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Sinusitis:- Acute& Chronic Sinusitis, Sign & Symptoms, Causes, Diagnosis, Prevention, Treatment, General Care, Home Remedies of Sinusitis

Sinus infections afflict about 37 million Americans every year. Sinusitis is so widespread that Americans with the problem miss an average of four work days a year. There are over 500,000 sinus surgeries performed each year.

Sinusitis is the medical term for inflammation (irritation and swelling) of the sinuses. Sinusitis is inflammation of the sinuses. If the mucous membrane lining the nose becomes congested and swollen, the tiny openings into"the sinuses become blocked, and no air can get in or out. These are ideal conditions for germs to multiply within the sinuses, resulting in si­nusitis.

Sinuses are air pockets that are located in your face - the cheek area under your eyes, between your eyes, just behind your nose, and in your forehead. The sinuses are attached to the nasal passages via small tubes, which allow drainage to take place. When these small tubes become blocked, sinus problems begin. Sinusitis occurs when bacteria infects the sinus cavities, usually due to blockage of the small tubes attached to your nasal passages. This causes an inflammation of your sinuses, which stops proper drainage.

Types of Sinusitis

Acute Sinusitis :- Acute sinusitis is much more common in certain patients than in the general population. For example, sinusitis occurs more often in patients with reduced immune function (such as patients with immune deficiencies and HIV infection) and with abnormality of mucus secretion or mucus movement (such as cystic fibrosis and diseases of abnormal cilia [Kartagener's syndrome]).

Chronic Sinusitis :- Allergies are frequently associated with chronic sinusitis. Patients with asthma have a particularly high frequency of chronic sinusitis. Inhalation of airborne allergens (substances that provoke an allergic reaction), such as dust, mold, and pollen, often set off allergic reactions (allergic rhinitis) that, in turn, may contribute to sinusitis. People who are allergic to fungi can develop a condition called "allergic fungal sinusitis."

Sign & Symptoms of Sinusitis

The main symptom of sinusitis is a throbbing pain and pressure in the face, which is worse bending forwards.

• Frontal sinusitis can cause pain above your eyebrows, and your forehead may be tender to touch.
• Maxillary sinusitis can cause your upper jaw, teeth and cheeks to ache and may be mistaken for toothache.
• Inflammation of the ethmoid sinuses can cause pain around and between your eyes and the sides of your nose.
• Inflammation of the sphenoid sinus can cause you to ache behind your eyes, at the top of your head or in your temples. You may also have earache and neck pain.
• a stuffy or runny nose with a daytime cough that lasts for 10 to 14 days without improvement
• mucus discharge from the nose (this can occur with both viral and bacterial sinusitis but continuous thick discharge is more likely to be from bacterial sinusitis)
• persistent dull pain or swelling around the eyes
• tenderness or pain in or around the cheekbones
• a feeling of pressure in your head
• a headache when you wake up in the morning or when bending over
• bad breath, even after brushing your teeth
• pain in the upper teeth
• a fever greater than 102 degrees Fahrenheit (39 degrees Celsius)

In older children and teens, the most frequent symptoms of sinusitis are a daytime dry cough that doesn't improve after the first 7 days of cold symptoms, fever, worsening congestion, dental pain, ear pain, or tenderness in the face. Sometimes teens who have sinusitis also develop upset stomachs, nausea, headaches, and pain behind the eyes.

Causes of Sinusitis

Sinusitis results from the congestion of the sinus passages due to cold, coryza or fever. It is caused by over-secretion of mucus in the mem­branes lining the nose, throat and head. This over-secretion is due to irritation caused by tox­ins in the blood. Other conditions that may cause sinus problem are dental infection and a change in atmospheric pressure such as during air travel.A faulty diet is another cause of sinus trouble. When a person consumes certain types of foods or drinks regularly, these, in due course, have a conditioning effect on the entire system. As a result, some persons become more sensitive tocertain allergens, whose reaction ultimately turns into sinusitis.

The sinuses are four sets of hollow spaces that are located in the cheekbones, the forehead, behind the nasal passages, and deep in the brain. Sinuses are lined with the same mucous membranes that line the nose and mouth. 

When a child gets a cold or allergies, and the nasal passages become swollen and make more mucus, so do the sinus tissues. The drainage system for the sinuses can get blocked, and mucus can become trapped in the sinuses. Bacteria, viruses, and fungi can grow there and lead to sinusitis.

Sometimes, fungal infections can cause acute sinusitis. Although these organisms are abundant in the environment, they usually are harmless to healthy people, indicating that the human body has a natural resistance to them. Fungi, such as Aspergillus, can cause serious illness in people whose immune systems are not functioning properly. Some people with fungal sinusitis have an allergic-type reaction to the fungi.

Chronic sinusitis is often difficult to treat successfully, as symptoms persist even after prolonged courses of antibiotics. In general, the treatment of chronic sinusitis, such as with antibiotics and decongestants, is similar to treatment of acute sinusitis. However, the role of bacterial infections, and hence the usefulness of antibiotics in treating chronic sinusitis, is debated. Steroid nasal sprays are commonly used to reduce inflammation in chronic sinusitis. Although these nasal sprays are occasionally used for long-term treatment for patients with chronic sinusitis, the long-term safety of these medications, especially in children, is not fully understood, and the benefits and risks need to be balanced. For patients with severe chronic sinusitis, a doctor may prescribe oral steroids, such as prednisone. Because oral steroids can have significant side effects, they are prescribed only when other medications have not been effective.

Chronic inflammation of the nasal passages (rhinitis) also can lead to sinusitis. Allergic rhinitis or hay fever (discussed below) may be complicated by episodes of acute sinusitis. Patients with allergic rhinitis also often have chronic sinusitis. Vasomotor rhinitis, caused by humidity, cold air, alcohol, perfumes, and other environmental conditions, also may be complicated by sinus infections.

Diagnosis of Sinusitis

Sinusitis is most often diagnosed based on a history and examination made by your doctor. Because plain x-ray studies of the sinuses may be misleading and procedures such as CT scans and MRI scans, which are much more sensitive in their ability to diagnose sinusitis, are so expensive, most cases of sinusitis are initially diagnosed and treated based on clinical findings on examination. These physical findings may include redness and swelling of the nasal passages, purulent (pus like) drainage from the nasal passages, tenderness to percussion (tapping) over the cheeks or forehead region of the sinuses, and swelling about the eyes and cheeks. If sinusitis fails to respond to the initial treatment prescribed, then more in depth studies such as the above scans may be performed. Rhinoscopy, a procedure for directly looking in the back of the nasal passages with a small flexible fiber optic tube, may be used to directly look at the sinus openings and check for obstruction of these openings by either swelling or growths. It may sometimes be necessary to perform a needle aspiration of a sinus to confirm the diagnosis of sinusitis, and to get infected material to culture to determine what bacteria is actually causing the sinus infection. Cultures of the nasal passages are rarely helpful in determining what bacteria or fungus is causing a sinus infection.

Prevention in Sinusitis

You can lower your risk of getting sinusitis by making some simple changes in your home environment. Try using a humidifier during cold weather to stop dry, heated air from irritating your sinuses, which can make them more susceptible to infection. Clean the humidifier regularly because mold, which can trigger allergies in some people, forms easily in moist environments.

Although sinusitis itself is not contagious, it is often preceded by a cold, which can spread easily, particularly among family or friends. The most effective way to prevent germs from spreading is to teach your child the importance of frequent hand washing, particularly when he or she has a cold.

Treatment of Sinusitis

Acute sinusitis can usually be treated with home treatments and over-the-counter medicines.Breathing in steam from a bowl of hot water containing a few drops of aromatic oil (eg Olbas oil or Karvol) can bring relief, although you should be careful not to scald yourself with the hot water.Taking ibuprofen or paracetamol may help to relieve pain and lower your temperature if you have a fever.Decongestants, such as pseudoephedrine (eg Sudafed), may reduce swelling in your nose and allow your sinuses to drain. Decongestant nasal sprays are also available but you should not use them for more than three days, as prolonged use can actually make nasal blockage worse in the long run.

Some doctors recommend gently flushing out the nose, using a syringe and a glass of warm water with a teaspoon of salt added. This can dislodge some mucus in the nose and sinuses, and bring some relief. An alternative is to use pre-filled squeeze bottles, which are available from pharmacies.Nasal sprays containing steroids such as beclometasone (eg Beconase) are available over-the-counter and on prescription from your doctor. They can help to reduce swelling of the nasal lining and open up the drainage holes.If your chronic sinusitis is caused by an allergy, nasal sprays can also reduce inflammation. Antihistamine tablets such as loratidine (eg Clarityn), which you can buy without a prescription, may also help. In severe cases, your doctor may recommend a short course of steroid tablets but these are only available on prescription.Some doctors recommend gently flushing out the nose, using a syringe and a glass of warm water with a teaspoon of salt added. This can dislodge some mucus in the nose and sinuses, and bring some relief. An alternative is to use pre-filled squeeze bottles, which are available from pharmacies.

When medical treatment fails, surgery may be the only alternative for treating chronic sinusitis. Studies suggest that the vast majority of patients who undergo surgery have fewer symptoms and better quality of life. 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. This type of surgery is less invasive than conventional sinus surgery and serious complications are rare.

General home care in sinusitis

• If you are allergic to dust, dirt, smoke etc., wherever you go, your allergic sensitivity will follow you and diseases like Sinusitis will not leave you free.
• The only thing you can do is to keep yourself away from these substances. In spite of such precautions, sinusitis may visit again and again. Here are a few tips that you can follow in your house.
• Mix Amrutanjan, Vicks that contains Eucalyptus and Menthol in a basin of hot steaming water. Cover the head with a towel, bend down on the vessel and inhale the steam deeply with the nose.
• If your nose gets stuffy while you are in office, get a cup of very hot tea or coffee, bend down on the cup, keep your palms on either side of your face and inhale the steam deeply. You may have some relief.
• Mix one teaspoonful of table salt and a pinch of baking soda in two cups of lukewarm water and suck the water with your nose. Keep your head a little bent backwards, block one nose with your thumb, breathe in with the other nose so that the water goes inside and then blowout this nose gently. Repeat the operation with the another nose. This makes the thick mucus to come out.
• Drink a lot of water-hot or cold. This makes the thick mucus thin and come out.
• If you blow nostrils at the same time, pressure in the ear increases and bacteria may go back further inside beyond the sinuses. So, blow only one nose at a time.
• Many types of nasal drops are available. One or two drops of such medicines into your nose will make the mucus thin and then it comes out easily. But, such drops will give only temporary relief and they should not be continuously used.
• When the nose is blocked, apply pressure on both sides of the nose with your thumbs for about 15-30 seconds. Repeat it for a few times. Blood will flow into these parts causing relief.

Home Remedies of Sinusitis

Tomato Juice Add 1 cup tomato juice, 1 tsp chopped fresh garlic, 1/2 tsp of hot sauce, 1 tsp lemon juice, and a pinch or two of celery salt for flavor. Heat ingredients and drink hot.

Peppermint A little peppermint tea is very good for relieving sinus problems.

Eucalyptus Boil ½ cup of water and add a few drops of oil of eucalyptus. Pour the mixture into a bowl, lean over it while covering your head with a large towel, and inhale the steam for 10 minutes, keeping your eyes tightly shut. Eucalyptus oil is widely used for various breathing problems.

. Put a few drops on a handkerchief and sniff periodically.

Salt/baking soda  To relieve stuffed up sinuses due to allergies, try making this nasal flush: mix 1/4 teaspoon of salt and 1/4 teaspoon of baking soda in one cup of warm water; fill an ear syringe and squirt the mixture up your nose. Another variation uses one teaspoon of uniodized salt and 1/2 teaspoon of baking soda dissolved in a pint of water. Place the mixture in a nasal inhaler.

Thyme has been used for generations for respiratory infections because of its strong antiseptic properties. Steep 1-2 teaspoons of thyme in a cup of boiling water for 10 minutes. Drink a cup three times a day. Thyme is a drying herb for the body.