Sinus Ailments

The sufferers are many and vocal.

Sinus headaches, sinus trouble, sinus medicine.  Year-round, people complain of stuffy noses, congestion, and drainage, all of which they attribute to troublesome sinuses.  But, sinusitis is more than just a stuffy nose.  It's unlikely to go away by itself.  Confusing matters further are the numerous methods of treatment, from simple over-the-counter medications to endoscopic sinus surgery.

In a normal person, the nose and sinuses produce large amounts of secretions daily (between a pint and a quart of mucus).  This passes into and through the nose, washing the membranes and picking up dust particles and air pollutants.  Then, the mucus flow back into the throat, where it's swallowed.  In the stomach, acids destroy the dangerous bacteria.

But, when nasal passages secrete more than normal, due to allergies, smoke, viral infections, or air pollution, you may begin to notice "postnasal drip."  Though usually clear and watery, it can become thick and sticky mucus due to too-dry air.  Bacterial infections can also produce a thick, sticky mucus with pus in it (usually yellow or green in color).

Sinusitis refers to infection or inflammation of the sinuses.  Often, it starts with a cold or flu, which causes swelling of the nasal membranes and increased mucus.  The membranes become so swollen that sinus openings become blocked.  Abnormal pressure and/or builds up, resulting in a pressure pain in the forehead or face, between the eyes, or in the cheeks and upper teeth.

Causes of sinusitis include viral infection, allergy, anatomic defects, and air pollution.  Sinus infection comes in two types: acute (severe) and chronic (ongoing) sinusitis.  If a cold gets worse, acute sinusitis may develop, and acute sinusitis can lead to chronic sinusitis.

It's important to know that sinusitis is more than just a stuffy nose and thus, won't go away by itself, in most cases.  Many patients don't realize that it's not simply the remnants of a recent cold or hay fever bout.  As a result, they may fail to seek medical attention until they are very sick, usually a week or two after the initial cold or allergy attack seals off the sinus cavities.  You may have a fever, cough, and large quantities of infected mucus.

People with chronic sinus infections may complain of having a continuous cold.  Symptoms are nasal congestion, facial pressure, bad breath, chronic sore throat, cough, and decreased or no sense of smell.

A third of cases include sinus pain - a throbbing that gets worse when you bend over.  Pressure in the maxillary sinuses in the cheeks may masquerade as a toothache.  Normal flow of mucus - postnasal drip - can spread the infection to the bronchi and lungs and may trigger asthma attacks, promote bronchitis, chronic cough, or pneumonia.

A blocked sinus cavity filled with mucus is a good place for bacteria to grow.  And if a cold lasts more than a week, or when mucus turns yellow/green, bad-tasting, or foul-smelling, this may well be the case.

Fortunately, most cases of sinusitis respond quickly to treatment.  However it's important to see your otolaryngologist; an infection in the sinus is close to the eye and the brain.  If allowed to spread, it could affect your vision or even your life.

Treatment varies.  Infections may require antibiotics, surgery, or both.  Acute sinusitis usually responds well to medication.

And what if surgery is necessary?  Technological advances in endoscopic procedures allow doctors to diagnose and treat sinus disorders readily and effectively.  Thanks to new and improved instrumentation, your doctor can perform sinus surgery in a way that's simpler, more exact, and requires less recovery time.  He will place a lighted telescope inside your nose to magnify the area, which means greater precision.

© 2004 AAO-HNS/AAO-HNSF