The sinuses are small cavities that are filled with air and are located above, in between, and below the eyes. They are connected to the inside of the nose through small tubes that are supposed to ventilate the sinuses and drain any mucus or secretions that accumulate within the sinuses.
What could go wrong with the sinuses?
The sinus trouble begins when small openings that drain into the nose and throat get blocked. This is usually caused by minor viral infections, allergy, or exposure to environmental irritants.
The blockage will then lead to accumulation of secretions within the sinuses, which act as a perfect culture for bacteria to grow. This in turn leads to more swelling and inflammation leading to further closure of these tubes that connect the sinuses into the nose. If this is not adequately treated it might turn into a chronic low-grade infection causing symptoms that might persist from a few months to a few years.
What are the symptoms of sinusitis?
Blocked nose, persistent drainage, facial & periorbital pain. Other symptoms include loss of sense of smell & taste, intermittent sore throat & cough due to post nasal drip and excessive tearing of eyes.
How do we make diagnosis?
The diagnosis is usually based on patient’s symptom description & simple office examination for new cases. If the condition had lasted for a few months, and did not respond to initial treatment, or if the diagnosis is in question, then more studies are needed. There are two important tests, the first one is examination of the inside of the nose using a small endoscope that is inserted into the nose in the clinic to examine the tubes connecting the sinuses to the nose. The other important test is an x-ray called CAT scan of the sinuses which shows clearly the inside of the tubes connecting the nose to the sinus.
How do we treat sinuses?
The focus of treatment is to restore the ability of the tubes to ventilate and drain the sinuses.
The treatment of sinusitis, may involve several approaches:
- Topical steroid nasal sprays to reduce the swelling and promote drainage
- Antibiotic therapy to cure the infection responsible for the fever, pan, blockage
- Pain medication as needed
It is important that you follow your doctor’s order and finish the course of antibiotics and nasal spray even though you may feel better after a few days. This is necessary to cure the underlying infection.
Surgery for sinuses
There are cases where nasal sprays do not open the tubes connecting the sinuses to the nose and CAT scan shows severe obstruction that requires surgery. This is usually performed through the endoscope with the help of a shaver that opens p the tubes connecting the sinuses to the nose.