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DEALING WITH SINUSITIS ByDr Douglas Street

Published:Tuesday | September 1, 2015 | 9:00 AM

Sinusitis is a fairly common condition. Most of us either have it or know someone with it. It not only annoys those with it, but also those who have to be around them. What is it, though, and what can we do about it?

The para-nasal sinuses are the ones that will be focused on. These are air-filled pockets in the skull. They are connected to the nasal passage by small holes with which they share the same type of lining. Their presence reduces the weight of the skull; moistens and warms the air in the nasal passage; gives resonance to our voices; insulates the nearby structures (for example, eyes and nerves); and absorbs some of the force from facial trauma.

There are four sets: the frontal sinus (in the forehead); the maxillary sinus (in the cheeks); the ethmoid sinus (between the eyes); the sphenoid sinus (behind the ethmoid sinus).

Sinusitis is inflammation of the sinuses. This inflammation may be due to allergy, irritation, or infection. When they are inflamed, the secretions they produce become thick and may block the small holes that connect them. The secretions continue to be produced, and this builds up pressure in the sinuses and this may cause discomfort or even pain.

Sinusitis may be acute (of recent onset and temporary duration, usually four weeks or less) or chronic (more than four weeks). It may be contributed to by smoking, tumours which block the connections, or a weakened immune system (AIDS). The infections that may cause it may be bacterial, viral, or fungal.

Sinusitis may cause facial pressure, headache, and fever. It may also cause a thick green or yellow discharge that comes out through the nose or down the throat. It can also cause reduced sense of smell, bad breath, and pain in the teeth of the upper jaw. When it is due to allergy, the discharge may be clear.

The presence of the symptoms mentioned above may help in the diagnosis of sinusitis. There may also be tenderness over the maxillary and/or frontal sinuses. X-rays may help but are unreliable, so a CT or MRI scan may be necessary.

Antihistamines (for example, DPH) with or without decongestant may be used to treat the congestion. If a bacterial infection is present, then an antibiotic will be necessary. If it's caused by allergy, then a steroid nasal spray would help. Surgery may also be necessary.