Sinuses are air-filled pockets present in the facial bones behind the eyebrows, cheeks and jaws Sinusitis is inflammation of these sinuses which causes dull to throbbing pain and pressure in the head and around the eyes and cheeks. It often follows a cold or viral infection.
- Constant allergic cold
- Infections due to viruses, bacteria and sometimes fungi
- Changes in air pressure or temperature
- Deviated nasal septumor nasal polyps
- Reduced immunity
- Pacifiers and drinking from a bottle while lying on the back can lead to sinusitis in children
- Breach in the lining of the sinuses due to extensive tooth infections/root canals/dental surgeries
- Irritation of the sinuses from smoking and alcohol
- Acute sinusitis – sudden onset of cold-like symptoms and lasts 4 weeks or less. Generally caused by a bacterial infection from an upper respiratory tract infection.
- Subacute sinusitis – inflammation lasting 4 to 8 weeks
- Chronic sinusitis – symptoms lasting 8 weeks or longer. Caused by bacteria or a fungus or as a result of allergy to airborne allergens.
- Recurrent sinusitis – several attacks within a year
Signs and symptoms
Both acute and chronic sinusitis have the same symptoms. But the symptoms of chronic sinusitis tend to be milder and last longer than 12 weeks. Symptoms may include:
- Facial pain/pressure
- Nasal obstruction/blockage
- Thick, green, or yellow nasal discharge
- Cough/congestion, often worse at night
- Sore throat
- Reduced smell and taste sensation
- Severe headache
- Bad breath and dental pain
Diagnosis of sinusitis is based on symptoms and through physical examinations like looking for presence of nasal polyps, trans illumination for signs of inflammation, etc. Presence of two or more symptoms and/or the presence of thick, green, or yellow nasal discharge is diagnosed as acute sinusitis. Other tests that may be recommended are:
- Computed tomography (CT) scan
- Nasal endoscopy or rhinoscopy
To diagnose chronic or recurrent sinusitis, other tests may include:
- Allergy testing
- Ciliary function tests
- Nasal cytology
- Blood tests for HIV or other tests for poor immune function
- Sweat chloride tests for cystic fibrosis
Treatment of sinusitis involves swelling reduction, infection eradication and sinus draining.
- steam inhalation
- saline nasal spray
- plenty of rest
- increasing fluid intake
- increasing indoor moisture level
- using humidifiers at home
- Analgesics – to reduce fever and relieve headache, toothache, and facial pain
- Decongestants –to help drain sinuses
- Antihistamines – to relieve acute sinusitis symptoms caused due to of allergies
- Nasal corticosteroid sprays to decrease swelling, especially if there are nasal polyps
- Antibiotics –for bacterial sinus infections with severe symptoms that don’t improve with self-care treatment or with complications (such as pus formation in sinus cavities).
- Allergy shots (immunotherapy) to help prevent the disease from returning.
Functional endoscopic sinus surgery (FESS) is the standard surgical treatment for sinusitis. This surgery removes anatomical and pathological obstructions associated with sinusitis. Septoplasty is the surgical treatment to straighten a deviated septum. Cadwell-Luc operation is used for managing maxillary sinusitis, secondary to persistent oro-antral fistula and also when longer-lasting drainage is necessary. Surgery may be considered in the following cases:
- Antibiotics and other medicines are not effective in opening the sinus
- Structural abnormality of the sinus such as nasal polyps, deviated nasal septum, etc. obstruct sinus drainage
- Presence of signs of infection that has spread beyond the nasal sinuses into the bone, brain, or other parts of the skull
- Fungal infection
- Infection due to an abnormal communication (oro-antral fistula) between the oral cavity and the maxillary sinus resulting from foreign body or extruded root canal filling in the sinus
4) Alternate therapies
- The understanding of a disease in Ayurveda is based on three doshas – kapha, pitta, and vata. Kapha is the transporter of fluids. Phlegm is associated with kapha dosha. Vata is the transporter of air and energy. The accumulation of phlegm in the sinus area disturbs vata which disturbs transport of air in the lungs and sinuses. Pitta is the transporter for substances of metabolism. Kapha and vata doshas along with ama (undigested or partially digested food that circulates in the body as toxins) cause an imbalance in pitta. Hence in sinusitis there is an excess of kapha, disturbance of vata and imbalance in pitta. Ayurveda advises panchakarma treatment to treat sinusitis. Special form of cleansing called nasya with medicated oil and dhoopam (steam inhalation) with turmeric can help reduce sinusitis.
- Homeopathic remedies help restore body’s immunity which helps ward off the symptoms and remove the root cause. They relieve sinus congestion and inflammation thereby relieving pain and pressure. Homeopathic approach eliminates the susceptibility to allergy and in turn, inhibits recurrent infections. The number of attacks and their frequency are reduced.
- Acupuncture therapy uses needles to stimulate key healing points and meridians. Upon stimulation, these acupoints promote blood circulation and encourage the body’s natural self-healing abilities. This healing art describes sinusitis as dampness which creates inflammation and congestion in the mucus membranes. The dampness is cleared by strengthening the spleen meridian and by working with the stomach meridian.
- In Yoga, kriyas (postures) such as jala nethi can help treat and prevent sinusitis.
Very rarely, sinusitis may lead to various complications like:
- Bone infection (osteomyelitis)
- Skin infection around the eye (orbital cellulitis)