Your sinuses are four pairs of hollow spaces in your cheeks and around your eyes.
The frontal sinuses are behind the forehead; the maxillary sinuses are behind the cheeks; the ethmoid sinuses are behind the bridge of the nose; and the sphenoid sinuses are deeper in the skull behind the nose (see image below).
A membrane that produces mucus lines the sinuses. When you're healthy, the mucus is a thin, watery fluid that flows freely into the upper part of your nose. But when your sinuses become inflamed, the mucus gets thick and sticky, so it can't flow through the tiny openings that lead to the nose. Fluid builds up in the sinuses, causing pressure and pain - it's Sinusitis.
Sinusitis is an infection caused by bacteria. All of us harbor millions of bacteria in our nose, and many of us have one or more of the germs that cause sinusitis. These bacteria are harmless in the nose, and they don't even cause trouble when a few move up into the sinuses - as long as they drain back into the nose.
But if sinus drainage is blocked, the bacteria multiply and cause infection. Blockage is the main reason we get sinusitis - and good drainage is the key to treatment.
- The common cold is the leading culprit. Viruses, not bacteria, cause colds, and antibiotics are useless for treatment.
- Colds also change the mucus, preventing it from doing its normal job of trapping bacteria.
- Many other things can block your sinuses and lead to infection. The list includes allergies, cigarette smoke and other irritating fumes, changes in barometric pressure during flying or scuba diving, nasal polyps, and a deviated nasal septum.
The main symptoms of sinusitis are a runny or stuffy nose and pain and pressure in your head and face.
You may also have a yellow or green drainage or drip from your nose or down the back of your throat (Postnasal discharge).
Where you feel the pain and tenderness depends on which sinus is affected.
Other common symptoms of sinusitis may include
- A headache
- Bad breath
- A cough that produces mucus
- A fever
- Pain in your teeth
- A reduced sense of taste or smell
Sinusitis is a common problem, and most people can learn to diagnose it themselves. The Table below is a simple guide to help you tell sinusitis from colds and allergies.
Table1: Comparing Sinusitis, Cold and Allergy Symptoms
Your doctor's role
- In most cases, your doctor can diagnose sinusitis from your symptoms. If pressing over your sinuses causes pain, sinusitis is likely. If complications are suspected, or if your sinusitis is unusually severe, a CT scan is very helpful.
People with early sinusitis can recover simply by promoting drainage. Here's what to do:
- Drink lots of water : Good hydration helps keep the mucus thin and loose.
- Sleep with your head elevated : If your pain is only on one side, sleep with the pain-free side of your face on the pillow.
- Inhale steam : Stay behind in a hot shower; Boil a kettle, pour the water into a pan, and bend over the pan with a towel over your head to inhale the steam. Even hot tea or chicken soup will help; the secret ingredient is the steam. One way or another, inhale steam three to four times a day.
- Ask your doctor: about prescription nasal sprays containing steroids, particularly if you have allergies or if your sinusitis is stubborn.
- Use a salt-water nasal spray to loosen mucus and rinse your sinuses.
- Use decongestants : Tablets containing pseu-doephedrine are very helpful, but may raise your blood pressure, speed up your pulse, or make you jittery and keep you up at night. Nasal sprays containing oxymetazoline or phenylephrine don't have these side effects, but if you use them too often or too long, your nose can become irritated or dependent on them.
- Avoid antihistamines : They're great for allergies and when your nose waters from a cold, but they make mucus thick and hard to drain, the last thing you want in sinusitis.
- A warm compress on your face may soothe sinus pain.
- Over-the-counter pain relievers such as aspirin or acetaminophen will help reduce pain and fever.
If your sinusitis does not improve after two to four days of drainage therapy - or if it's very severe to begin with- your doctor will prescribe an antibotic.
Many drugs are effective, so your physician will decide what's best for you.
The sinuses are surrounded by critical structures, including the brain, the eyes, and the skull. On rare occasions, sinus infections can spread to one of these areas. Notify your doctor promptly if your sinusitis gets worse with one or more of these warning symptoms:
- High fever
- Severe headache
- Mental confusion or stiff neck
- Swelling of the cheek, forehead, or roof of the mouth
- A swollen, red, painful eye
- Impaired vision
- Difficulty breathing, swallowing, or speaking.
Fortunately, none of these problems is likely. Still, they serve to remind us that sinusitis is not just the sniffles. And patients with weakened immune systems always require careful medical evaluation and treatment for sinusitis.