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Friday, June 17, 2011

Sinus infection


Sinusitis

Causes, incidence, and risk factors

The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other germs. Usually, mucus is able to drain out and air is able to circulate.
When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.
Sinusitis can occur from one of these conditions:
  • Small hairs (cilia) in the sinuses, which help move mucus out, do not work properly due to some medical conditions.
  • Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.
  • A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.
Sinusitis can be:
  • Acute -- symptoms last up to 4 weeks
  • Sub-acute -- symptoms last 4 - 12 weeks
  • Chronic -- symptoms last 3 months or longer
Acute sinusitis is usually caused by a bacterial infection in the sinuses that results from an upper respiratory tract infection. Chronic sinusitis refers to long-term swelling and inflammation of the sinuses that may be caused by bacteria or a fungus.
The following may increase your risk or your child's risk of developing sinusitis:
  • Allergic rhinitis or hay fever
  • Cystic fibrosis
  • Day care
  • Diseases that prevent the cilia from working properly, such as Kartagener syndrome and immotile cilia syndrome.
  • Changes in altitude (flying or scuba diving)
  • Smoking
  • Tooth infections (rare)
  • Weakened immune system from HIV or chemotherapy

Symptoms

The classic symptoms of acute sinusitis in adults usually follow a cold that does not improve, or one that worsens after 5 - 7 days of symptoms. Symptoms include:
  • Bad breath or loss of smell
  • Cough, often worse at night
  • Fatigue and generally not feeling well
  • Fever
  • Headache -- pressure-like pain, pain behind the eyes, toothache, or facial tenderness
  • Nasal congestion and discharge
  • Sore throat and postnasal drip
Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 12 weeks.
Symptoms of sinusitis in children include:
  • Cold or respiratory illness that has been improving and then begins to get worse
  • High fever, along with a darkened nasal discharge, for at least 3 days
  • Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving








  • Sinuses

  • The sinuses are hollow cavities within the facial bones. Sinuses are not fully developed until after age twelve. When people speak of sinus infections, they are most frequently referring to the maxillary and frontal sinuses.









  • Sinusitis

    Sinusitis refers to inflammation of the sinus cavities, which are moist, hollow spaces in the bones of the skull. There are four pairs of sinuses:
    • Frontal sinuses
    • Maxillary sinuses
    • Ethmoid sinuses
    • Sphenoid sinuses (not shown in illustration)
    If the opening from a sinus cavity becomes plugged, the flow of mucus is blocked and pressure builds up, causing pain and inflammation.

Signs and tests

The doctor will examine you or your child for sinusitis by:
  • Looking in the nose for signs of polyps
  • Shining a light against the sinus (transillumination) for signs of inflammation
  • Tapping over a sinus area to find infection
Regular x-rays of the sinuses are not very accurate for diagnosing sinusitis.
Viewing the sinuses through a fiberoptic scope (called nasal endoscopy or rhinoscopy) may help diagnose sinusitis. This is usually done by doctors who specialize in ear, nose, and throat problems (ENTs).
However, these tests are not very sensitive at detecting sinusitis.
A CT scan of the sinuses may also be used to help diagnose sinusitis or to evaluate the anatomy of the sinuses to determine whether surgery will be beneficial. If sinusitis is thought to involve a tumor or fungal infection, an MRI of the sinuses may be necessary.
If you or your child has chronic or recurrent sinusitis, other tests may include:
  • Allergy testing
  • Blood tests for HIV or other tests for poor immune function
  • Ciliary function tests
  • Nasal cytology
  • Sweat chloride tests for cystic fibrosis

Treatment


SELF CARE
Try the following measures to help reduce congestion in your sinuses:
  • Apply a warm, moist washcloth to your face several times a day.
  • Drink plenty of fluids to thin the mucus.
  • Inhale steam 2 - 4 times per day (for example, sitting in the bathroom with the shower running).
  • Spray with nasal saline several times per day.

    Development
    Sinusitis usually follows a viral infection of the upper respiratory tract. The viruses damage the cells lining the sinuses, causing inflammation, swelling, and buildup of fluids that obstruct the nasal passages. The obstruction disrupts elimination of bacteria normally present in the sinus cavity. The bacteria multiply and invade the sinuses causing thick yellowish or greenish exudate. Allergens, pollutants, dryness, and chronic acid reflux create a similar effect, damaging the lining of the sinuses.
    StreptococcuspneumoniaeHaemophilus influenzae, and Moraxella catarrhalis are normally involved in acute sinusitis.Staphylococcus aureus and anaerobes are sometimes involved in chronic sinusitis. Fungi is an increasing cause of chronic sinusitis, especially in people with compromised immunity, such as with AIDS, leukemia, and diabetes.
    Ayurveda considers these pathogens opportunists taking advantage of an underlying weakness. Rather than fight the pathogen, Ayurveda considers the pathogen a symptom and addresses the deeper disease patterns that promote their growth. Disease patterns that commonly lead to infection of the sinuses include a diet or lifestyle with an excess of the following qualities:
    • Cold
    • Rough (as in lifestyle)
    • Sharp (allergens or irritants)
    • Slimy (as in mucus)
    • Dry (causing constipation or irritation)
    • Heavy (heavy food causing acid reflux)


    Proper Drainage
    Proper drainage of the sinus passages will help the bacterial infection to resolve. Since all infection involves pitta dosha and inflammation, avoid substances that clear the sinuses by further irritating them.
    1. Humidifiers make the air warm and moist, soothing the lungs and nasal passages. Inhaling steam infused with gingeror a few drops of eucalyptus oil can open up the nasal passages. Avoid dry heat.
    2. Hot baths move circulation. Heat up the room beforehand to avoid a chill when finished bathing.
    3. Vibrations from humming can help phelgm to drain.
    4. Keep the head upright to help the sinuses drain.
    5. Dry throat and lung irritation from mouth breathing can be alleviated using lemon, ginger, black pepper, honey & salty tea. Sour, salty, and sweet tastes are secretagogues, encouraging fluid secretions. Fluid secretion in the sinuses thins mucus for easy removal and also coats dry membranes.
    6. Pungents like ginger, black pepper and cinnamon break up mucus and assist expectoration. Demulcents like wild cherry bark, licorice root, and marshmallow root also assist expectoration. Sip or gargle teas made from these ingredients.
    7. For sore throats try Honey, Turmeric, Ginger, & Black Pepper Tea.
    8. Clear the nasal passages by inhaling the vapors from crushed raw onions. Just as chopping raw onions make the eyes watery, sniffing them liquefies mucus. Raw onions are also a fast acting anti-inflammatory that reduces swelling in the nasal passages when appropriate. Simply crush a 1/4" thick slice of onion in a mortar and pestle and inhale the vapors until clear.
    9. Once the nasal passages have been cleared with crushed onions, rinse them with a saline solution of 1/8tsp salt to 1c water. Use a neti pot if you have one.
  • Use a humidifier.
Be careful with over-the-counter spray nasal decongestants. They may help at first, but using them for more than 3 - 5 days can actually worsen nasal congestion.
Also, for sinus pain or pressure:
  • Avoid flying when you are congested.
  • Avoid temperature extremes, sudden changes in temperature, and bending forward with your head down.
  • Try acetaminophen or ibuprofen.
MEDICATIONS AND OTHER TREATMENTS
Antibiotics are usually not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time you or your child is sick. Antibiotics may be prescribed sooner for:
  • Children with nasal discharge, possibly with a cough, that is not getting better after 2 - 3 weeks
  • Fever higher than 102.2° Fahrenheit (39° Celsius)
  • Headache or pain in the face
  • Severe swelling around the eyes
Acute sinusitis should be treated for 10 - 14 days. Chronic sinusitis should be treated for 3 - 4 weeks. Some people with chronic sinusitis may need special medicines to treat fungal infections.
At some point, your doctor will consider other prescription medications, further testing, or referral to an ear, nose, and throat (ENT) or allergy specialist.
Other treatments for sinusitis include:
  • Allergy shots (immunotherapy) to help prevent the disease from returning
  • Avoiding allergy triggers
  • Nasal corticosteroid sprays and antihistamines to decrease swelling, especially if there are nasal polyps or allergies
Surgery to clean and drain the sinuses may also be necessary, especially in patients whose symptoms fail to go away after 3 months, despite medical treatment, or in patients who have more than two or three episodes of acute sinusitis each year. An ENT specialist (also known as an otolaryngologist) can perform this surgery.
Most fungal sinus infections require surgery. Surgical repair of a deviated septum or nasal polyps may prevent the condition from returning.

Expectations (prognosis)

Sinus infections are usually curable with self-care measures and medical treatment. If you are having recurrent attacks, you should be checked for underlying causes such as nasal polyps or other problems, such as allergies.

Complications

Although very rare, complications may include:
  • Abscess
  • Bone infection (osteomyelitis)
  • Meningitis
  • Skin infection around the eye (orbital cellulitis)

Calling your health care provider

Call your doctor if:
  • Your symptoms last longer than 10 - 14 days or you have a cold that gets worse after 7 days
  • You have a severe headache, unrelieved by over-the-counter pain medicine
  • You have a fever
  • You still have symptoms after taking all of your antibiotics properly
  • You have any changes in your vision during a sinus infection
A green or yellow discharge does not necessarily indicate a sinus infection or the need for antibiotics.

Prevention

The best way to prevent sinusitis is to avoid or quickly treat flus and colds:
  • Eat plenty of fruits and vegetables, which are rich in antioxidants and other chemicals that could boost your immune system and help your body resist infection.
  • Get an influenza vaccine each year.
  • Reduce stress.
  • Wash your hands often, particularly after shaking hands with others.
Other tips for preventing sinusitis:
  • Avoid smoke and pollutants.
  • Drink plenty of fluids to increase moisture in your body.
  • Take decongestants during an upper respiratory infection.
  • Treat allergies quickly and appropriately.
  • Use a humidifier to increase moisture in your nose and sinuses.


    sinus infection home remedy can help you in more ways than one.  The simplest sinus infection home remedy is water.   So, drink plenty of water throughout the day to cure sinus infection.  Water will help thin the mucus and thus promotes its drainage, which can relieve the symptoms of sinus infection. Many industry professionals approximate that beyond 40 million folks will be afflicted by sinusitisevery year, defining it as one of the most common health conditions in America.  That number may be appreciably larger, due to the fact the indicators of bacterial sinusitis generally imitate those of colds or allergies, and a good number of afflicted people never see a health care provider for appropriate analysis and treatment. Most try to find a sinus infection home remedy. Here is a list of Effective Sinus Infection Home Remedy
    • Sinusitis often subsides on its own and responds well to sinus infection home remedyand treatment. You can get a very effective sinus infection home remedy using items from your grocery stores.  It works and will cure your sinus infections.
    • Steaming is another effective sinus infection home remedy.  Boil water in a pan or bowl, place a towel over your head to create a “steam tent,” and inhale the steam for about ten minutes.  Be sure to pause for thirty seconds every two minutes to properly catch your breath. this is an effective sinus infection home remedy. But  you’ll also want to be careful not to get too close to the steam to avoid getting burned!  Taking a hot shower or two each day can give the same effect, as the humidity and steam will begin to break up your congestion.  A humidifier can help keep your home humid, which may also bring you some relief.
    • One can get considerable relief from sinusitis symptoms by inhaling steam from a bowl of hot water. Place a towel over your head while inhaling the steam. Steam inhalation can be done two to three times a day for about 10 minutes to get relief from sinusitis.
    • You can also use eucalyptus oil and menthol oil for natural sinus infection treatment. Just add a few drops of eucalyptus or menthol oil to a bowl of hot water, and then inhale the steam.
    • One of the most effective sinus infection home remedies is nasal irrigation. You can use saline water for this purpose, which would help to drain out the mucus and clear the nasal passages.
    • Another way to promote drainage of the mucus is to apply hot compress or a warm washcloth over the face and the sinuses. This would help to clear nasal congestion to provide quick relief to the sinuses.
    • Drink black and green tea. made with herbs like, sage, fennel, fenugreek and ginger, as well as hot soup can prove beneficial for sinus infection home remedy.
    • Garlic is known for its antibiotic properties, which make it an effective sinus infection home remedy. You can take two or three cloves of garlic daily, or chop some fresh garlic and place it in a bowl of hot water and then inhale the steam.
    • Grate some ginger or ginger root and boil it in water for 10 to 15 minutes, and strain the liquid. Now, dip a washcloth in it and place the damp washcloth on your face. You can also apply a paste of ginger on your forehead to facilitate the drainage of mucus from the nasal passages.
    • Take some dried leaves of lemon balm and steep them in hot water for a few minutes. Then strain the water and drink it or use it for gargling for natural sinus infection home remedy.
    • Mix about 2 teaspoons of apple cider vinegar in a glass of lukewarm water and drink the mixture. This sinus infection home remedy can be used twice daily for 2 to 3 days to get quick relief from sinusitis. Apple cider vinegar contains several vitamins and vital minerals such as sodium, magnesium, potassium, calcium, phosphorous, sulfur, iron and fluorine. Since the presence of acetic acid make the taste unpleasant, adding honey makes it taste better. You can make this drink by adding a tablespoon of honey and apple cider vinegar  to a glass of warm distilled water.

    Nasal passages and sinus cavities swelling connected with sinus problems can turn into incapacitating when it reaches the stage of infection. As the symptoms can resemble a cold or the flu, people do not realize an infection is involved. As soon as the trouble begins, if home remedies for sinus infection are started it works best. If sinus infection is not treated then it can spread to other parts of the body. In the following article there are tips of using salt water for sinus infection.

    Endoscopic Sinus Surgery

    The sinuses are air-filled spaces within the face and head. The lining of the nasal cavities and sinuses produces mucous. There are eight sinus cavities altogether. If the system works well, the nasal airway functions efficiently even in the presence of an upper respiratory tract infection. If the outlet tracts are blocked, mucociliary flow is impaired and symptoms prevail.

    Symptoms

    Blocked nose, facial pressure, persistent post-nasal drip and decreased sense of smell and taste are some of the presenting symptoms experienced by patients with 'sinus' problems. These symptoms may occur on their own or in conjunction with a history of allergy. Some of these patients may have co-existing illnesses like asthma and may be quite unwell on presentation. A combination of afibreoptic nasendoscope and CT scan of the sinuses is required as part of the examination and investigation for accurate diagnosis and management plan.

    Indications for surgery

    Endoscopic sinus surgery may be done for either medical or surgical conditions.
    1. Medical conditions
    Examples of these are episodes of recurrent acute sinus infections which present with the above symptoms in conjunction with fever. Each episode may resolve with optimised medical treatment but if frequency and longevity are present with time off work, surgery is an option. The other main example is that of bilateral nasal polyposis. Again after optimisation of medical treatment, if nasal obstruction persists and especially in the case of asthmatics if asthma control is becoming difficult, surgery is an option to control the airway.
    2. Surgical conditions
    Examples of these are nasal tumours, unilateral nasal polyps (polyps on one side of the nose only).

    What is endoscopic sinus surgery?

    The outflow tracts of the sinuses are opened to enable drainage and ventilation of the sinuses. This is done through the nose and fibreoptic telescopes are used. The image is magnified by the use of a monitor and this allows precise application of the instruments.
    The actual sinuses that have to be targeted would have been previously decided during the consultation. A septoplasty may need to be done first to gain access to the sinuses and to remove any other pathology.

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