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Sinusitis
OVERVIEW
You're coughing and sneezing and tired and achy. You think that you might be
getting a cold. Later, when the medicines you've been taking to relieve the symptoms
of the common cold are not working and you've now got a terrible headache, you
finally drag yourself to the doctor. After listening to your history of symptoms,
examining your face and forehead, and perhaps doing a sinus X-ray, the doctor
says you have sinusitis.
Sinusitis simply means your sinuses are infected or inflamed, but this gives
little indication of the misery and pain this condition can cause. Health care
experts usually divide sinusitis cases into
- Acute, which
last for 3 weeks or less
- Chronic, which usually
last for 3 to 8 weeks but can continue for months or
even years
- Recurrent, which are
several acute attacks within a year
Health care experts estimate that
37 million Americans are affected by sinusitis every
year. Health care providers report nearly 32 million
cases of chronic sinusitis to the Centers for Disease
Control and Prevention annually. Americans spend millions
of dollars each year for medications that promise relief
from their sinus symptoms.
http://www.niaid.nih.gov/factsheets/sinusitis.htm
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SYMPTOMS
The location of your sinus pain depends on which sinus is affected.
- Headache when you wake up in the
morning is typical of a sinus problem.
- Pain when your forehead over the frontal
sinuses is touched may indicate that your frontal sinuses are inflamed.
- Infection in the maxillary sinuses can
cause your upper jaw and teeth to ache and your cheeks to become tender
to the touch.
- Since the ethmoid sinuses are near the
tear ducts in the corner of the eyes, inflammation of these cavities often
causes swelling of the eyelids and tissues around your eyes, and pain between
your eyes. Ethmoid inflammation also can cause tenderness when the sides
of your nose are touched, a loss of smell, and a stuffy nose.
- Although the sphenoid sinuses are less
frequently affected, infection in this area can cause earaches, neck pain,
and deep aching at the top of your head.
Most people with sinusitis, however, have pain or tenderness
in several locations, and their symptoms usually do not clearly indicate
which sinuses are inflamed.
Other symptoms of sinusitis can include
- Fever
- Weakness
- Tiredness
- A cough that may be more severe at night
- Runny nose (rhinitis) or nasal congestion
In addition, the drainage of mucus from the sphenoid
or other sinuses down the back of your throat (postnasal drip) can cause
you to have a sore throat. Mucus drainage also can irritate the membranes
lining your larynx (upper windpipe). Not everyone with these symptoms, however,
has sinusitis.
On rare occasions, acute sinusitis can result in brain infection and other
serious complications.
http://www.niaid.nih.gov/factsheets/sinusitis.htm
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SOME CAUSES OF ACUTE SINUSITIS
Most cases of acute sinusitis start with a common cold, which is caused by a
virus. These viral colds do not cause symptoms of sinusitis, but they do inflame
the sinuses. Both the cold and the sinus inflammation usually go away without
treatment in 2 weeks. The inflammation, however, might explain why having a cold
increases your likelihood of developing acute sinusitis. For example, your nose
reacts to an invasion by viruses that cause infections such as the common cold
or flu by producing mucus and sending white blood cells to the lining of the
nose, which congest and swell the nasal passages.
When this swelling involves the adjacent mucous membranes
of your sinuses, air and mucus are trapped behind the narrowed
openings of the sinuses. When your sinus openings become
too narrow, mucus cannot drain properly. This increase
in mucus sets up prime conditions for bacteria to multiply.
Most healthy people harbor bacteria, such as Streptococcus
pneumoniae and Haemophilus influenzae , in their upper
respiratory tracts with no problems until the body's defenses
are weakened or drainage from the sinuses is blocked by
a cold or other viral infection. Thus, bacteria that may
have been living harmlessly in your nose or throat can
multiply and invade your sinuses, causing an acute sinus
infection.
Sometimes, fungal infections can cause acute sinusitis.
Although fungi are abundant in the environment, they usually
are harmless to healthy people, indicating that the human
body has a natural resistance to them. Fungi, such as Aspergillus
, can cause serious illness in people whose immune systems
are not functioning properly. Some people with fungal sinusitis
have an allergic-type reaction to the fungi.
Chronic inflammation of the nasal passages also can lead
to sinusitis. If you have allergic rhinitis or hay fever,
you can develop episodes of acute sinusitis. Vasomotor
rhinitis, caused by humidity, cold air, alcohol, perfumes,
and other environmental conditions, also may be complicated
by sinus infections.
Acute sinusitis is much more common in some people than
in the general population. For example, sinusitis occurs
more often in people who have reduced immune function (such
as those with primary immune deficiency diseases or HIV
infection) and with abnormality of mucus secretion or mucus
movement (such as those with cystic fibrosis).
http://www.niaid.nih.gov/factsheets/sinusitis.htm
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CAUSES OF CHRONIC SINUSITIS
It can be difficult to determine the cause of chronic sinusitis. Some investigators
think it is an infectious disease but others are not certain. It is an inflammatory
disease that often occurs in patients with asthma. If you have asthma, an allergic
disease, you may have chronic sinusitis with exacerbations. If you are allergic
to airborne allergens, such as dust, mold, and pollen, which trigger allergic
rhinitis, you may develop chronic sinusitis. An immune response to antigens in
fungi may be responsible for at least some cases of chronic sinusitis. In addition,
people who are allergic to fungi can develop a condition called "allergic
fungal sinusitis." If you are subject to getting chronic sinusitis, damp
weather, especially in northern temperate climates, or pollutants in the air
and in buildings also can affect you.
If you have an immune deficiency disease or an abnormality
in the way mucus moves through and from your respiratory
system (e.g., primary immune deficiency, HIV infection,
and cystic fibrosis) you might develop chronic sinusitis
with frequent flare-ups of acute sinusitis due to infections.
In otherwise normal individuals, sinusitis may or may not
be infectious. In addition, if you have severe asthma,
nasal polyps (small growths in the nose), or a severe asthma
attacks caused by aspirin and aspirin-like medicines such
as ibuprofen, you might have chronic sinusitis.
http://www.niaid.nih.gov/factsheets/sinusitis.htm
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PREVENTION
Although you cannot prevent all sinus disorders—any more than you can avoid
all colds or bacterial infections—you can do certain things to reduce the
number and severity of the attacks and possibly prevent acute sinusitis from
becoming chronic.
- You may get some
relief from your symptoms with a humidifier, particularly
if room air in your home is heated by a dry forced-air
system.
- Air conditioners help
to provide an even temperature.
- Electrostatic filters
attached to heating and air conditioning equipment
are helpful in removing allergens from the air.
If you are prone to getting sinus disorders, especially if you have allergies,
you should avoid cigarette smoke and other air pollutants. If your allergies
inflame your nasal passages, you are more likely to have a strong reaction
to all irritants.
If you suspect that your sinus inflammation may be related
to dust, mold, pollen, or food—or any of the hundreds
of allergens that can trigger an upper respiratory reaction—you
should consult your doctor. Your doctor can use various
tests to determine whether you have an allergy and its
cause. This will help you and your doctor take appropriate
steps to reduce or limit your allergy symptoms.
Drinking alcohol also causes nasal and sinus membranes
to swell.
If you are prone to sinusitis, it may be uncomfortable
for you to swim in pools treated with chlorine, since it
irritates the lining of the nose and sinuses.
Divers often get sinus congestion and infection when water
is forced into the sinuses from the nasal passages.
You may find that air travel poses a problem if you are
suffering from acute or chronic sinusitis. As air pressure
in a plane is reduced, pressure can build up in your head
blocking your sinuses or eustachian tubes in your ears.
Therefore, you might feel discomfort in your sinus or middle
ear during the plane's ascent or descent. Some health experts
recommend using decongestant nose drops or inhalers before
a flight to avoid this problem.
http://www.niaid.nih.gov/factsheets/sinusitis.html
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