(Adapted from Allergy & Asthma Today Spring 2005, Robert Bahadori, M.D.)

1. Understand the anatomy.
   Sinuses are air pockets that begin as pea sized pouches in a newborn, extending outward from the inside of the nose into the bones of the face and skull. They expand and grow through childhood into young adulthood and are connected to the inside of the nose through small openings about the size of the tip of a ball point pen.
   
   
2. Understand sinusitis.
   When the openings into the sinuses become plugged up, sinus pressure develops and the nose may feel blocked. These blockages may be caused by infections, irritants, anatomic problems and allergies. Sinus disease can be common among family members, and stress may play a role in chronic sinus disease.
   
   
3. Control your allergies.
   Allergies cause inflammation inside the nose leading to swollen nasal membranes which in turn lead to nasal/sinus congestion, increasing mucus secretions and irritated nerve endings that can cause sneezing, and if these symptoms are severe or last long enough, can cause a secondary sinusitis. Patients with asthma have an increased frequency of having co existing sinusitis, and it is felt that this relationship occurs because the sinuses are responsible for regulating the temperature of the air that we breathe before it enters the lungs.
   
   
4. Wash your hands often.
   Most adults will get colds and upper respiratory infections about three times per year; children get them more frequently. Washing your hands and getting an annual flu shot should decrease the frequency of these flare ups. Both viral and bacterial infections cause swelling of the nasal membranes and thickening of the normal nasal mucus. Therefore, acute infection, regardless of cause, can also cause nasal congestion, increased production of nasal mucus, and with infection, the mucus often thickens and will therefore interfere with proper sinus drainage.
   
   
5. Avoid irritants.
   Air pollution, tobacco smoke and chemical irritants (e.g., disinfectants, household detergents and some sprays containing pesticides) may cause swelling and blockage of the narrow channels from the nose to the sinuses, and in susceptible people, can cause secondary sinusitis.
   
   
6. Open the nose and allow the drainage to flow.
   Trapped or stagnant mucus provides a breeding ground for bacteria. Topical decongestants like Afrin or Neosinephrine can help shrink the tissues in the nose so the sinuses can drain. Don't use a nasal spray containing a decongestant for more than three days without your doctor's advice. Beyond that, the swelling in your sinuses may get worse, as these over the counter decongestant sprays can cause a rebound swelling of the nasal membranes (Rhinitis Medicamentosa).
   
   
7. Flushing the nose is a good thing.
   Rinse your sinus passages with a preservative free saline solution. You can make this solution yourself or purchase a commercial kit. Michigan Allergy, Sinus and Asthma Specialists has a handout that describes how this flushing procedure can be done; please feel free to ask the nurse or doctor for this handout if you feel it would be helpful to you. In addition, nasal and sinus irrigation can be done on a regular basis to help with chronic allergic and/or chronic non allergic rhinitis.
   
   
8. Avoid indiscriminate use of over the counter medications.
   Use an over the counter (OTC) medicine such as acetaminophen or ibuprofen for pain, but talk with your nurse or doctor before using an OTC cold medicine. Some decongestants taken orally may thicken secretions, making it harder to drain the sinus cavities.
   
   
9. A few other tips.
   Sip hot liquids and drink plenty of fluids; get plenty of rest; and apply moist heat by holding a warm, wet towel against your face or breathing in steam through a cloth or towel.
   
   
10. Last but not least.
    Visit your doctor if you are not feeling better or are getting worse. Generally, a secondary, bacterial sinus infection may be present if you have had significant symptoms for more than 5-7 days. Antibiotics may be necessary at that time..
    
    

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Michigan Allergy, Sinus & Asthma Specialists

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Web: www.michiganallergy.com
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