The sinuses are hollow spaces in the bones behind the face. Directly behind the nose is a cavity. On either side of the nasal cavity are large sinuses. A row of very small sinuses runs behind the bridge of the nose, and two more large sinuses are located above and behind the inner part of the eyebrows.
Sinusitis is inflammation of the sinuses. It may be associated with both bacterial and viral infections, but it may be due to non-infectious inflammation in the sinuses as well.
It's extremely common, affecting about one person in 10 each year, both children and adults.
Sinus symptoms are very common during a cold or the flu, but in most cases they are due to the effects of the infecting virus and resolve when the infection does. It is important to differentiate between inflamed sinuses associated with cold or flu virus and sinusitis caused by bacteria.
The sinuses produce mucus that helps us clean the nose and to smell. It's moved out of the sinuses and into the nasal cavity by thousands of tiny hairs, called cilia, which operate in unison to form a sort of conveyor belt. Foreign particles and organisms entering the sinuses land in the mucus and are sent back to the nose, away from danger. To get to the nose, the mucus has to pass through small holes in the bones that surround the sinuses.
Sinusitis usually begins during a common cold, influenza (flu), or some other viral infection. This causes the nasal mucous membrane (which is soft tissue inside the nose, not simply mucus) to swell. It can press against the hole through which mucus leaves a sinus. The sinus fills with mucus and empties of oxygen, creating an ideal setting for bacteria to grow.
The bacteria are often already in the nose, but don't cause any symptoms. Humans are typically infested by organisms that are held in check by the body's natural defences. If something goes wrong with the defensive system, they can cause medical problems like sinusitis.
Apart from viral infections, anything that inflames the nose can cause sinusitis. Hay fever, for example, increases your chances of getting sinusitis.
People with diabetes, cystic fibrosis, or AIDS are at increased risk, as are those who have had their nose broken previously and those who were born with a malformed septum (the dividing wall between the nostrils).
Website Disclaimer - for educational purposes only
The signs and symptoms that are associated with the diagnosis of sinusitis include one to two of the following:
- Nasal congestion and discharge that typically is thick and becomes yellowish to yellow-green
- Facial pain, pressure, congestion, or fullness (that is also accompanied by other symptoms of sinusitis)
- Symptoms that continue for 10 days or more after the start of a cold or flu
- Symptoms worsen after 5 - 7 days, or return after initial improvement in a cold (called double sickening)
- Reduced or absent sense of smell
- Fever, although should also be accompanied by other symptoms of sinusitis
Other symptoms of sinusitis that usually occur in adults include one to two of the following:
- Eyes may be red, bulging, or painful if the sinus infection occurs around the eyes
- A persistent cough (particularly during the day)
- Ear pain, pressure, or fullness
- Halitosis (bad breath)
- Dental pain
However, many studies have shown that symptoms used to diagnose sinusitis often do not predict prognosis or response to antibiotic treatment.
Sneezing, sore throat, and muscle aches may be present, but they are rarely caused by sinusitis itself. Muscle aches may be caused by fever, sore throat by post-nasal drip, and sneezing from cold or allergies.
Rare complications of sinusitis can produce additional symptoms, which may be severe or even life threatening.
Symptoms Indicating Medical Emergency
- Increasing severity of symptoms
- Swelling and drooping eyelid
- Loss of eye movement (possible orbital infection, which is in the eye socket)
- Vision changes
- Pupil fixed or dilated
- Symptoms spreading to both sides of face (may indicate blood clot)
- Development of severe headache, altered vision
- Mild personality or mental changes (may indicate spread of infection to brain)
- A soft swelling over the bone (may indicate bone infection)
Bacteria are the most common direct cause of acute sinusitis. (Other organisms might be the infecting cause in less common cases.) The ability of bacteria or other organisms to infect the sinuses, however, must first be set up by conditions that create a favorable environment in the sinus cavities. Sinusitis is most often an acute condition, which is self-limiting and treatable. In some cases, however, the inflammation in the sinuses is lasting, or is chronic do begin with. The causes for such chronic sinusitis cases are sometimes unclear.
Upper Respiratory Infections
The typical process leading to acute sinusitis starts with a flu or cold virus. Over 85% of people with colds have inflamed sinuses. These inflammations are typically brief and mild, however, and only between 0.5 - 10% of people with colds develop true sinusitis. Instead, colds and flu set the stage by causing inflammation and congestion in the nasal passages (called rhinitis ), leading to obstruction in the sinuses. This creates a hospitable environment for bacterial growth, which is the direct cause of sinus infection. In fact, rhinitis is the precursor to sinusitis in so many cases that expert groups now refer to most cases of sinusitis as rhinosinusitis.
Rhinosinusitis tends to involve the following sinuses:
- The maxillary sinuses (behind the cheekbones) are the most common sites.
- The ethmoid sinuses (between the eyes) are the second most common sites affected by colds.
- The frontal (behind the forehead) and sphenoid (behind the eyes) sinuses are involved in about a third of cold-related cases.
Nearly everyone with colds has inflamed sinuses. These inflammations are typically brief and mild, however, and most people with colds do not develop true sinusitis.
Conditions That Cause Chronic or Recurrent Sinusitis
Chronic or recurrent acute sinusitis typically results from one of the following conditions:
- Untreated acute sinusitis that results in damage to the mucous membranes
- Chronic medical disorders that cause inflammation in the airways or persistent thickened stagnant mucus (such as diabetes, AIDS, other disorders of the immune system, hypothyroidism, cystic fibrosis, Kartagener's syndrome, and Wegener's granulomatosis)
- Structural abnormalities
- Allergic reaction to fungi
Chronic or recurrent acute sinusitis can be a lifelong condition.
Inflammatory Response, Allergies, and Asthma
The absence of bacterial organisms as factor in many cases suggests that some instances of chronic sinusitis may be due to a continuing inflammatory condition. Many of the immune factors observed in people with chronic sinusitis resemble those that appear in allergic rhinitis, suggesting that sinusitis in some individuals is due to an allergic response.
Allergies, asthma, and sinusitis often overlap. Those with allergic rhinitis (so-called hay fever and rose fever) often have symptoms of sinusitis, and true sinusitis can develop as a result of the mucus blockage it causes. A causal association, however, has not been proved, and many experts believe allergies themselves rarely predispose to sinusitis. People with chronic sinusitis may also have an allergic reaction to fungal organisms.
Abnormalities of the Nasal Passage
Abnormalities in the nasal passage can cause blockage and thereby increase the risk for chronic sinusitis. Some abnormalities include:
- Polyps (small benign growths) in the nasal passage block mucus drainage and restrict airflow. Polyps themselves may be consequences of previous sinus infections that caused overgrowth of the nasal membrane.
- Enlarged adenoids can lead to sinusitis.
- Cleft palate
- Deviated septum (a common structural abnormality in which the septum, the center section of the nose, is shifted to one side, usually the left.
While fungi are an uncommon cause of sinusitis, the incidence of such infections is increasing. At least 5 - 10% of chronic rhinosinusitis patients may actually have allergic fungal sinusitis.
Many patients with chronic sinusitis may be colonized with fungi, but this does not necessarily mean the patient has a fungal infection causing their symptoms. Studies suggest that some people who suffer from chronic sinusitis have an immune and inflammatory response to fungi and may benefit from anti-fungal treatment.
Fungi involved in sinusitis include:
- Aspergillus is the most common cause of all forms of fungal sinusitis.
- Other fungi include Curvularia, Bipolaris, Alternaria, Dreschslera, Cryptococcus, Candida, Sporothrix,Exserohilum, and Mucormycosis.
- There have been a few reports of fungal sinusitis caused by Metarrhizium anisopliae, which is used in biological insect control.
There are four categories of fungal sinusitis:
- Acute or invasive fungal sinusitis. This infection is most likely to affect people with diabetes and compromised immune systems.
- Chronic or indolent fungal sinusitis. This form is generally found outside the U.S., most commonly in the Sudan and northern India.
- Fungus ball (mycetoma). This fungal sinusitis is noninvasive and occurs usually in one sinus, most often the maxillary sinus.
- Allergic fungal sinusitis. This form typically occurs because of an allergy to the fungus Aspergillus (rather than being caused by the fungus itself). In such cases, a peanut butter-like fungal growth occurs in the sinus cavities that may cause nasal passage obstruction and the erosion of the bones.
Fungal infections can be very serious, and both chronic and acute fungal sinusitis require immediate treatment. Fungal ball is not invasive and is nearly always treatable.
Fungal infections should be suspected in people with sinusitis who also have diabetes, leukemia, AIDS, or other conditions that impair the immune system. Fungal infections can also occur in patients with healthy immune systems, but they are far less common.
If you find yourself prone to them, using a neti pot regularly is the number one home remedy for sinus infections. This link also contains instructions on how to use it. They are a great natural remedy for sinus infections.
If you do not get sinus infections regularly, then having a neti pot on hand is still a REALLY important part of treating a stuffy nose when you are sick. It's also for treating a sinus infection should you get one. Using a neti pot helps keep your nasal passages healthy with all the pollution, pollen, dust and other irritants in the air.
By the way, the non-iodized salt you have in your kitchen is all you need to use in it.
Garlic has the same chemical found in a drug given to make mucus less sticky. This is a wonderful natural antibiotic and detoxifier which protects the body against infection by enhancing immune function.
Cayenne Peppers contain Capsaicin, a substance that can stimulate the nerve fibers and may act as a natural nasal decongestant.
Running a cold-mist machine in your bedroom will keep your nasal and sinus passages from drying out.
Steam is effective in curing sinusitis. It opens the nasal passage by draining the sinuses and making mucous flow easy.
Gargling with salted lukewarm water is beneficial in treating sinusitis. For this, add a pinch of salt in a glass of lukewarm water and gargle with it.
Bathe your nostrils daily. To flush out stale nasal secretions use a commercial saline product or mixing 1 teaspoon of table salt with 2 cups of warm water and a pinch of baking soda. Pour it into a shot glass, tilt your head back, close one nostril with your thumb, and sniff the solution with the open nostril. Then blow your nose gently. Repeat on the other side.
Blow one nostril at a time. This will help prevent pressure buildup in the ears, which can send bacteria further back into the sinus passages
If you have suggestions or know of a proven home remedy add it here in the comment area.
Anise, tea helps break up congestion.
Cat's Claw, relieves inflammation, and fights bacterial infection.
Elderberry, helps loosen congestion.
Sipping hot teas made with herbs such as fenugreek, fennel, anise, or sage may help move mucus even more.
Boil a tsp of Fenugreek seeds in half a glass of water, until the decoction reduces to half. Consuming 3 to 4 cups of this tea would help in expelling all the toxins, increasing the perspiration rate and thereby reducing fever, along with sinusitis.
Eucalyptus - This is a fragrant herb that soothes sore throats. It also has antiseptic properties and can help shrink swollen tissues such as swollen sinus passages. It is readily available in throat lozenges, which are a convenient way to take it. You can also drink eucalyptus tea. It is very helpful to steep some eucalyptus in a large pot of boiling water and use as an inhalant to unblock nasal passages.
Peppermint - The anti-inflammatory properties of peppermint help to calm mucous membranes. You may drink peppermint tea or steep the peppermint and breathe in the steam. The scent of peppermint when inhaled helps to ease your breathing.
Echinacea - Echinacea helps boost the immune system and makes it function better. It has been known to kill some viruses of the respiratory system. Take in capsule form. Increase the dosage at the onset of illness and decrease after several days. Do not take if you have an allergy to ragweed.
Licorice - The root of this herb helps reduce inflammation and stimulates the immune system to fight sinus infections. There are two types of licorice products. Be sure to take licorice capsules that boost the immune system and not those for treating ulcers.
If you have suggestions or know of a proven herbal remedy add it here in the comment area.
The best way to prevent sinusitis is to avoid colds and influenza. If you are unable to avoid them, the next best way to prevent sinusitis is to effectively treat colds and influenza.
Good Hygiene and Preventing Transmission
Colds and flu are spread primarily when an infected person coughs or sneezes near someone else. A very common method for transmitting a cold is by shaking hands. Everyone should always wash their hands before eating and after going outside. Ordinary soap is sufficient. Waterless hand cleaners that contain an alcohol-based gel are also effective for every day use and may even kill cold viruses. (They are less effective, however, if extreme hygiene is required. In such cases, alcohol-based rinses are needed.) Antibacterial soaps add little protection, particularly against viruses. In fact, one study suggests that common liquid dish washing soaps are up to 100 times more effective than antibacterial soaps in killing respiratory syncytial virus (RSV), which is known to cause pneumonia. Wiping surfaces with a solution that contains one part bleach to 10 parts water is very effective in killing viruses.
Influenza Vaccine. Vaccines against influenza use inactivated (not live) viruses. Because influenza viruses change from year to year, influenza vaccines are redesigned annually to match the anticipated viral strains. Experts recommend that people receive annual influenza vaccinations in October or November. People who should definitely be vaccinated include: all adults 65 years or older; children age 6 months to 5 years; other adults or children who are at high risk for developing serious medical complications from influenza; health care workers and others who care for individuals who are at high risk for influenza complications. However, annual influenza vaccination is safe and appropriate for all children older than 6 months and adults.
Notice: This site has been created purely for educational purposes only. It is not our purpose to offer or render medical advice or professional services. If you feel that you have a health problem, you should seek the advice of a certified Physician or health care Practitioner. If you have information that may help us improve this site please contact us immediately. If there is information on this site that infringes on copyrighted material please advise us. The information on this site is made up of student and website visitor submissions. For more information please read the full Website Disclaimer Notice.