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Sleep DisordersSinus Infection Overview Sinus infection, or sinusitis, is an inflammation of the sinuses and nasal passages. A sinus infection can cause a headache or pressure in the eyes, nose, cheek area, or on one side of the head. A person with a sinus infection may also have a cough, a fever, bad breath, and nasal congestion with thick nasal secretions. Sinusitis is categorized as acute (sudden onset) or chronic (long term, the most common type). Anatomy of the sinuses (also called paranasal sinuses): The human skull contains four major pairs of hollow air–filled–cavities called sinuses. These are connected to the space between the nostrils and the nasal passage. Sinuses help insulate the skull, reduce its weight, and allow the voice to resonate within it. The four major pairs of sinuses are the: Frontal sinuses (in the forehead) Maxillary sinuses (behind the cheek bones) Ethmoid sinuses (between the eyes) Sphenoid sinuses (behind the eyes) The sinuses contain defenses against foreign bacteria (germs). If a disruption occurs that affects the normal host defenses inside the sinuses, those defenses may allow bacteria, which are normally present in the nasal passages, to enter any of the sinuses. Once there, the bacteria may stick to the lining cells and cause a sinus infection. Acute sinusitis usually lasts less than eight weeks or occurs no more than three times per year with each episode lasting no longer than 10 days. Medications are usually effective against acute sinusitis. Successful treatment counteracts damage done to the mucous lining of the sinuses and surrounding bone of the skull. Chronic sinusitis lasts longer than eight weeks or occurs more than four times per year with symptoms usually lasting more than 20 days. The sinuses are covered with a mucus layer and cells that contain little hairs on their surfaces called cilia. These help trap and propel bacteria and pollutants outward. The ostiomeatal complex (OMC) connects the nasal passage to the paranasal sinuses. Sinus Infection Causes Acute sinusitis usually follows a viral infection in the upper respiratory tract, but allergens (allergy–causing substances), or pollutants may also trigger acute sinusitis. A viral infection causes damage to the cells of the sinus lining, which leads to inflammation. The lining thickens with fluid that obstructs the nasal passage. This passage connects to the sinuses. The obstruction disrupts the process that removes bacteria normally present in the nasal passages, and the bacteria begin to multiply and invade the lining of the sinus. This causes the symptoms of sinus infection. Allergens and pollutants produce a similar effect. Bacteria that normally cause acute sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. These microorganisms, along with Staphylococcus aureus and anaerobes (bacteria that live without oxygen), are involved in chronic sinusitis. Fungi are also becoming an increasing cause of chronic sinusitis, especially in people with diseases that weaken the immune system, such as AIDS, leukemia, and diabetes. Sinus Infection Symptoms Signs and symptoms of sinus infections depend upon which sinuses are affected and whether the sinus infection is acute or chronic. Acute sinusitis: Ethmoid sinusitis (behind the eyes) Nasal congestion with discharge or postnasal drip (mucus drips down the throat behind the nose) Pain or pressure around the inner corner of the eye or down one side of the nose Headache in the temple or surrounding the eye Pain or pressure symptoms worse when coughing, straining, or lying on the back and better when the head is upright Fever common Maxillary sinusitis (behind the cheek bones) Pain across the cheekbone, under or around the eye, or around the upper teeth Pain or pressure on one side or both Tender, red, or swollen cheekbone Pain and pressure symptoms worse with the head upright and bending forward and better when reclining Nasal discharge or postnasal drip Fever common Frontal sinusitis (behind forehead, one or both sides) Severe headaches in the forehead Fever common Pain worse when reclining and better with the head upright Nasal discharge or postnasal drip Sphenoid sinusitis (behind the eyes) Deep headache with pain behind and on top of the head, across the forehead, and behind the eye Fever common Pain worse when lying on the back or bending forward Double vision or vision disturbances if pressure extends into the brain Nasal discharge or postnasal drip Chronic sinusitis: Ethmoid sinusitis Chronic nasal discharge, obstruction, and low–grade discomfort across the bridge of the nose Pain worse in the late morning or when wearing glasses Chronic sore throat and bad breath Usually recurs in other sinuses Maxillary sinusitis Discomfort or pressure below the eye Chronic toothache Pain possibly worse with colds, flu, or allergies Increased discomfort throughout the day with increased cough at night Frontal sinusitis Persistent, low–grade headache in the forehead History of trauma or damage to the sinus area Sphenoid sinusitis Low–grade general headache common When to Seek Medical Care A person should call a doctor when experiencing pain or pressure in the upper face accompanied by nasal congestion or discharge, postnasal drip, or ongoing bad breath that is unrelated to dental problems. Fever can be a symptom of a sinus infection or a cold. A person experiencing simple congestion with a low–grade fever probably has a cold and may not need special medications or antibiotics. Those also experiencing facial pain or headaches may have a sinus infection. A doctor often can treat simple sinusitis. If left undiagnosed and untreated, though, complications of sinusitis can occur that may lead to severe medical problems and possibly death. The following complications are medical emergencies and require immediate treatment in a hospital's emergency department. Headache, fever, and soft tissue swelling over the frontal sinus may indicate an infection of the frontal bone, called Pott's puffy tumor or osteomyelitis. Usually, this complication is limited to children. Infection of the eye socket may result from ethmoid sinusitis. The eyelid may swell and become droopy. Fever and severe illness are usually present. A person with this infection may lose the ability to move the eye, and permanent–– blindness may result. Ethmoid or frontal sinusitis may also cause the formation of a blood clot in the sinus area around the front and top of the face. Symptoms may be similar to those of eye socket infection with the addition of a fixed and dilated pupil. This condition usually affects both sides of the face. If a person experiences mild personality changes, headache, altered consciousness, visual problems, or seizures, infection may have spread to the brain. Coma and even death may follow. Self–Care at Home Home care can help open the sinuses and alleviate their dryness. Promote drainage Drink plenty of water and hydrating beverages. Hot tea is often recommended. Inhale steam two to four times per day by leaning over a bowl of boiling hot water (not while the water is on the stove) or using a steam vaporizer with a towel over the head and bowl to prevent the escape of the steam. Inhale the steam for about 10 minutes. Taking a hot, steamy shower may also work. Mentholated preparations, such as Vicks Vapo–Rub, can be added to the water or vaporizer to aid in opening the passageways. Alternatively use any of the following essential oils in a steam inhalation and repeat it up to 5-6 times per day. Euaclyptus, Lavender, Peppermint, Pine, Thyme and Tea Tree oils are all effective but for best results use Lavender and Thyme where there is a lot of pain. Use Eucalyptus, Peppermint and Pinefor blockages and stuffiness and Tea Tree is renowned for its powerful antiseptic properties. Special techniques of facial massage can help to drain mucus from the nose and sinuses. Other therapies which can be beneficial are acupuncture. Garlic decongests so include plenty of fresh garlic in the diet and during attacks give the sufferer garlic tablets. Thin the mucus: Expectorants are drugs that help to expel mucus from the lungs and respiratory passages. They help to thin mucous secretions, enhancing drainage from the sinuses. The most common is guaifenesin (contained in Robitussin, for example). Over–the–counter (OTC) liquid cough medications or prescription tablets can also combine decongestants and cough suppressants to reduce symptoms as well as to eliminate the need for the use of many medications. Read label ingredients to find the right combination of ingredients or ask the pharmacist for help. Relieve pain: Pain medication such as ibuprofen (Motrin and Advil are examples), aspirin, and acetaminophen (Tylenol is in this category) can reduce pain and inflammation. These medications help to open the airways by reducing swelling. |
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