Sinusitis

Sinusitis, or inflammation of the sinuses, is an exceedingly common problem, affecting millions of Americans of all ages. The nasal sinuses consist of eight air pockets in the bones around the nose, cheeks, and eyes. These cavities are lined with mucous glands, which keep the passages moist. Sinusitis develops when these passages become inflamed and swollen, usually due to an infection or allergic response.

Most sufferers complain of a feeling of congestion accompanied by a headache and perhaps a runny nose. The nature of the headache varies according to which sinuses are affected. Inflammation of the maxillary sinuses, those situated below the eyes and on either side of the nose, can cause facial pain, toothache, and a frontal headache. A blockage in the frontal sinuses, located in the forehead, also produces a headache in that area. A so-called splitting headache and pain behind the eyes point to inflammation of the ethmoid sinuses, which are located on either side of the eyes and just over the nose. In addition to a headache, there might be visible swelling in the area over the affected sinus.

Sinusitis may be acute or chronic; acute attacks are more likely to be due to an upper respiratory infection, while chronic sinusitis is often caused by allergies, although many people who have it do not suffer from them. Dental abscesses or infections are responsible for about 25 percent of chronic maxillary sinusitis. Infectious agents that can cause acute sinusitis include strains of streptococci, pneumococci, staphylococci, and Haemophilus influenzae bacteria as well as some viruses.

Diagnostic Studies and Procedures

Diagnosis is usually based on the patient's description of the symptoms and a physical examination of the sinus areas. The mucous membranes of the nose may also be red and swollen and nasal discharge may be greenish-yellow or tinged with blood. X-rays are sometimes ordered, but they often fail to find any abnormality because swollen mucous membranes usually are not visible on film. A CT scan may produce better results, but is not necessary as a rule. In a few cases, dental X-rays will be taken if an abscess is suspected of causing the sinusitis. A laboratory culture of the nasal discharge may also be ordered. This facilitates identification of any infecting organism.

Medical Treatments

Antibiotics are used to fight the underlying infection. They will probably be prescribed for 10 to 12 days; it is important to complete the full course of antibiotics, even if symptoms of sinusitis have already disappeared. Otherwise, the infection may recur. Chronic sinusitis is most often treated with ampicillin or tetracycline, which may be needed for four to six weeks to eradicate the underlying infection. Nasal sprays may be prescribed to shrink swollen membranes and ease congestion, but should not be used for more than a week. In severe cases or when some deformity of the sinus passages is contributing to the problem, surgery to correct the abnormality, drain the sinuses, and remove infected material may be necessary.

Alternative Therapies

Aromatherapy. Therapists recommend inhalation of eucalyptus, peppermint, basil, or lavender oils to help clear blocked sinuses. This can be done by putting about 10 drops of the oil on a handkerchief and inhaling from it. A more effective means is to bring a pot of water to a boil, add a few drops of the aromatic oil after removing the water from the heat, and then inhale the steamy vapors that rise from it.

Herbal Medicine. A capsule containing a mixture of echinacea, goldenrod, goldenseal, and marshmallow may be prescribed. Herbalists also recommend taking garlic, which is considered a natural antibiotic, and drinking teas or infusions made of mullein, fenugreek, red clover, rose hips, or a combination of anise and horehound.

Homeopathy. A wide variety of homeopathic remedies may be used, with kalibi, Pulsatilla, ignalia, and thuya often suggested.

Self-Treatment

Over-the-counter decongestants are sometimes helpful, but they should not be taken for longer than a week. Use them only as directed; these drugs should be avoided if you have high blood pressure, glaucoma, diabetes, heart disease, and certain other chronic conditions. Also, do not take cold or allergy pills containing antihistamines, since they dry up the sinus mucus and interfere with drainage.

Blow your nose gently; blowing too hard can worsen the problem by forcing mucus into the sinus cavities. To help clear nasal and sinus passages, some doctors recommend a daily nasal wash.This can be done by filling a nasal syringe with warm, salty water and drawing it into one nostril at a time.
Placing a warm compress over your forehead or taking a hot, steamy shower can provide temporary relief. Keep air moist by using a misting vaporizer.
Drink plenty of fluids, especially steamy bullion and other hot liquids, to help thin mucus. Eating hot, spicy food such as chilies or horseradish also may help clear congested sinuses.

Other Causes of Sinus Symptoms

A cold or other upper respiratory infection can cause congestion, headache, and other symptoms similar to those of sinusitis. Head pain from muscle tension and other causes should also be ruled out when making a diagnosis.