Sinuses General ~ Causes ~
Acute Sinuses ~ Treating Sinuses ~
Non drug Remedies ~
Sinus Surgery ~ Sinusitis in Children ~ Signs of Sinusitis ~
Treatment
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The Sinuses
Sinusitis is an inflammation or infection of the air pockets on either side of and behind the nose. It can be caused by bacteria, viruses, fungi (molds) and possibly by allergies. About 15-20 % of the population has a chronic sinusitis (meaning lasting longer than 3 weeks). It can cause a tremendous amount of suffering.
Sinusitis causes a wide variety of symptoms which can often be confused with other medical problems or dismissed as being due to a "cold". There may commonly be single symptoms such as a post nasal drip, stuffiness, or pressure around the nose, but can also be a combination of the these symptoms associated with a runny nose, clear or colored mucus, a cough, a sore or irritated throat, pain in the teeth, headache, or fever. Additional symptoms which sometimes occur are hoarseness, a decreased sense of smell, and fullness of the ears, but they can be extremely varied as you will see in the FAQ section.
Sinus infections must first be diagnosed accurately, and then subsequently need to be treated with antibiotics, and prescription nasal sprays, as well as decongestants and often medications to thin the mucus. I also suggest that people use a vaporizer at night, and occasionally nasal irrigation, as well as Aspirin (if you can tolerate it), and I am sure that your friends and relatives will attempt to force you to take all kinds of non-drug remedies. Believe me, it gets overwhelming . We will try to sort it out for you.
If sinus infections are not treated early, they may become chronic. Early means no later than 2-3 weeks after the symptoms first start - the cold that lingers may not be just a cold. The longer you wait to treat sinus problems, the more difficult they become to treat, the more likely complications will ensue, and the more likely surgery may be necessary as opposed to medical treatment.
What causes sinusitis?
Sinusitis is caused by anything that blocks sinus drainage or prevents cilia from sweeping properly. Predisposing factors for acute sinusitis include:
Chronic sinusitis (as well as recurrent and lingering acute sinusitis) can stem from the same factors associated with acute sinusitis. The following often are found in chronic sinusitis:
Acute or chronic?
Acute sinus infections may last from 2 to 3 weeks or can linger for as long as 12 weeks. In some instances, acute sinus infections may recur more than several times a year. You may have acute sinusitis if you have one or more of the following signs and symptoms:
Although the signs and symptoms for chronic sinusitis are similar to acute sinusitis, they may not be as apparent, so you may not even know you have a sinus infection. However, you may experience episodes of sudden worsening.
"If a person suspects that they have sinusitis, it's important that they seek medical attention," says James T. Li, M.D., an allergy specialist at Mayo Clinic, Rochester, Minn. "Acute sinusitis may require treatment with antibiotics. Chronic sinusitis should be investigated and treated aggressively. Sometimes, people have an allergy and it's not sinusitis at all. Allergy tests will be able to determine that."
What other non drug remedies can be used?
Many patients will report that breathing in eucalyptus oils will help open the nose.
Steam rooms are also often helpful.
Patients often report that after a hot shower their nose seems to open up and they are more comfortable.
Some patients also report help with garlic. Some patients who stuffed garlic cloves up their nose!!.
Irrigation, saline nasal sprays, and other medications can be helpful
Remember if you choose to use these non drug treatments, they must be used in conjunction with prescription medication in order to avoid serious complications.
How long does sinusitis have to be treated?
Because of the fact that we are dealing with an abscess which can not be adequately drained without doing a major surgical procedure, it often takes an extended period of time for the sinus infection to be completely treated by what we can call medical drainage. Some physicians often will only treat patients with sinus infections for a week or ten days and as a result patients are partially cured, but never get complete relief of symptoms. It is critical that treatment occur for a minimum of two to three weeks, and commonly patients may need to be treated for several months. We commonly continue non- antibiotic treatment after stopping antibiotics. If patients don't get better, it is important for them to be evaluated for surgery by an otolaryngologist.
Sinus Surgery
When medical management fails, sinus surgery is recommended. There is more than one surgical option available, depending on the surgeon, the indications, and the sinuses affected. Some surgeries require external incisions, some require incisions under the upper lip and others involve work within the nasal cavities only.
The technique commonly used at present involves intranasal work with the help of fiberoptic telescopes. The telescopes allow better visualization thanks to modern lenses that permit angular vision and thus provide access to areas that were previously not accessible through the intranasal approach. The telescopes also allow the application of the increasingly popular Functional Endoscopic Sinus Surgery (FESS). This technique consists of removing obstructing tissue in a key area of the nose where the commonly involved sinuses drain. The removal of the abnormal tissue restores ventilation and drainage of the sinuses, and therefore their well-being.
Patients opting for a surgical intervention may expect the following:
Hospitalization: Surgery takes around one to two hours, using local or general anesthesia. An overnight hospital stay may be required, along with a nasal packing. Post-operative pain usually is not very bothersome.
Follow-up: Patients should plan on at least two post-operative visits at approximately weekly intervals. During these visits, a local anesthetic is sprayed inside the nose to allow proper cleaning. Plastic implants, if used, also are removed. Usually, patients may resume activities that do not involve physical strain in several days. Physical exercise should be deferred for a couple of weeks.
Possible Complications: As in all surgeries, complications may happen, but they rarely do. General complications include bleeding, fever, infection, pain, and possibly, failure to achieve the anticipated results. Specific complications due to the location of the sinuses may include smell disorders, eye disorders, and central nervous system complications. These complications are very rare and may be managed successfully when recognized early.
Sinusitis in Children
Sinusitis is the inflammation of one or more of the sinuses that drain into the nose. Everyone has four sets of sinuses. In children, the ethmoid sinuses are most commonly affected.
A common cold may start a sinus infection. Also, unusual little things such as a peanut, a raisin or a bead pushed into the nose may cause a nasal infection.
When an infection begins, the lining of the sinuses may become swollen blocking the passage where normal sinus mucous drains. This results in a back up of mucus which can not get out. When this mucous remains in the sinus too long it can become infected.
Signs of Sinusitis
Many of the signs of childhood sinusitis are the same as the common cold. When the symptoms of a cold last longer than seven or ten days it is time to consider a sinus infection. Common sinus infection symptoms include:
How will doctor know if sinusitis is my child's problem?
Often your doctor is able to diagnose sinusitis from your description of the problem. Sometimes your physician will need an X-ray (CAT scan) of the sinuses to exactly identify the problem.
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Treatment
Antibiotics are the primary medication for the treatment of sinusitis. Other medications include:
It is very important to finish all of the medication even if the symptoms of the infection seem to have gone away.
Sometimes the medications do not completely clear away the infection. The child then requires a re-evaluation. It is very important for you to keep in contact with your physician. Your child depends on you.
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