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Sinusitis
What is Sinus?
There are 10 pairs of Sinuses in the Head, located around the nose, and are opened into the nose through small openings. These Sinuses are nothing but "air filled Spaces" within the bony structure of the face. One pair is located above the nose (Frontal Sinus), another on either side of the nose (Maxillary Sinus) and three pairs behind the nose (Anterior and Posterior Ethmoid Sinus and Sphenoid Sinus)
What is the use of Sinus?
Sinuses are nothing but air filled chambers within the facial bones that makes the head lighter. Air filled Sinuses will act as resonators to add quality to the voice. In severe facial injuries these Sinuses will collapse and absorb the force of impact. So the Sinuses will protect the important facial structures and BRAIN.
What is Sinusitis?
All the Sinuses open into the nose through their openings called "Sinus Ostea". The air will be flowing from the nose in and out of the Sinus through these Ostea. When these openings are blocked due to any nasal problems like Deviated Septum, Nasal Mass, Polyps, Allergy etc., the air entry into the Sinuses will be affected. Then the vacuum will be created. This vacuum is nothing but a "NEGATIVE PRESSURE". This Negative Pressure sucks the tissue fluids from the inner Sinus coverings into the Sinus cavity. Due to the blockage of the Sinus openings the fluid will stagnate in the Sinus and gets infected to develop Sinus infection.
What is Nasal Polyp?
The "NEGATIVE PRESSURE" created inside the Sinus will suck the tissue fluids from the Sinus Inner mucosal layers, in the beginning stage. Later the negative pressure increases and sucks the inner mucosal layers also into the Sinus cavity. These layers will become thick and occupies the entire Sinus cavity. Then the tissue comes out into the Nose through the Sinus openings as a MASS. The thickened mucosal layers and the tissue fluid within the layers together forms smooth and round mass very much look like grapes and are called "POLYPI".
Complaints of sinusitis:
Facial pain & Headache are the most common complaints.
Nasal discharge.
Nasal block.
Bad breathe.
Nasal congestion, sneezing and fever.
Post - Nasal drip.
Recurrent throat infection.
Tiredness, lethargy, mild body pains, Neck pain etc.,
For children, they may develop high fever and sometimes eye swelling.
When to see a Specialist?
If the cold associated with heaviness of the head or facial pain, thick nasal discharge and three or more other complaints given above are persisting even after two weeks of regular medical treatment, one should consult an ENT specialist.
Complications:
Chronic Sinus disease can lead to allergic response in the lungs - "SINO BRONCHIAL ALLERGY" and later Lung infection.
Sinusitis and Nasal Polypi will facilitate FUNGAL GROWTH. This fungal disease can destroy the bony partitions and spread into the EYES and BRAIN.
In children the infection can spread into eyes and brain easily. The child will be presenting with high fever. Sometimes they may develop semi or unconscious state and convulsions. If not properly treated at this stage the infection can be dangerous to the life of the child.
Treatment of Sinusitis:
Depends on whether it is acute or chronic.
Severity of the problem.
Acute Sinusitis:
Bacteria, virus, allergies and environmental irritants can cause acute Sinus problem. An anti-biotic and oral decongestant medicine is the treatment of choice. This treatment is advisable when there is pain in the checks or upper back teeth. When there is greenish or yellowish pus discharge from the nose, when the symptoms gets worse instead of being better after the common cold is gone.
Don'ts
Avoid prolonged use of Nasal Spray or drops. Instead you can use saline drops or steam inhalation to reduce the discomfort.
Chronic Sinusitis:
Chronic Sinusitis usually occurs due to some physical obstruction to the Sinus openings. The surgical treatment is the ideal one for the chronic problems. First of all we have to confirm the cause, severity and extent of the problem to plan the surgical treatment.
Nasal Endoscopy and C.T Scan of the Sinuses are essential to identify the key areas of correction and to avoid major interventions. So that the radical surgeries can be avoided and limited procedures like correcting the key areas can do wonders. These limited surgical procedures are called as "Functional Endoscopic Sinus Surgeries (FESS)".
Sinusitis - FESS:
Now a days due to advanced technology and skill any gross disease involving Sinus, orbit and brain can be effectively treated by using Sinus Endoscopes, Sinus Shaver systems, Operating Microscopes and Laser Technology. By this combined approach technology we can operate meticulously, precisely in the bloodless field without damaging the normal tissues.
Endoscopic Sinus Surgery Sinus Polyp After removal with Debridor
The Results
Good results requires not only good skills and technology but also the combined efforts between the patients and the surgeon through out the healing process. Postoperative Follow-up is very important.
Prevention of Sinuses Problems:
Keeping away from allergens. In my experience the most important avoidable allergens are tomatoes, green chilies, brinjal, banana, fish and Air pollution.
Drinking plenty of water will help to keep nasal secretions thin.
Never blow the Nose to clear the Nasal discharge. One can pull the Nasal discharge into the throat by sucking in from the back of the nose.
Using prescribed nasal decongestants tablets for short courses.
Precautions for Air Travel:
When there is Sinus infection using prescribed Nasal spray or Nasal decongestant tablets during air travel can prevent Ear pain and ear damage by preventing Eustachian block.
Symptoms to be noted with caution
Chronic / Prolonged Nasal block or Nasal discharge.
Long-standing headache above and between eyes.
Heaviness of the head while bending forward.
Neck pain and back pain along with Sinus problem.
Sleep disturbances and daytime sleepiness.
Lack of interest and concentration in the work.
Getting tired than usual and laziness even after working 2 to 3 hours.
These symptoms cause no worry if they exist for a short period. But if they are prolonged you must consult a specialist.
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