Si­nusi­tis strikes

Abi Jack­son on when the snif­fles turn into some­thing nas­tier

Irish Examiner - Feelgood - - This Week -

EVER had what seemed like a bad case of the snif­fles only for your face to sud­denly de­scend into hor­ri­ble pain, as in­tense pres­sure builds around your eye sock­ets and nose?

It might have been si­nusi­tis — “an in­fec­tion or in­flam­ma­tion of the air-filled si­nus cav­i­ties sur­round­ing your nose,” says Dr Sarah Brewer, a general prac­ti­tioner.

“You have four pairs of si­nuses: The frontal si­nuses over your eyes; the eth­moids be­tween your eyes; the sphe­noids in the up­per part of your nose be­hind your eyes; and the max­il­lary si­nuses in­side your cheek­bones. Th­ese help to lighten the bones of the skill and im­prove the res­o­nance of your voice. They also act as a safety ‘crum­ple zone’ to ab­sorb blows to the face.”

Some peo­ple suf­fer from chronic si­nusi­tis, though this is some­what dif­fer­ent from hav­ing an acute in­fec­tion, ex­plains David Howe, an ear, nose, and throat con­sul­tant sur­geon.

“Si­nus in­fec­tions arise from a com­bi­na­tion of block­age within the si­nus and in­fec­tion form­ing within it. This ob­struc­tion of the tiny ducts that drain the si­nus into the nose leads to the symp­toms of pain, pres­sure, and con­ges­tion that peo­ple re­port with acute si­nusi­tis.

“Chronic si­nusi­tis is a rather dif­fer­ent con­di­tion and is of­ten as­so­ci­ated with nasal polyps,” says Howe. “This tends to cause pa­tients to have a very blocked nose, loss of smell, and re­cur­rent dis­charge from the nose.”

So how come si­nus in­fec­tions can be so painful? “When a si­nus is in­flamed, it swells and pro­duces larger amounts of mu­cus, so the fluid be­comes thicker and more pro­fuse. If the nar­row drainage chan­nel from a si­nus be­comes blocked by swollen tis­sue or mu­cus, the se­cre­tions re­main trapped and pres­sure builds to cause a throb­bing pain be­tween the eyes, in the cheeks, headache, and/or pain in the up­per teeth” ex­plains Brewer.

“You may de­velop ten­der­ness over the si­nus, with swelling and red­ness of over­ly­ing skin. If the in­fec­tion’s se­vere, pus will pool in the si­nus and you will de­velop a fever. Some pus may drain out through the nose to cause in­creas­ing pain and a con­stant, nasal dis­charge that drops into the back of the nose. This trig­gers a cough and tastes foul.”

Acute si­nusi­tis, she ex­plains, typ­i­cally lasts up to three weeks — al­though the ‘acute’, very painful phase should hope­fully ease long be­fore that. “It is nor­mally the af­ter­math of a cold or flu in­fec­tion, and can oc­cur af­ter lots of fly­ing,” adds Brewer.

You don’t al­ways need an­tibi­otics — how­ever it’s im­por­tant to see a doc­tor if the acute symp­toms don’t im­prove. In­fec­tions will nor­mally clear up by them­selves, and reg­u­lar painkillers like parac­eta­mol, plus over-the-counter de­con­ges­tant tablets and nasal drops or sprays — ask your phar­ma­cist which ones are suitable — can help.

Steam­ing can some­times help too, and Ali­son Cullen, nu­tri­tional ther­a­pist for A.Vo­gel, says: “Warm face packs placed over your si­nuses can be com­fort­ing and re­duce pain.”

Howe ex­plains: “An­tibi­otics are rarely needed, un­less the pa­tient be­comes toxic or gets frontal headaches, sug­gest­ing a frontal si­nusi­tis. [Also] If the [acute] episode lasts more than a few days, then an­tibi­otics might be ap­pro­pri­ate.”

BLOCKED UP: Acute si­nusi­tis is nor­mally the af­ter­math of a cold or flu in­fec­tion.

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