SINUSITIS

The sinuses are air-conditioning spaces in the front of the skull and in the bones of the face. The most important sinuses lie above and below the eye socket and behind the bridge of the nose. They are lined by a moisture producing mucous membrane. Moisture normally drains (actually transported) unnoticed from the sinuses into the back of the nose and down the throat; this may amount to a quart or more a day. The purpose of the sinuses are to help moisturize and humidify the air we breathe. Through frequently blamed, the sinuses usually are not the cause of nasal stuffiness and headache. The older the child or adult may complain of pain over an infected sinus and ache in the back of the eye or pain in a tooth. Infections of the ethmoid sinuses cause swelling of the skin around the eye or nose. Anyone who seems to have one cold after another or a continuous cold may be suffering from a chronic sinus infection which flares up from time to time. The flare-ups may be triggered by chilling, swimming, fatigue, weather changes, or contact with allergens. With treatment, the nasal congestion and other symptoms should improve gradually over the next 14 days. A doctor may choose to culture the mucous. Sometimes an x-ray of the sinuses is made in problem cases. In some stubborn instances, the mucous in the sinus is too thick and may be washed out.


ACUTE OR CHRONIC SINUSITUS


 What is sinusitis?

Sinusitis, the inflammation of the mucous membranes in the sinuses, is a very common disorder. In general, it is caused by infection, allergies and irritation from toxic substances in the air. There are two types and you should know the difference so that you can seek appropriate medical treatment.


What are the two types?

The first is acute sinusitis. The second type, chronic or recurring sinusitis, is more complex and more common.


Do the treatments differ?

Acute sinusitis responds well to antibiotics and decongestants. If there is pus within the sinus cavity it must be drained. For chronic sinusitis, medication may be temporarily effective. If symptoms recur or persists, then a more detailed assessment is required to determine whether surgery is needed.


What type do I have?

To find out whether you have acute or chronic sinusitis, simply check the symptoms below that apply:

      • Pain in only one area

      • The sudden start of pain

      • Discoloured drainage on one side of the nose

      • Congestion (stuffiness) on one side of the nose

      • Frequent and sometimes severe headaches

      • Pressure in the head that may be intense

If you have the first four symptoms only, you probably have acute sinusitis. If your symptoms are those in the second half of the list, you probably have chronic sinusitis.


How can you be sure?

If you think you have acute sinusitis, you should see your family doctor. He or she probably diagnose your condition according to the rule of one:

      •  One area of pain

      • Drainage on one side of the nose

      • Stuffiness on one side of the nose

 If you think that you have chronic sinusitis, you should see a specialist, who will probably diagnose the problem with the help of a CT scan of the sinus cavities.

How does chronic sinusitis develop?

 Chronic sinusitis usually develops when the inflamed mucosal lining obstructs the sinus drainage. The body constantly produces mucous as a lubricant. In the sinus cavities, the lubricant is moved across tissue lining toward the opening of each sinus by millions of hair-like cilia. If one of these openings is already narrow, inflammation can cause it to swell completely shut and block the movement of mucus. Surgery may be needed to correct the problem.


What will surgery do?

 Surgery to correct chronic sinusitis performs two functions. First, it enlarges the natural opening. Since the cilia move mucous in only one direction - toward the natural opening in each sinus - creating a second opening that is not at the natural site would not help, because the cilia would simply ignore it.
Second, it leaves many cilia in place. Procedures that reduce the number of active cilia, whether by creating holes or scar tissue, block the movement of mucous and are less effective.
Endoscopic sinus surgery is the most effective procedure because it restores the flow of mucous by removing areas of obstruction. This permanently restores the normal flow of mucous and air through the natural sinus openings.


What can you expect from surgery?

A simple procedure (see header endoscopic surgery ) is usually performed under general anaesthesia, with patients returning to normal activities within a few days, and complete recovery taking about four weeks. Procedures for more complex cases can however, last longer under general anaesthesia, with the recovery process taking longer. The physician can follow up as needed according to the type and complexity of surgery.