How common is sinusitis?
More than 120 million Indians suffer from at least one episode of acute sinusitis each year. The prevalence of sinusitis has soared in the last decade due to increased pollution, urban sprawl, and increased resistance to antibiotics.
What is sinusitis?
Sinusitis is an inflammation of the membrane lining of any sinus, especially one of the paranasal sinuses. Acute sinusitis is a short-term condition that responds well to antibiotics and decongestants; chronic sinusitis is characterised by at least four recurrences of acute sinusitis. Either medication or surgery is a possible treatment.
What are the symptoms of acute sinusitis?
Symptoms include facial pain/pressure, nasal obstruction, nasal discharge, diminished sense of smell, and cough not due to asthma (in children). Additionally, sufferers could incur fever, bad breath, fatigue, dental pain, and cough (in adults).
Acute sinusitis can last four weeks or more. It may be present when the patient has two or more symptoms and/or the presence of thick, green or yellow nasal discharge. Acute bacterial infection might be present when symptoms worsen after five days, persist after 10 days, or the severity of symptoms is out of proportion to those normally associated with a viral infection.
How is acute sinusitis treated?
Acute sinusitis is generally treated with 10 to 14 days of antibiotic care. With treatment, the symptoms disappear and antibiotics are no longer required for that episode. Oral and topical decongestants also may be prescribed to alleviate the symptoms.
What are the symptoms of chronic sinusitis?
Victims of chronic sinusitis may have the following symptoms for 12 weeks or more: facial pain/pressure, facial congestion/fullness, nasal obstruction/ blockage, thick nasal discharge/ discoloured post-nasal drainage, pus in the nasal cavity, and at times, fever. They may also have headache, bad breath, and fatigue.
What measures can be taken at home to relieve sinus pain?
Warm moist air may alleviate sinus congestion. A vaporiser or steam from a pan of boiled water (removed from the heat) are both recommended (humidifiers should have a clear filter to preclude spraying bacteria or fungal spores into the air). Warm compresses are useful in relieving pain in the nose and sinuses. Saline nose drops are safe for use at home.
How effective are non-prescription nose drops or sprays?
Use of non-prescription drops or sprays might help control symptoms. However, non-prescription drops should not be used beyond their label recommendation.
What is the best treatment for acute or chronic sinusitis?
To obtain the best treatment option, the ENT surgeon needs to properly assess the patient’s history and symptoms and then progress through a structured physical examination. During a physical examination, the ENT specialist will explore the facial features where swelling and erythema (redness of the skin) over the cheekbone exists. Facial swelling and redness are generally worse in the morning; as the patient remains upright, the symptoms gradually improve. The doctor may feel and press the sinuses for tenderness. Additionally, the doctor may tap the teeth to help identify an inflamed paranasal sinus.
Are other diagnostic procedures required?
Other diagnostic tests may include a study of a mucus culture, endoscopy, x-rays, allergy testing, or CT scan of the sinuses.
What is nasal endoscopy?
An endoscope is a special fibre optic instrument for the examination of the interior of a canal or hollow viscous. It allows a visual examination of the nose and sinus drainage areas.
Nasal endoscopy offers the ENT specialist a reliable, visual view of all the accessible areas of the sinus drainage pathways. First, the patient’s nasal cavity is anesthetised; a rigid or flexible endoscope is used to view the structure of the nasal cavity. The procedure helps observe signs of obstruction as well as detect nasal polyps hidden from routine nasal examination. During the endoscopic examination, the ENT specialist also looks for pus, polyp formation and structural abnormalities that causes recurrent sinusitis.
What is the course of treatment?
To reduce congestion, nasal sprays, nose drops, or oral decongestants may be prescribed. Antibiotics will be prescribed for any bacterial infection found in the sinuses (antibiotics are not effective against a viral infection). Antihistamines may be recommended for the treatment of allergies. Antifungal medicine will be the treatment for any fungal infection.
Are lifestyle changes required?
If the patient is a smoker, it is important to refrain during treatment. A special diet is not required, but drinking extra fluids helps thin mucus.
When is surgery necessary?
The body develops mucus to act as a lubricant. In the sinus cavities, the lubricant is moved across mucous membrane linings toward the opening of each sinus by millions of cilia (a mobile extension of a cell). Inflammation from an allergy causes membrane swelling and the sinus opening to narrow, thereby blocking mucus movement. If antibiotics are not effective, sinus surgery can correct the problem.
What does surgery involve?
The basic endoscopic surgical procedure is performed under local or general anaesthesia. The patient returns to normal within four days; full recovery takes about four weeks.
What does sinus surgery accomplish?
The surgery should enlarge the natural opening to the sinuses, leaving as many cilia in place as possible. Endoscopic surgery is highly effective in restoring normal functioning to the sinuses. The procedure removes areas of obstruction, resulting in normal flow of mucus.
What are the consequences of not treating infected sinuses?
Not seeking treatment will result in unnecessary pain and discomfort. In rare circumstances, meningitis or brain abscess and infection of the bone or bone marrow can occur.
Where should sinus pain sufferers seek treatment?
If you suffer from severe sinus pain, seek treatment from an ENT surgeon who can treat your condition with medical and/or surgical remedies.
The writers are consultant ENT surgeons based in Chennai.
source:www.hindu.com
Monday, June 25, 2007
Treating sinusitis
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