Sinuses are air pockets that are present behind the nose, cheekbones, between the eyes and forehead. The lining of these sinuses are responsible for producing mucus, the slimy fluid that protects against foreign particles and germs from entering the body via the nasal cavity by trapping them. Inflammation of this lining can cause mucus to build-up excessively in the nasal passages which can lead to blockages, leading to bacterial and viral infection, this condition is called sinusitis. Sinusitis affects an estimated 134 Million Indians, severe and chronic Sinusitis can be debilitating and hamper the patients' quality of life.
Symptoms of Sinusitis are often indistinguishable from a common cold. If symptoms do not improve in 1-2 weeks it is necessary to consult a doctor to ensure that the infection is not aggravated.
The symptoms to watch out for are:
When viral infection caused by the common cold leads to inflammation of the nasal passage it is called acute sinusitis. The symptoms usually last around two weeks and up to four weeks. This kind of Sinusitis can also be caused by seasonal allergies such as pollen or dust.
When a Sinus infection lasts for more than 4 weeks and up to 3 months it’s called subacute sinusitis. It is recommended to meet a professional if the sinus infection lasts for more than a week.
When Sinus infection lasts longer than 3 months it’s called chronic sinusitis, this is mostly the case when patients have structural nasal problems or persistent allergies.
The common conditions that cause Sinus infection include:
The common cold: If a cold is not treated at the appropriate time, it may aggravte into a sinus infection.
Allergic Rhinitis: Also known as hay fever, this is an inflammation of the nose that occurs due to a heightened sensitivity to allergens. The symptoms include a constant running nose, itchy eyelids and watery eyes.
Nasal Polyps: These are soft painless growths in the inner lining of the nose, they are benign and non cancerous, however they could cause obstruction to drainage and lead to development of Sinus Infections.
Deviated Septum: This occurs when your nasal septum, the thin wall between your nasal passages has eviated (bent) to one side. It can be form birth or due to any injury to the nose.
Certain health conditions or risk factors can increase the chances of developing a sinus infection such as:
A Sinus headache is caused when there is a blockage and the sinuses are not drained adequately. The mucus build-up in the sinuses can lead to increased pressure sensation and pain.
Only Acute Sinus infection leads to headaches and facial pain. Generally chronic sinusitis is not associated with headache and other causes of headache such as migraine and facial pain should be investigated for. More than 80% of people with sinus headaches actually have migraines.
The first step for your doctor will be to inquire about your symptoms and your medical history. They may examine the inside of your nose to check for blockages and look for other causes and risk factors of Sinusitis.
In the case of chronic sinusitis, your doctor may recommend further tests such as a CT scan. This is done to reveal if there are any abnormalities such as a deviated septum or the development of nasal polyps which may require surgical treatment.
They may also choose to conduct a nasal endoscopy, where a camera attached to a fiber optic scope is passed through the nose. The doctor may also obtain a sample of mucus for culture testing to check for the presence of bacterial infection.
Sinus is treated based on the underlying cause of the infection and based on the seriousness of the infection your doctor may prescribe the following courses of action.
Use a humidifier - This can help to ensure that the air around you is moist and relieve nasal blockage that develops overnight.
Steam inhalation - You can also inhale steam or use a hot shower for relief. For steaming fill up a bowl with hot water and lean over it while covering yourself in a blanket to prevent steam from escaping. Initially inhale through both nostrils and then alternate between nostrils to ensure the passages are completely clear. Cough up the loose phlegm and blow your nose to get rid of the mucous causing blockage.
Essential oils - Oils like eucalyptus oil/menthol etc can provide relief as well. However they must be used with caution for only short periods of time as there is evidence that they can cause epilepsy
Jala Neti (Irrigation of nose)/saline nasal douching - Irrigating the nose using saline water is an effective home remedy for Sinusitis. Make sure to use purified water in the case of nasal irrigation to prevent the risk of contaminants.
Use a warm compress - Another go to method to clear up the nasal passages is the use of a warm towel. Placing the towel over the affected area while resting or sleeping can help loosen up the passages and provide relief.
Rest adequately - Sinusitis can be very taxing on the body especially if over a prolonged period of time. Make sure you get plenty of rest to give yourself a good chance to recover.
These medications are used to clear up the nasal passages and make it easier for mucus to drain out from the sinuses. But use caution and only use them for a short period of time (usually 5-7 days)
If Sinus infection is caused by bacterial infection, only then a course of antibiotics can improve the condition. However, if antibiotics are used indiscriminately they can lead to antibiotic resistance. Hence antibiotics should be used sparingly and only after consulting with the doctor.
If Sinus infection is caused due to seasonal allergies then using an antihistamine can resolve the problem. The Antihistamine reduces inflammation caused due to the allergen and prevents the onset of infection. Otherwise the antihistamines can dry the secretions and hamper with adequate drainage of the blocked sinuses.
Pain Remedies: Medications such as paracetamol and ibuprofen can help alleviate symptoms such as fever,headache and facial / body pain.
In the case of structural deformities such as a deviated septum or nasal polyps there might be a need forsurgical treatment.
Functional endoscopic sinus surgery
In this form of surgery, an endoscope is inserted into the nasal passageway. The doctors then use special surgical instruments to remove any kind of blockages such as nasal polyps. The procedure does not leave behind any trace of scarring. If the sinusitis reoccurs, the surgery can be repeated a few times.
This is more or less an obsolete procedure and may be done in some very specific cases. In this procedure, the surgeon creates a pathway between nose and the maxillary sinus to aid in the easy drainage of any mucus that builds up in the area. The surgery is performed by making a cut in the premolar region of the upper jaw to enter the sinus cavity. The procedure is only recommended if there is a growth inside the sinus cavity that needs to be removed.
The recovery after sinus surgery is usually quick as it is an endoscopic procedure. The doctor might insert a sterile gauze/pack into the nasal cavity to prevent any kind of bleeding after the surgical procedure. In most cases the gauze/pack that is used is dissolvable and is absorbed by the body. In case a non-dissolvable gauze is used, the doctor usually removes it in a separate procedure in a day or two after the surgery
The patients may experience nasal congestion, slight bleeding and fatigue as a result of surgery for a few days upto a few weeks after the surgery. The doctor may recommend a course of antibiotics and may also recommend painkillers and saline rinse to ensure the blockages are completely cleared and disinfected.
It’s important to consider the risks involved while undertaking any surgery. Make sure to consult with the doctor to understand all the possible risks before going ahead with your decision. Here are the possible risks and complications of Sinus surgery.
Sinus surgery can in rare circumstances lead to damaged eyesight or blindness during the procedure. This happens if the layer of bone between the eye and the nose is damaged and the eye gets injured. In rare cases, the tear ducts of the eyes can be affected leading to involuntary tearing up. There may also be cases where the muscular structure of the eye is affected leading to double vision and deterioration of eyesight.
In rare cases, the bone between the nose and the brain may be damaged during surgery and brain fluid can leak into the nasal passages. This can lead to an infection of the brain membrane called meningitis, which can potentially be fatal.
After the surgery, there may be complications where infection affects the sense of smell or taste for a short period of time. These usually resolve a few days after the procedure.
Sinus surgery is usually successful in improving airflow through the nasal passages, however, in rare cases, there may a build-up of scar tissue in the nose that leads to blockage. This will require corrective surgery at a later stage.
As with every surgery, there is a risk of bleeding after the procedure. This is usually prevented by using nasal packaging, but in case of a blood clot or excessive bleeding, there may be a need for revision surgery to remove the clot or stop bleeding.
The foods to avoid include:
Foods to include:
To reduce inflammation it is recommended to have diet that is rich in antioxidants and Omega 3 fatty acids.
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