What is Sinusitis?

Sinusitis is the medical term for inflammation (irritation and swelling) of the sinuses. It's usually caused by infection.

Our sinuses are the moist air spaces within the bones of the face around the nose. The frontal sinuses are located in the area near the eyebrows; the maxillary sinuses are located inside the cheekbones; the ethmoid sinuses are between the eyes; and the sphenoid sinuses sit behind the ethmoid sinuses.

When we're healthy, our sinuses are filled with air, making our facial bones less dense and much lighter in weight. Sinuses also play a role in how our voices sound.

Infection with viruses or bacteria — or a combination of both — can cause sinusitis. Generally, someone with a cold also has inflammation of the sinuses. This is viral sinusitis. Allergies also can lead a person to develop sinusitis.

When the nasal congestion (stuffiness) associated with the common cold or allergies doesn't allow the sinuses to drain properly, bacteria can become trapped inside the sinuses, leading to bacterial sinusitis.

Bacterial sinusitis tends to make someone feel sicker than viral sinusitis. A person with bacterial sinusitis usually will have more facial pain and swelling than someone with viral sinusitis, and might also develop a fever.

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Causes.

Acute Sinusitis

The most common causes of acute sinusitis are:

• Virus. Viral infections can paralyze or even destroy the cilia so that they are unable to move mucus out of the nose.

• Bacteria. If the sinus openings become blocked and the infected mucus cannot move out of the body or drain down the throat, it creates is an ideal environment for bacteria to grow. The bacteria in turn creates an acid environment in the sinuses, which further paralyzes the cilia. This causes the mucous membrane to swell more. The sinus openings become even more blocked.

• Fungus. Fungus is a plant or mold, often microscopic, that can be ingested with food or inhaled in the air. Once in the body, it can affect the immune system and aggravate the sinuses.

• Medications. The side effect of certain medications may affect the functioning of the mucous membrane

Cronic sinusitis is most often caused by:

• Allergies. Allergies can be caused by almost anything. However, the most common allergens are airborne particles, foods, animals, feathers, and fabrics. If the culprit is a food, fabric, or animal, simply avoiding the allergen will stop symptoms. If the allergen is a chemical or substance in the air, such as dust or ragweed, treatment such as regular allergy shots for a period of time can provide relief.

• Asthma. Adults and children suffering from asthma are more prone to sinusitis.

• Temperature and humidity. When temperature and humidity are extreme, or when these air conditions change quickly, the sinuses can become irritated.

• Defective mucous membrane. Some people have poorly functioning mucous membranes, sometimes permanently damaged by a past infection.
  

Sinusitis Treatment

Sinusitis is treated with medications and home treatment methods, such as applying moist heat to your face. The goals of treatment for sinusitis are to:

• Improve drainage of mucus and reduce swelling in the sinuses.
• Relieve pain and pressure.
• Clear up any infection.
• Prevent the formation of scar tissue, and avoid permanent damage to the tissues lining the nose and sinuses.

Medications may be used to treat sinusitis, especially when it is caused by a bacterial infection. There are varying lengths of treatment with medications-treatment may be as short as three days or last as long as several weeks or more. Medications most often used to treat sinusitis include a combination of:

• Antibiotics, such as amoxicillin, which kill bacteria.
• Decongestants, such as pseudoephedrine hydrochloride, which reduce the swelling of the mucous membranes in the nose.
• Analgesics, such as aspirin, acetaminophen, or ibuprofen, to relieve pain.
• Mucolytics, such as guaifenesin, which thin the mucus.
• Corticosteroids, such as beclomethasone dipropionate or prednisone, which reduce inflammation in the nasal passages. These medications may also be used as an inhaled nasal spray.

Inhaled antibiotics are a fairly new treatment choice for chronic sinusitis. Initial studies show that since inhaled antibiotics make direct contact with the mucous membranes, they may be effective when other treatments have failed.²

It is possible to develop "double sickening" while being treated for acute or chronic sinusitis. At first, you may begin to feel better from antibiotics and home treatment, but then your symptoms become worse and additional treatment may be needed.

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