         Kartagener's syndrome

 

Miscellaneous Risk Factors

ยท         Dental Problems

ยท         Changes in Atmospheric Pressure

ยท         Cigarette Smoke and Other Air Pollutants

 

 

Symptoms:

Some of the signs that someone may have bacterial sinusitis are:

ยท         Stuffy or runny nose with a daytime cough that lasts more than 10 to 14 days without improvement

ยท         Mucus discharge from the nose

ยท         Persistent dull pain or swelling around the eyes

ยท         Facial pain/pressure

ยท         A feeling of pressure in your head

ยท         Headaches when you wake up or when you bend down

ยท         a fever greater than 102ยฐ F (39ยฐ C)

ยท         Cough/congestion

 

Less common symptoms of sinusitis (acute or chronic) can include the following:

ยท         Tiredness

ยท         Decreased sense of smell

ยท         Cough that may be worse at night

ยท         Sore throat

ยท         Bad breath

ยท         Dental pain

 

Symptoms in children include:

ยท         Cold or respiratory illness that improves and then starts getting worse

ยท         High fever, with a darkened nasal discharge, for at least 3 days

ยท         Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving

 

 

Complication:

Although very rare, complications may include:

ยท         Abscess

ยท         Bone infection (osteomyelitis)

ยท         Meningitis

ยท         Skin infection around the eye (orbital cellulitis)

ยท         Osteomyelitis

ยท         Infection of the Eye Socket

ยท         Blood Clot

ยท         Brain Infection

ยท         Increased Asthma Severity

ยท         Effects on Quality of Life

ยท         Asthma flare-ups

 

 

Prevention

There are no scientifically proven methods to prevent acute or chronic sinusitis. The following actions may help to reduce your risk of sinusitis:

ยท         Eat plenty of fruits and vegetables, which are rich in antioxidants to boost your immune system

ยท         Drink plenty of fluids to increase moisture in your body

ยท         Good Hygiene and Preventing Transmission

ยท         Get an influenza vaccine each year

ยท         Manage stress

ยท         Use Nasal Decongestant Spray

ยท         Stop Smoking

ยท         Filter and Humidify the Air

ยท         Treat Your Allergies

ยท         Discuss Sinus Surgery

 

 

Modern Treatment Options

The goals of treating sinusitis include:

ยท         Relieving your discomfort

ยท         Reduce sinus inflammation

ยท         Keep your nasal passages draining

ยท         Opening up your nasal passages

ยท         Curing the infection

ยท         Eliminate the underlying cause

ยท         Reduce the number of sinusitis flare-ups you have

ยท         Preventing complications

ยท         Preventing recurrence

 

Medicine

ยท         Decongestants

ยท         Expectorants

 

Specific Antibiotics Used for Sinusitis

ยท         Penicillins

ยท         Amoxicillin-clavulanate (Augmentin)

ยท         Cephalosporins

ยท         Macrolides

ยท         Trimethoprim-Sulfamethoxazole

ยท         Fluoroquinolones (Quinolones)

ยท         Lincosamides

ยท         Tetracyclines

 

Corticosteroids for Chronic Sinusitis

Nasal-spray corticosteroids, most commonly called steroids, are effective drugs for treating allergic rhinitis. They also help in the treatment of chronic sinusitis and are sometimes used for acute sinusitis.

 

Antifungals for Chronic Sinusitis

Scientists are investigating whether antifungal drugs may help treat chronic sinusitis. One such drug, Amphotericin B (SinuNase), is currently in Phase III trials for patients who have had sinus surgery but are still experiencing recurrent sinusitis.

 

Surgery

When medicine fails, surgery may be the only alternative to enlarge the natural openings of the sinuses, remove nasal polyps and correct significant structural problems inside the nose. Procedures include:

ยท         Insertion of a Drainage Tube

ยท         Functional Endoscopic Sinus Surgery

ยท         Balloon Sinuplasty

ยท         Invasive Conventional Surgery

 

Other Treatments

ยท         Allergy shots (immunotherapy) to help prevent the disease from returning

ยท         Avoiding allergy triggers

ยท         Nasal corticosteroid sprays and antihistamines to decrease swelling, especially if there are nasal polyps or allergies

 

 

Side effects of modern treatment options

Side Effects of Antibiotics:

ยท         Gastrointestinal distress

ยท         Antibiotics double the risk for vaginal infections in women

ยท         Allergic reactions

 

Side Effects of Corticosteroids:

ยท         Dryness, burning, stinging in the nasal passage

ยท         Sneezing

ยท         Headaches and nosebleed

 

 

Alternative Treatment Options

Homeopathy

ยท         Allium cepa

ยท         Kali bichromicum

ยท         Sulphur

 

Hydrotherapy

Alternating hot and cold baths or compresses can be beneficial

 

Nutritional Therapy

ยท         Vitamins B6 and C

ยท         Avoid dairy products and food allergens

 

Herbal Remedies

ยท         Astragalus root

ยท         Cajeput Oil

ยท         Cayenne Pepper

ยท         Echinacea

ยท         Elderberry

ยท         Eucalyptus

ยท         Eyebright

ยท         Garlic

ยท         Myrrh

ยท         Oregon grape root

ยท         Peppermint

 

Aromatherapy

ยท         Basil Ocimum basilicum Bay (Laurus nobilis)

ยท         Cajeput (Melaleuka leukadendron)

ยท         Clove (Eugenia caryophyllata)

ยท         Eucalyptus (Eucalyptus globulus)

ยท         Helichrysum or Immortelle (Helichrysum agusifolium)

ยท         Peppermint (Mentha piperita)

ยท         Rosemary (Rosmarinus officinalis)

ยท         Tea Tree (Melaleuca alternifolia)

 

Self-care measure:

Here are some home remedies to consider when symptoms become too much to bear:

1.       Make sure to get plenty of rest

2.       Lots of Liquids: Drink decent amount of liquids, like juices and water.

3.       Avoid caffeinated beverages, which can cause a dehydrating effect.

4.       Avoid Alcohol: Alcoholic beverages can worsen your symptoms

5.       Oregano has a great deal of antiseptic value. Drinking tea containing the herb can serve as a sinus infection treatment.

6.       Treat your sinus cavities to a steam bath by draping a towel over your head and breathing in the steam from a bowl of boiling water.

7.       When taking a hot shower, breathe in the warm, moist air

8.       Sleep with you head elevated

9.       The extremely strong flavor and taste of horseradish and wasabi are known to open up and clear out the sinuses.

10.   Include pungent foods like onion and garlic in your daily diet.

11.   Boil a teaspoon of fenugreek seeds in a cup of water and drink when warm. Fenugreek leaves have long been valued as a cure for sinusitis.

12.   Tie a teaspoon of black cumin seeds in a thin cotton cloth in a pan of hot water and inhale.

13.   Heat a pan of water, add a few drops of eucalyptus oil and inhale.

14.   Eat a paste of tulsi leaves (Ocimum sanctum) and honey early in the morning.

15.   Put few drops of eucalyptus oil on your handkerchief and sniff periodically.

16.   Blow one nostril at a time. This will help prevent pressure build-up in the ears, which can send bacteria further back into the sinus passages.

17.   Apply warm wash cloth over your eyes and cheekbones. Leave it till you feel the sinus pain subsiding.

18.   Carrot and spinach juice taken regularly is also found to be highly beneficial.

 

Yoga treatment

ยท         Surya Namaskara

ยท         Pavanamuktasana

ยท         UtthanPadasana

ยท         Simhasana

ยท         Bhujangasana

ยท         Dhanurasana

ยท         Matsyasana

ยท         Shavasana

ยท         Kapal bhati pranayama

ยท         Nadi shodhan pranayama

ยท         Suryabhedi pranayama

ยท         Bhastrika pranayama

 

 

Hydration

ยท         Drinking plenty of fluids

ยท         Inhaling steam 2 - 4 times a day is extremely helpful

ยท         Nasal Wash

ยท         Neti pots