Who would believe that four sets of hollow air space in the bones that surround the nose could create such misery - headaches, nasal congestion, fever, weakness and cough - for an estimated 37 million Americans each year? But when your sinuses become inflamed - a condition called sinusitis - that's exactly what happens.

Why do we need these cavities in the first place? Are they worth the trouble? Yes, they are. They protect the brain against injury; they produce the mucus that protects against infection and irritation; they warm and moisten the air we breathe; and these hollow spaces make the head lighter and easier to carry on our shoulders.

What causes the pain?

Sinusitis can be acute (the symptoms clear up within three weeks), chronic (lasting for months or years) or recurrent (an attack that is cured but repeatedly followed by others).

All of the eight sinuses open into the nasal passage directly through tiny openings (about the size of the hole of a ballpoint pen), and air and mucus normally flow freely between them. Since the nasal lining extends into the sinuses, when your nasal membranes become swollen for any reason (allergy, infection, irritants), the sinuses also are affected. Allergies, viral infections and irritants can cause the nasal membranes to swell and increase mucus production. When the mucus does not drain as it should and is trapped within the sinuses, a sinus infection occurs.

Irritation or infection of the sinuses, regardless of the cause, will give you headaches in different locations that are usually worse upon awakening in the morning. They can cause fever (during the acute phase), fatigue (especially when the sinusitis is chronic), chronic cough, and persistent nasal congestion or a runny nose. You may experience postnasal drip which can cause a sore throat or upset stomach.

Treating sinusitis depends upon whether it is acute or chronic, and what caused the sinusitis to occur in the first place. The doctors at Michigan Allergy, Sinus & Asthma Specialists are board-certified physicians trained in obtaining a detailed history, doing the appropriate physical examination, and ordering the appropriate tests.

Treatment can involve several different steps including shrinking the nasal membranes so that the sinuses can drain, reducing the inflammation of the membranes, and allowing proper humidification and moisture for the mucus to thin. Antibiotics are penerally not prescribed initially, but may be necessary if these first steps do not alleviate symptoms within a few days. Antibiotics are generally not used initially because the blood supply to the sinuses is poor, and large doses of antibiotics have to be given for several days in order for them to affect a cure.

Sinusitis is apt to become chronic if you have allergies, and asthmatics are more likely to develop sinusitis. An uncommon cause of sinusitis can be an impaired immune system. Flexible endoscopy sinus surgery (FESS) may be necessary if the sinus anatomy is abnormal and the obstruction cannot be relieved with medication. FESS may also be necessary if nasal polyps are complicating sinusitis. Correction of a deviated nasal septum may also be helpful. Although the doctors at Michigan Allergy, Sinus & Asthma Specialists are not surgeons, we readily refer to highly-trained surgeons when we feel a surgical option would be helpful for our patients.

For patients with allergies or recurrent sinusitis, the following tips may be helpful:

• Maintain humidity between 30-45% in your home or office.
• Use air filters to remove allergens from the air. Air cleaners with HEPA (high-efficiency particulate air) filters are recommended.
• Try to avoid pollutants in your environment, especially cigarette smoke, dust, vapors, perfumes and damp areas.
• The use of over-the-counter saline sprays or isotonic saline irrigation on a daily basis will help keep your nasal membranes moist, and isotonic saline irrigation will also help to remove mucus and other debris from the nasal passageways.
• Cut down on alcohol when your sinuses are acting up. Drinking can cause swelling and excessive dryness of the nasal and sinus membranes.
• Avoid swimming pools that contain large concentrations of chorine, which can irritate the nasal and sinus membranes.
• If you are flying, you should take a decongestant nasal spray or oral decongestant before takeoff, and use an over-the-counter saline spray while on board the aircraft. (See also airplane tips for allergy patients.

The doctors at Michigan Allergy, Sinus & Asthma Specialists treat acute, recurrent and chronic sinusitis on a regular basis, and we make every effort to ensure that our patients understand the cause(s) of their sinusitis and the proper treatment and prevention. Patients are encouraged to call us at any time should they have further questions or concerns about their sinusitis.

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Michigan Allergy, Sinus & Asthma Specialists

6330 Orchard Lake Road #110 West Bloomfield, MI 48322 Tel: 248.932.0082 Fax: 248.932.0182 view map

37595 Seven Mile Road #320 Livonia, MI 48152 Tel: 800.739.6100 Fax: 248.932.0182 view map

Web: www.michiganallergy.com
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Email: miallergy@comcast.net

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