Every year more than 30 million Americans suffer from headaches, facial pressure and nasal congestion caused by sinus infections. To explain these sinus conditions, we spoke with Dr. Johnny Arruda of Redlands Community Hospital. Dr.
Arruda explains the function of the sinus cavity. The sinuses, we don't know for sure but they're air filled cavities in our facial skeleton. In a traumatic situation it can help absorb and impact. It may have a resonating affect also with our speech and singing. Unfortunately the openings into our sinuses tend to be very small. So even a little bit of swelling or inflammation or allergy can cause obstruction of these openings and then it doesn't equalize the pressure well and that can cause severe pain and then once it doesn't equalize the pressure you can get inflammatory response and build up purulent pus in your sinus literally or huge polyps can develop usually associated with allergy. The lining of our sinus in the nose and down into the airway, there's some similarities there and so if you have a problem with one it tends to be associated with other: like patients with asthma frequently have chronic sinus issues.
Even problems with the ears cause those are air filled cavities also. So there can be an association between multiple things. When people come to my office with concerns of their sinuses, frequently they'll complain of facial pressure and discomfort, sensitivity of the upper teeth, a lot of times associated with difficulty breathing through the nose. We diagnose it through a series of things. The history's perhaps the most important thing initially and then looking at the nose, seeing if there's obstruction or whats helpful also is to use a fiber optic scope or a rigid scope and you can look further up into the nasal cavity cause its a very narrow, it could be tough to tell just from looking at casually up the front. So with the fiber optic you can tell details of the anatomy or if there is actual purulence or bleeding which could point to a tumor perhaps. Some patients will have problems that go from months off and on or years.
It can vary though, you can have a patient with severe symptoms, you do films and actually the sinuses look pretty clear, another person's not complaining that much, you do films and they're totally filled with mucus and pus and so forth. So then unfortunately the symptoms don't correlate with the severity of the disease sometimes. Dr.
Arruda describes the treatments for sinus problems. The mainstay of treatment is antibiotics and decongestants. Today we also have some nasal steroid strays that can reduce the inflammation in your nose and try to maintain the opening of the sinuses. Irrigating the nose with saltwater can be very helpful. If I have someone with severe obstruction of their nose, I'll frequently get at least plain X-rays to make sure the sinuses are clear and if they're not, then we try to manage that medically and then we go on from there and get a cat scan. The cat scan will give extreme details, show all the details of the anatomy and it can also be a road map for the surgery, if a surgery is required. Our specialty tends to see the patients who have failed the simple interventions, the medical management, the irrigation the steroid sprays and frequently there's a mechanical issue that needs to be corrected, especially if you can breathe clearly through the nose, you're less likely to have chronic sinus issues and you may not need direct sinus surgery, it may be an issue of just breathing better.
If the patient severe underlying issues like allergies, perhaps lung disease also and severe large polyps there can be an recurrence rate and one way to avoid recurrence is to have the allergist involved also. So if you treat the underlying issue then you're less likely to have the recurring polyps and so forth but if it's a straight forward sinus that was obstructed and you relieved the obstructions, success is excellent, long term.
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