Sinusitis

Sinusitis (also called "Rhino sinusitis") is an inflammation of the sinus membranes that can be infectious (caused by a virus or bacteria) or non-infectious (often caused by allergies).

Sinus infection, or sinusitis, is an inflammation of one or more of sinuses and nasal passages. A sinus infection can cause a headache or pressure in the eyes, nose, cheek area, or on one side of the head. A person with a sinus infection may also have a cough, a fever, bad breath, and nasal congestion with thick nasal secretions. Sinusitis is categorized as acute (sudden onset) or chronic (long term, the most common type).

If sinusitis lasts anything from a few days up to a month it's called acute sinusitis. If  sinusitis is an ongoing problem lasting three months or more have chronic sinusitis. The medical terms acute and chronic refer to how long the condition lasts for, rather than how severe it is.

Acute sinusitis is common and can affect people of any age.

Sinusitis occurs most often in the maxillary sinus area. Symptoms include facial pain, which is sometimes aggravated when stooping. There may also be purulent nasal discharge or altered facial sensations. Headache can be associated with sinusitis. Complications are rare.

Sinusitis in the ethmoid sinus area may lead to complications of the eye such as edema or cellulites of the eyelid and orbital cellulitis. Sinusitis in the ethmoid sinuses may lead to meningitis.

Sphenoid sinusitis is somewhat rare; however, the relationship of the sphenoid sinus to other organs may lead to severe complications such as pituitary insufficiency; or meningitis.

 

Causes

Sinusitis can be caused by three things:

·        Viruses.

·        Bacteria.

·        Fungi.

The same viruses that cause the common cold cause most cases of sinusitis.

When the lining of the sinus cavities gets inflamed from a viral infection like a cold, it swells. This is viral sinusitis. The swelling can block the normal drainage of fluid from the sinuses into the nose and throat. If the fluid cannot drain and builds up over time, bacteria or fungi (plural of fungus) may start to grow in it. These bacterial or fungal infections can cause more swelling and pain. They are more likely to last longer, get worse with time, and become chronic.

Nasal allergies or other problems that block the nasal passages and allow fluid to build up in the sinuses can also lead to sinusitis.

There are several types of para nasal sinuses:

·        Maxillary sinuses: These are the largest and are located underneath the eyes.

·        Frontal sinuses: These are in the frontal bone above the eyes.

·        Ethmoid sinuses: These are located in the ethmoid bone between the nose and eyes.

·        Sphenoid sinuses: These are in the sphenoid bone near the front of the skull.

Treatment

The majority of episodes of sinusitis are successfully treated without the use of antibiotics by simply treating the thick mucus and nasal swelling. Even if bacterial infection is involved, sinusitis often goes away without antibiotics. Inappropriate use of antibiotics can lead to bacterial resistance and side effects; thus these medications must be used carefully and thoughtfully. Many people can control their sinusitis with nasal washing and steroid nasal spray.

more about nasal wash in the managing section. Decongestants, antihistamines, and steroids help many people. Some people with chronic sinusitis may benefit from surgery.

Antibiotics : In some cases of sinusitis, but certainly not all, the underlying cause will be a bacterial infection. Such an infection can be difficult to treat because the bacteria thrive in the warm, moist, dark sinus cavities. These infections usually respond to antibiotic treatment, but need to continue treatment for one to three weeks or longer.

Steroid nasal spray : A prescription steroid nasal spray can decrease nasal inflammation and mucus production. This will relieve symptoms of nasal congestion and improve sinus drainage. A steroid nasal spray does not provide immediate relief of symptoms and may require several weeks of routine use to be effective. If have chronic sinusitis, may benefit from continued daily use of this medication. If have occasional sinusitis episodes, may only require periodic use. The combination of nasal wash and nasal steroid sprays can be highly effective for many patients with nasal and sinus problems.

Decongestants : These medicines, available as tablet, syrup, or nasal spray, help unblock the openings of the sinuses and temporarily reduce symptoms of nasal congestion. Common over the counter decongestants include Pseudoephedrine. Topical nasal decongestants (sprays) can be highly effective in the immediate shrinking of swollen nasal tissue. However these sprays must be used for no more than three consecutive days because more prolonged use can cause rebound nasal congestion with increased symptoms.

Antihistamines : Antihistamines are medicines designed to counter the actions of histamine, the main chemical produced in the body in allergic reactions. Antihistamines in tablet or syrup form may help reduce the allergic symptoms of sneezing and itchy eyes and nose, and may reduce mucus production.

Common over-the-counter antihistamines include:

·        Loratadine

·        Chlorpheniramine

·        Diphenhydramine

·        Desloratadine

·        Fexofenadine

·        Cetirizine

     Topical antihistamine sprays :

·        Azelastine

·        Olopatadine.

     Systemic Steroids : Systemic corticosteroids are sometimes required to treat severe nasal and sinus inflammation. They may also shrink nasal polyps. Steroids are powerful medicines that are very good at reducing inflammation and mucus production in the airways. Corticosteroids are not the same as anabolic steroids, used illegally by some athletes for bodybuilding, and do not affect the liver or cause sterility. Corticosteroids are similar to cortisol, a hormone produced by the adrenal glands in the body.

Fess :The majority of patients with sinusitis do not require surgery. However, in some patients with chronic sinusitis, the symptoms continue despite prolonged medical treatment. Surgery should only be considered when medicines have failed to improve the patient's symptoms and quality of life. The most common indications for surgery include chronic bacterial infection, nasal obstruction or blockage, and nasal polyps.

Functional Endoscopic Sinus Surgery (FESS) has become the standard technique for sinus surgery.

Steam inhalation in Sinusitis

Increased mucociliary activity has been observed with saline irrigation and steam inhalation which seems to achieve faster recovery. In patients of chronic sinusitis disease, the mucociliary activity is known to be impaired.

It is found that steam inhalation improved mucociliary activity significantly in chronic sinus patients.

Nasal inhalation of steam has been proposed as treatment of viral colds on the assumption that increased intranasal temperature will inhibit replication of rhinovirus. The steam inactivates the flu virus. Most people at home use the old fashioned way of head over a bowl of steaming hot water.
Eucalyptus oil or menthol or aromatic herbal leaves (tulsi) in steam inhalation is recommended for relieving nasal congestion and sinus congestion, usually from colds and flu. It can be done two to four times a day to relieve symptoms.

Yoga-Pranayam

The breathing exercises of yoga, especially the pranayam (Breath exercise) of Yoga opens the ducts which aids in free breath movements and cures the sinus ailment. These breath exercises free the nose and the tract of the congestion and ill effects of contamination in the environment.

Yoga rejuvenates the mind and the body. The inhalation and exhalation as a part of yoga practice creates sound vibrations which clears the nasal tract and aids in better breathing. The air movement in the nasal passage achieves free movements, this aids the lungs to function more effectively. It helps to deal with the virus that block the nasal tract and reduces the inflammation in the tract too. It helps to reduce the nasal discharge and helps to clot the mucous in the nasal cavity so that a person is cured from a runny nose.