Sinus

Where are the sinuses? 

 

The sinuses are paired air-filled spaces within the bones of the face and skull. The sinuses are not fully formed until 12 years or older.

There is one located in the cheek bone, beneath each eye (maxillary sinus), a honeycomb of sinuses between the eyes (ethmoid sinuses), a sinus in the very back of the nose (sphenoid sinus) and in older children, sinuses in the bones of the forehead (frontal sinuses).

 
 
What is sinusitis? 
 

By definition this means inflammation of the sinuses. Such inflammation can be due to multiple causes including infection, allergies, exposure to chemicals or fumes, and even reflux. Other causes can include anatomic blockages that keep the sinuses from draining properly. Such abnormalities include a deviated septum, nasal polyps, and rarely nasal tumors or other rare conditions such as immune deficiency or cystic fibrosis.

 

Once blockage of the sinuses occurs the natural drainage pathway can no longer allow natural mucus flow within the nose. At this point, the perfect environment exists for bacteria to take over causing even more inflammation and the typical symptoms of sinusitis.

What are the symptoms of sinusitis? 

 

Symptoms include congestion, thick nasal drainage, headaches, and cough. Other symptoms may include post-nasal drip, facial swelling, bad breath, and vague behavioral changes. Sometimes it can be difficult to tell the difference between sinus infection, a common cold, or nasal allergy. Typically a cold will only last a week to 10 days, whereas a sinus infection may last longer. And while allergy can also cause nasal congestion and a runny nose typically allergies have clear watery secretions, itchy watery eyes and nose, and often a longer duration. Allergies may change with the season or geographic location.

How can you help diagnosis sinusitis? 

 

Looking closely into the type and duration of symptoms and a physical exam are the tools that are often most useful to your doctor. When necessary a closer look with an endoscope in the nose or possibly a CT scan may be needed.

How can sinusitis be treated? 

 

Depending on the root cause of the problem, medications are usually prescribed. These can be in the form of oral medications or nasal sprays. In addition, the use of nasal saline washes/sprays can be especially helpful. If all attempts at controlling sinus infections with medications fail, sinus surgery may be helpful.

Are there any dangers associated with sinusitis? 

 

Yes, but fortunately these are very uncommon. Rarely a sinus infection can spread to the soft tissue around the eye (orbital cellulitis), to the bones of the face (osteomyelitis), or even the tissue and fluid surrounding the brain (meningitis or brain abscess). High fevers, stiff neck, or a bulging eye can all be danger signs that should be evaluated immediately.

The following are useful fact sheets regarding sinusitis in children:

 
What is Nasal and Sinus Disease?

 

Sinus and allergy disease affects nearly one quarter of all Americans and leads to significant impairment of life's quality, loss of participation in activities and work, and costly efforts seeking over-the-counter and prescription remedies. The Sinus and Allergy division of CENTA was developed in 1991 to provide a center of advanced care for patients who suffer from problems related to their sinuses, allergies and breathing.

Although antihistamines, decongestants and nasal sprays provide temporary relief from occasional allergy, nasal and sinus symptoms they may not be the best solution for long-term and effective control. It is preferable to find the potentially elusive causes of the symptoms and eliminate them. Although there are a large number of causes, they often produce similar symptoms. Chronic infections caused by viruses, bacteria or fungus cause headaches, congestion, drainage and fatigue, but only bacteria respond to antibiotics.

Although seasonal allergies lead to sneezing, itching and watery drainage, year-round mold or food allergies can create symptoms that are similar to infections. Exposure to irritants such as smoke, chemicals and pollution can trigger congestion, drainage, pressure or headaches. Thorough review of symptoms, environmental exposures, dietary patterns, responses to therapy, examination and prudent testing enable the doctors at Sinus & Allergy Center to develop a treatment strategy that can relieve or solve persistent respiratory symptoms.

Symptoms

 

Symptoms of an irritated respiratory tract can be divided into primary and secondary. The primary symptoms are:

  • Congestion or the feeling of blockage or obstruction in the nose or sinuses

  • Drainage, which can be cause the nose to run, course through the back of the throat, or be produced by coughing

  • Pressure or the sensation of fullness in the nose or sinuses

  • Headaches, which can occur anywhere in the head or neck

Secondary symptoms result from the inflammation affecting the body or communicating structures such as the ears, throat, voice box, or lungs. These symptoms are:

  • Fever, usually low grade

  • Fatigue, lack of energy or desire

  • Migraines, often begin with sinus pressure or headaches

  • Lightheadedness

  • Dizziness

  • Ear fullness

  • Cough

  • Wheezing

  • Shortness of breath, especially with exertion

  • Chest tightness

How can we help?

 

We are the experts in the medical and surgical management of nasal and sinus disease. Although all of the Sinus & Allergy Center physicians actively work within this area, Drs. Freeman and Phillips are fellowship trained in Otolaryngic Allergy. Dr. Freeman subspecializes in the management of advanced sinus disease, and Dr. Huntley enjoys working on obstructive nasal breathing as it relates to snoring and sleep apnea. Dr. Freeman's particular interest in the frontal sinus has led to his development of the Freeman Frontal Sinus Stent.

Sinus and allergy and related diseases treated at the Sinus & Allergy Center include:

  • Nasal drainage

  • Nasal obstruction

  • Nasal and facial trauma

  • Nosebleeds

  • Nasal septal perforations

  • Nasal tumors and cancers

  • Sinus infections

  • Sinus headaches

  • Sinus polyps

  • Sinus fungal disease

  • Seasonal, year-round, mold, candida and food allergies