Treating sinusitis

Dear Readers,

J.R. is a 26-year-old woman who lives in Portmore, St. Catherine. She doesn't know if it's due to the heat but her "sinusitis" has never been worse. She has a continuous post-nasal drip which sometimes results in hoarseness and a sore throat. In the morning when she gets up she sneezes a lot. This is also often associated with a runny nose. More recently J.R. is experiencing headaches and dizziness.

J.R. says she has taken antibiotics and various antihistamine tablets but the condition keeps returning. According to J.R. her sinus condition is "worse than having the flu." She asks "What can I do to obtain some prolonged relief?"

Sinusitis is an inflammatory process occurring in the sinuses. The sinuses are air spaces found within the facial bones which are lined with epithelial cells and communicate with the space at the back of the nose via ostia.

Ostia are small "holes" which allow secretions to drain from the sinuses and air to enter the sinuses.

When inflammation occurs in the sinuses, blockage of a sinus ostium can occur following an acute and infective Rhinitis (cold). Spread of infection to a sinus can also occur following dental infections or infected adenoids. When sinusitis occurs the following symptoms are commonly experienced:

Pain over the affected sinus

Facial swelling

Tenderness over the facial sinus involved when it is touched.

Pus and secretions drain post -nasally.

Headaches

Many people confuse sinusitis with Allergic Rhinitis. In truth, most people actually are experiencing allergic (or Vasomotor) Rhinitis which causes the sneezing, running nose and can also cause headaches. Allergic Rhinitis is not associated with pus in the post nasal drip or facial swelling but it is the commonest predisposing cause leading to sinusitis.

Other predisposing conditions are nasal polyps and chronic dental infections. Individuals suffering with this condition should see their doctor and have the following investigations:

1) Nasal swab sent for culture

2) Full blood count

3) X-Ray of the sinuses.

X-Rays will reveal mucosal thickening, polyps and pus or fluid levels in the sinuses.

Treatment aims to get rid of the infection and establish normal sinus drainage in order to relieve pain and swelling. This is usually achieved by treating the sinuses for a minimum period of two weeks with antibiotics, decongesting the nose with prescribed nose drops and using an antihistamine as an internal decongestant.

Menthol crystals inhaled with steam also assists in decongesting the sinuses. Anti-inflammatory pain relievers are also very useful to relieve facial sinus pain. If pain and swelling persists the infected sinus might also require surgical drainage.

J.R. should see her family doctor and ask that investigation be done to determine if she has sinusitis or Allergic Rhinitis. She could also see an Otolaryngologist (an E.N.T. specialist) who would be skilled in the diagnosis and management of these conditions. If her condition is allergic in nature she will need to make a special effort to avoid dust, plant pollen, animal dander, "breezy" situations, perfumes, scents and sometimes even certain food kinds.

Milk products are well known for their association with allergies.

The hoarseness and sore throat which J.R. is experiencing is perhaps due to to an unrelenting post nasal drip which needs to be dried with medication. Headaches and dizziness when associated with this condition can have their genesis either in allergic sinus congestion or in actual sinusitis. Decongestants orally and topically in the nose are useful here. Antibiotics might also be needed along with temporary pain killers and medication for dizziness. An allergic condition tends to be recurrent unless the allergies are removed from the individuals environment.

Do you have a health question? Write to Lifeline, c/o The STAR, 7 North Street, Kingston.

By Dr. A.J. MORGAN

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