SINUSITIS

Sinuses are air filled spaces that are present in the bones of the face. The frontal sinus is located in the forehead region; maxillary sinuses are behind the cheek bones, and ethmoid and sphenoid sinuses behind the nasal bones. Among them, the most common is maxillary sinus infections, then followed by ethmoid, frontal and sphenoid. Majority of sinusitis is caused by viral infections, but bacterial are also seen. When mucus membranes lining the sinuses get irritated, they swell up. This may cause blockage of the small passages that permit the mucus to drain, and therefore secretions accumulate inside the sinuses and may cause symptoms as described below. Acute sinusitis may accompany a common cold or flu.

Causes of Sinusitis

1. Can be viral or bacterial

2. Anatomical abnormalities such as deviated nasal septum

3. Allergies resulting in nasal polyps

4. Impacted upper teeth

5. Chronic sinusitis may be caused by dust, allergy, pollution, and toxic exposure.

Symptoms
Facial pain and pain in the cheek bones are seen in maxillary sinusitis; headache and pressure over the eyes is seen in frontal sinusitis; swelling of the upper eyelids are seen in ethmoid sinusitis and pain behind the eyes are in sphenoid sinusitis. , Fever, chills and post nasal drainage of purulent discharge are also some of the symptoms. Headache is noted to be worse when the patient is leaning forward. Tooth ache may also be present because the maxillary sinuses are close to the teeth. 

Diagnosis
History and physical exam is to be done by a medical practitioner. X-ray of the sinuses may show fluid levels and haziness. CT scans provide details. Culture of the sinus after puncture may be needed to diagnose the causative organism in recurrent or resistant cases. 

Treatment
In mild or acute cases, decongestant such as pseudoephedrine and pain control may be required. Steam inhalation may also help in relieving symptoms. Decongestants should not be used for more than three days. Antihistaminics can be used to treat allergies. For severe pain and yellowish discharge, antibiotics may have to be administered. Surgery may be needed to drain sinuses and in extremely severe cases, hospitalization with IV antibiotics may be needed. In Ayurveda, 'Nasyam' is done to drain sinuses.