Tag Archives: Ear Nose and Throat

Pilonidal sinus

Alternative Names:pilonidal cyst, pilonidal abscess or sacrococcygeal fistula

Definition:
A pilonidal sinus is a dimple in the skin in the crease of your child’s buttocks.

This may be noted at birth as a depression or hairy dimple and be present for many years without any symptoms.
Pilonidal sinus affect men more often and most commonly occur in young adults.


You may click to see picture

Two pilonidal cysts in the natal cleft
A pilonidal sinus may also occur due to a blockage in the hair follicles, often associated with an ingrown hair.
In both situations, hair acts as a foreign body, which may produce an infection. The infection may spread into the tissues of your child’s buttocks and produce an abscess (collection of pus under the skin) at a site several inches away from the sinus.

Pilonidal means “nest of hair”, and is derived from the Latin words for hair (“pilus”) and nest (“nidus”).The term was used by Herbert Mayo as early as 1830. R.M. Hodges was the first to use the phrase “pilonidal cyst” to describe the condition in 1880.

Symptoms:
A pilonidal sinus may cause no noticeable symptoms (asymptomatic). The only sign of its presence may be a small pit on the surface of the skin.

When it’s infected, a pilonidal sinus becomes a swollen mass (abscess). Signs and symptoms of an infected pilonidal cyst include:

*Pain
*Localized swelling
*Reddening of the skin
*Drainage of pus or blood from an opening in the skin (pilonidal sinus)
*Foul smell from draining pus

Hair protruding from a passage (tract) below the surface of the skin that connects the infected pilonidal cyst to the opening on the skin’s surface (a pilonidal sinus) — more than one sinus tract may form
Fever (uncommon)

Causes:
Quite why it happens isn’t entirely clear. When they occur in the cleft between the buttocks, one popular explanation is that there’s a developmental defect in the direction that the hair grows – that is, the hair grows inwards rather than outwards.

One proposed cause of pilonidal cysts is ingrown hair. Excessive sitting is thought to predispose people to the condition because they increase pressure on the coccyx region. Trauma is not believed to cause a pilonidal cyst; however, such an event may result in inflammation of an existing cyst. However there are cases where this can occur months after a localized injury to the area. Some researchers have proposed that pilonidal cysts may be the result of a congenital pilonidal dimple. Excessive sweating can also contribute to the cause of a pilonidal cyst.

The condition was widespread in the United States Army during World War II. More than eighty thousand soldiers having the condition required hospitalization.  It was termed “jeep seat or “Jeep riders’ disease”, because a large portion of people who were being hospitalized for it rode in jeeps, and prolonged rides in the bumpy vehicles were believed to have caused the condition due to irritation and pressure on the coccyx.

Risk Factors:
Certain factors can make you more susceptible to developing pilonidal cysts. These include:

*Obesity
*Inactive lifestyle
*Occupation or sports requiring prolonged sitting
*Excess body hair
*Stiff or coarse hair
*Poor hygiene
*Excess sweating

Complications:
If a chronically infected pilonidal cyst isn’t treated properly, there may be an increased risk of developing a type of skin cancer called squamous cell carcinoma.

Differential diagnosis
A pilonidal sinus can resemble a dermoid cyst, a kind of teratoma (germ cell tumor). In particular, a pilonidal cyst in the gluteal cleft can resemble a sacrococcygeal teratoma. Correct diagnosis is important because all teratomas require complete surgical excision, if possible without any spillage, and consultation with an oncologist.

Treatment :
Treatment may include antibiotic therapy, hot compresses and application of depilatory creams.

In more severe cases, the cyst may need to be lanced or surgically excised (along with pilonidal sinus tracts). Post-surgical wound packing may be necessary, and packing typically must be replaced twice daily for 4 to 8 weeks. In some cases, one year may be required for complete granulation to occur. Sometimes the cyst is resolved via surgical marsupialization.

Surgeons can also excise the sinus and repair with a reconstructive flap technique, which is done under general anesthetic. This approach is mainly used for complicated or recurring pilonidal disease, leaves little scar tissue and flattens the region between the buttocks, reducing the risk of recurrence.

Picture of Pilonidal cyst two days after surgery.

A novel and less destructive treatment is scraping the tract out and filling it with fibrin glue. This has the advantage of causing much less pain than traditional surgical treatments and allowing return to normal activities after 1–2 days in most cases.

Pilonidal cysts recur and do so more frequently if the surgical wound is sutured in the midline, as opposed to away from the midline, which obliterates the natal cleft and removes the focus of shearing stress.

Prevention:
To prevent future pilonidal sinus from developing:

*Clean the area daily with glycerin soap, which tends to be less irritating. Rinse the area thoroughly to remove any soapy residue. Washing briskly with a washcloth helps keep the area free of hair accumulation.

*Keep the area clean and dry. Powders may help, but avoid using oils or herbal remedies.
Avoid sitting for long periods of time.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Pilonidal_sinus
http://www.mayoclinic.com/health/pilonidal-cyst/DS00747
http://www.bbc.co.uk/health/physical_health/conditions/pilonidalsinus.shtml
http://www.childrenshospital.org/az/Site923/mainpageS923P0.html

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Labyrinthitis

Definition:
The labyrinth is a group of interconnected canals chambers located in the inner ear. It is made up of the cochlea and the semicircular canals. The cochlea is involved in transmitting sounds to the brain. The semicircular canals send information to the brain about the head’s position and how it is moving. The brain uses this information to maintain balance. Labyrinthitis is caused by the inflammation of the labyrinth. Its most frequent symptom is vertigo ( dizziness ), because the information that the semicircular canals send to the brain about the position of the head is affected.
click & see the pictures
The labyrinth is a system of narrow fluid-filled channels in the inner ear, which is involved in the detection of body movement, helping to control balance and posture.

Labyrinthitis can cause balance disorders.

In addition to balance control problems, a labyrinthitis patient may encounter hearing loss and tinnitus. Labyrinthitis is usually caused by a virus, but it can also arise from bacterial infection, head injury, extreme stress, an allergy or as a reaction to a particular medication. Both bacterial and viral labyrinthitis can cause permanent hearing loss, although this is rare.

Labyrinthitis often follows an upper respiratory tract infection (URI).

Labyrinthitis is rare and is more likely to occur after middle ear infections, meningitis , or upper respiratory infection. It may also occur after trauma, because of a tumor, or after the ingesting of toxic substances. It is thought to be more common in females than in males.

Symptoms:
•The most common symptoms

*Vertigo

*Nausea

*Vomiting

*Loss of balance

Other possible symptoms are:

*A mild headache

*Tinnitus (a ringing or rushing noise)

*Hearing loss

•These symptoms often are provoked or made worse by moving your head, sitting up, rolling over, or looking upward.

•Symptoms may last for days or even weeks depending on the cause and severity.

*Symptoms may come back, so be careful about driving, working at heights, or operating heavy machinery for at least 1 week from the time the symptoms end.

*Rarely, the condition may last all your life, as with Meniere’s disease. This condition usually involves tinnitus and hearing loss with the vertigo. In rare cases it can be debilitating.

Causes:
Many times, you cannot determine the cause of labyrinthitis. Often, the condition follows a viral illness such as a cold or the flu. Viruses, or your body’s immune response to them, may cause inflammation that results in labyrinthitis.

Other potential causes are these:

•Trauma or injury to your head or ear

•Bacterial infections: If found in nearby structures such as your middle ear, such infections may cause the following:

*Fluid to collect in the labyrinth (serous labyrinthitis)

*Fluid to directly invade the labyrinth, causing pus-producing (suppurative) labyrinthitis

•Allergies

•Alcohol abuse

•A benign tumor of the middle ear

•Certain medications taken in high doses

*Furosemide (Lasix)

*Aspirin

*Some IV antibiotics

*Phenytoin (Dilantin) at toxic levels

•Benign paroxysmal positional vertigo: With this condition, small stones, or calcified particles, break off within the vestibule and bounce around. The particles trigger nerve impulses that the brain interprets as movement.

•More serious causes of vertigo can mimic labyrinthitis, but these occur rarely.

*Tumors at the base of the brain

*Strokes or insufficient blood supply to the brainstem or the nerves surrounding the labyrinth

Diagnosis
Diagnosis of labyrinthitis is based on a combination of the individual’s symptoms and history, especially a history of a recent upper respiratory infection. The doctor will test the child’s hearing and order a laboratory culture to identify the organism if the patient has a discharge.

If there is no history of a recent infection, the doctor will order tests such as a commuted topography (CT) scan or a magnetic resonance imaging (MRI) scan to help rule out other possible causes of vertigo, such as tumors. If it is believed a bacterium is causing the labyrinthitis, blood tests may be done, or any fluid draining from the ear may be analyzed to help determine what type of bacteria is present.

Labyrinthitis, or inner ear infection, causes the labyrinth area of the ear to become inflamed.
(Illustration by GGS Information Services.)
Recovery:
Recovery from acute labyrinthine inflammation generally takes from one to six weeks; however, it is not uncommon for residual symptoms (dysequilibrium and/or dizziness) to last for many months or even years[5] if permanent damage occurs.

Recovery from a permanently damaged inner ear typically follows three phases:

1.An acute period, which may include severe vertigo and vomiting
2.approximately two weeks of sub-acute symptoms and rapid recovery
3.finally a period of chronic compensation[clarification needed] which may last for months or years.

Labyrinthitis and anxiety:
Chronic anxiety is a common side effect of labyrinthitis which can produce tremors, heart palpitations, panic attacks, derealization and depression. Often a panic attack is one of the first symptoms to occur as labyrinthitis begins. While dizziness can occur from extreme anxiety, labyrinthitis itself can precipitate a panic disorder. Three models have been proposed to explain the relationship between vestibular dysfunction and panic disorder:

*Psychosomatic model: vestibular dysfunction which occurs as a result of anxiety.

*Somatopsychic model: panic disorder triggered by misinterpreted internal stimuli (e.g., stimuli from vestibular dysfunction), that are interpreted as signifying imminent physical danger. Heightened sensitivity to vestibular sensations leads to increased anxiety and, through conditioning, drives the development of panic disorder.

*Network alarm theory: panic which involves noradrenergic, serotonergic, and other connected neuronal systems. According to this theory, panic can be triggered by stimuli that set off a false alarm via afferents to the locus ceruleus, which then triggers the neuronal network. This network is thought to mediate anxiety and includes limbic, midbrain and prefrontal areas. Vestibular dysfunction in the setting of increased locus ceruleus sensitivity may be a potential trigger.
Treatment:
Vestibular rehabilitation therapy (VRT) is a highly effective way to substantially reduce or eliminate residual dizziness from labyrinthitis. VRT works by causing the brain to use already existing neural mechanisms for adaptation, plasticity, and compensation.

Rehabilitation strategies most commonly used are:
*Gaze stability exercises – moving the head from side to side while fixated on a stationary object (aimed to restore the Vestibulo-ocular reflex) An advanced progression of this exercise would be walking in a straight line while looking side to side by turning the head.

*Habituation exercises – movements designed to provoke symptoms and subsequently reduce the negative vestibular response upon repetition. Examples of these include Brandt-Daroff exercises.

*Functional retraining – including postural control, relaxation, and balance training.
These exercises function by challenging the vestibular system. Progression occurs by increasing the amplitude of the head or focal point movements, increasing the speed of movement, and combining movements such as walking and head turning.

One study found that patients who believed their illness was out of their control showed the slowest progression to full recovery, long after the initial vestibular injury had healed.  The study revealed that the patient who compensated well was one who, at the psychological level, was not afraid of the symptoms and had some positive control over them. Notably, a reduction in negative beliefs over time was greater in those patients treated with rehabilitation than in those untreated. “Of utmost importance, baseline beliefs were the only significant predictor of change in handicap at 6 months followup.”

Prochlorperazine is commonly prescribed to help alleviate the symptoms of vertigo and nausea.

Because anxiety interferes with the balance compensation process, it is important to treat an anxiety disorder and/or depression as soon as possible to allow the brain to compensate for any vestibular damage. Acute anxiety can be treated in the short term with benzodiazepines such as diazepam (Valium); however, long-term use is not recommended because of the addictive nature of benzodiazepines and the interference they may cause with vestibular compensation and adaptive plasticity.  Benzodiazepines and any other form of mind or mood altering addictive drug should not be used on patients with addictive history.

Prognosis :
Most people who have labyrinthitis recover completely, although it often takes five to six weeks for the vertigo to disappear entirely and the individual’s hearing to return to normal. In a few cases, the hearing loss may be permanent. Permanent hearing loss is more common in cases of labyrinthitis that are caused by bacteria. For some individuals, episodes of dizziness may still occur months after the main episode is over.

Prevention :
The most effective preventive strategy includes prompt treatment of middle ear infections, as well as monitoring of patients with mumps, measles, influenza, or colds for signs of dizziness or hearing problems.

Parental concerns:
Labyrinthitis generally resolves by itself; however, in some cases permanent hearing loss can result. Labyrinthitis may cause repeated episodes of vertigo even after the main symptoms have gone away. If the episodes occur when the head is moved suddenly, this can make it difficult for a child to engage in some physical activities or sports .

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose
Resources:
http://www.bbc.co.uk/health/physical_health/conditions/labyrinthitis.shtml
http://www.healthofchildren.com/L/Labyrinthitis.html
http://www.dizziness-and-balance.com/disorders/unilat/vneurit.html
http://en.wikipedia.org/wiki/Labyrinthitis

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Ears Popping when Flying

Introduction:
The ear consists of three chambers:

English: The middle ear : 1)Eardrum 2)Ossicles...

English: The middle ear : 1)Eardrum 2)Ossicles 3)Eustachian tube 4)Tensor tympani Français : Oreille moyenne : 1)Tympan 2)Chaine ossiculaire 3)Trompe d’Eustache 4)Muscle du marteau (Photo credit: Wikipedia)

1 – skull
2 – ear canal
3 – pinna
4 – tympanum
5 – fenestra ovalis
6 – malleus
7 – incus
8 – stapes
9 – labyrinth
10 – cochlea
11 – auditory nerve
12 – eustachian tube

CLICK TO SEE

•The outer ear canal which leads up to the ear drum.
•The middle ear chamber behind the drum which is filled with air.
•The very specialised inner ear.

The air in the middle ear is constantly being absorbed by the membranes that line the cavity, so the internal pressure can easily drop, putting tension on the tissues there. Fortunately, air is frequently resupplied to the middle ear during the process of swallowing.

Usually when you swallow, a small bubble of air passes from your throat or back of your nose, through a narrow tube known as the Eustachian tube which is usually closed, into your middle ear. As it does this, it makes a tiny click or popping sound.

This action keeps the air pressure on both sides of the eardrum about equal. If the air pressure isn’t equal, for example if the Eustachian tube isn’t working efficiently or if pressures suddenly change, the ear feels blocked or uncomfortable.

The pocket of air in the middle ear is particularly vulnerable to the changes in air pressure as you go up in a plane.

Click to see picture

The higher the plane, the lower the air pressure around you, although inside the cabin you’re protected, to some extent, from these pressure changes. Pressure in the middle ear remains higher until the Eustachian tube opens up to allow the pressure to equalise. Until this happens the relatively lower pressure outside the middle ear pulls the ear drum and tissues of the middle ear outwards, making them feel very uncomfortable.

The eardrum is stretched and can’t vibrate properly, so sounds become muffled. When the Eustachian tube opens, air travels out from the middle ear, making a popping noise as pressure equalises.

During the descent in a plane, the opposite happens as pressure builds up outside the ear, pushing the eardrum inwards.

Abnormal pressure can develop in the middle ear, pulling in or stretching the ear drum, when the Eustachian tube is blocked for other reasons – as the result of a bad cold, for example, or a nasal allergy – or because it’s narrow as a result of childhood ear infections.

Treatment and recovery:
Flyers often experience what is referred to as ear barotrauma or airplane ear. This condition is caused by the change in pressure between the inside and outside of the eardrum that causes the eustachian tubes inside the ear to swell. The popping noise in your ear is the sound of the eustachian tube opening. There are some simple tips that can be used to pop your ears in an effort to ease the pain and discomfort associated with airplane ear.
The following can help to relieve the problem:

•Swallowing activates the muscle that opens the Eustachian tube, and you swallow more often when chewing gum or sucking sweets so try this just before and during descent.
•Yawning is an even stronger activator of the muscles.
•Avoid sleeping during descent, because you may not be swallowing often enough to keep up with the pressure changes.

The most forceful way to unblock your ears is to pinch your nostrils, take in a mouthful of air and use your cheek and throat muscles to force the air into the back of your nose, as if you were trying to blow your thumb and fingers off your nostrils. You may have to repeat this several times before your ears pop.

Decongestants shrink internal membranes and make your ears pop more easily. Ask your pharmacist for advice. However, you should avoid making a habit of using nasal sprays, because after a few days they may cause more congestion than they relieve.

Few more Tips to releave :

Eat Candy or Chew Gum
One of the easiest ways to pop your ears is to chew a piece of gum or suck on a piece of hard candy. This forces your ears to pop on purpose by allowing the muscles around your eustachian tube to open. The movement of the jaw equalizes the pressure between the inside and outside of the eardrum upon the opening of the eustachian tube.

Ear Plugs
Purchase earplugs that are specifically designed for flying. The earplugs restrict the flow of air into your inner ear, allowing it more time to keep up with the rapid change in pressure. Earplugs can be purchased at your local pharmacy or drug store.

Breathing
There is a special way you can breathe to release the pressure in your ears while flying. Inhale, and then gently exhale while holding the nostrils closed and the mouth shut. Repeat several times, especially during descent, to equalize the pressure between your ears and the airplane cabin.

Use A Decongestant
Purchase an oral or nasal spray decongestant. A decongestant can be used before, during, or after the flight to relieve any built-up nasal congestion, and to open the eustachian tube. For best results, use a spray decongestant 30 minutes prior to landing. If is best to take an oral decongestant 30 minutes to an hour prior to your plane taking off.

Tips For Babies
The best way to control the change in pressure between the inside and outside of a baby’s eardrum is to have the child suck on a bottle or pacifier during take off and landing. It is also important to make sure that a baby does not sleep during descent.

To learn few more Tips You may click to see :How to Keep My Ears From Popping While Flying

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/earspopping.shtml
http://www.eustachian-tube.net/EUSTACHIAN-TUBE.html
http://www.ehow.com/list_6821346_tips-pop-ears-flying.html

http://commons.wikimedia.org/wiki/File:Ear-anatomy.png

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Some Health Quaries & Answers

Getting Rid of Body O dour
Q: I have been suffering from body odour, particularly from the armpits, for the last two years. The problem is so severe that if someone around me coughs, sneezes or looks away, I feel it’s because of my body odour.

A: You may be becoming self-conscious and attributing all actions of others to your odour. That may not be the case. However, to tackle the problem,

• Remove all the hair from your armpits and groin area

• Bathe twice a day using a loofah

• Use an antibacterial germicidal soap like Neko

• Wear only pure cotton clothes

• Apply body spray to the armpits after bathing

At work, if you feel particularly conscious, take a fresh shirt with you (buy two identical shirts, so no one will know you have changed). Change around 2pm after washing and spraying just your armpits.

Ear discharge
Q: My son has brown-coloured blood oozing intermittently from one ear. He does not have any pain or fever when this happens. We consulted a doctor but there was no discharge at that time.


A:
First, you have to be sure the secretion is actually blood. At times, the ear gets filled with brown wax, which can ooze out at times. But if it is blood, it’s a dangerous sign. It may be due to an infection, injury or a foreign body that the child may have inserted into his ear. If neglected, it can affect his hearing. Consult an ENT (ear, nose, throat) surgeon immediately.

Recurrent tonsillitis
Q: My daughter is prone to tonsillitis. The doctor has to give her antibiotics at least five times a year, and these are usually sulfa drugs. Recovery, however, is hardly ever complete and she keeps coughing and complaining of pain for a long time afterwards. She has now been advised tonsillectomy.

A: Tonsillitis is not always due to a bacterial infection. If it is because of a virus, antibiotics will not work. Bacterial infection in the tonsils is characterised by high fever and pain and difficulty in swallowing. Also, the sulfa group of drugs does not act against tonsillitis; you need to take penicillin or azithromycin. There are some age-old preventive measures for tonsillitis like regular gargling twice a day with warm, salted water.

Tonsillectomy is not advised unless one suffers from six or more attacks a year. Moreover, the child should preferably be over 10 years. The operation has its own dangers, drawbacks and after effects.

To shave or not
Q: My facial skin becomes black, rough and thick when I shave. My wife says it is because I do it with soap. Should I stop shaving?

A: Your wife is probably right. You need to use a shaving gel or foam containing a moisturiser. The latter will soften the hair and you do not have to scrape it off with a blade. An aftershave acts like an astringent and antiseptic. It will take care of any minor cut that shaving may produce. On the other hand, if you go out into the sun, any perfume in the aftershave may produce photosensitivity and darkening of the skin.

You can apply baby oil to your face at night. This will further soften the skin. Not shaving is often not a solution, because it may impart an unkempt and unprofessional look.

Sleepy child
Q: My granddaughter is an intelligent and active three-year-old. Every time she wakes up from sleep, she asks for her mother and is very slow and lethargic. It takes her about half an hour to become fully aware of her surroundings. Does she need an energising tonic?

A: Many children behave that way. When a child is sleeping, the brain is resting, and it needs time to adjust from zero activity to high activity. Just let your granddaughter make the transition slowly, hugging her for some time. Asking for the mother is normal. She does not need a tonic.

Tongue tie
Q: My son has tongue tie. He is now nine months old. He does not have any difficulty breast-feeding or eating. Relatives say he needs surgery. Which doctor should we consult and where should we have the surgery?

A: Tongue tie is serious if the infant cannot feed. If your son is able to chew and swallow, wait till speech develops. Sometimes tongue tie may be an impediment to speech. If that is the case, you can opt for surgery then. You can wait until he is six years old, as the condition might correct itself as the face, tongue and mouth grow.

Source The Telegraph (Kolkata, India)

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Those Painful Sinuses

Doctors have a lot of work in the winter months with the low temperatures, the monsoon, and the festivals with smoky fireworks. Almost everyone complains of colds and “sinusitis”.

CLICK & SEE

We have four pairs of sinuses that drain into the nasal cavity: frontal above the nose, maxillary in the cheekbone area, ethmoidal at the roof of the nose and between the orbits of the eyes, and sphenoidal on the sides of the forehead near the corner of the eyes. Sinuses are present at birth and continue to grow and develop until adolescence. They are, in fact, useful as they contain air, which helps to modulate the pitch and timber of the voice. They also reduce the total weight of the skull, which would otherwise be composed of heavy solid bone. They are lined with mucous membranes similar to that in the nose.

Sinuses may become inflamed as a result of viral infections, which are likely to occur with seasonal changes. A “cold” causes the nose to clog up and the natural orifices through which secretions from the sinus drain get blocked. Acute allergies to pollen, smoke, room fresheners and mosquito repellents compound the blockage. As the membrane swells, it exudes mucoid secretions which fill the sinus.

The space in the sinus is limited on all sides by rigid bone, leaving no room for expansion. The typical throbbing headache develops, and worsens on changing positions as the mucous shifts around. These clogged secretions may become secondarily infected by bacteria.

Sinusitis produces a nasal block, a thick yellow or green discharge, a troublesome sleep-disturbing night cough, fever and swelling over the affected sinuses. It can also cause bad breath, which persists despite brushing the teeth or using mouthwashes.

Acute sinusitis can be completely cured in 30 days with treatment — adequate doses of appropriate antibiotics for 10-14 days. If the treatment is discontinued after a few doses as relief is obtained, the infection tends to recur.

Recurrent sinusitis occurs in cycles with at least a 10-day, symptom-free intervening period. It occurs when there is exposure to the allergen again and again, perpetuating a cycle of nose blocks, infections, treatment and relief.

Sinusitis is labelled as chronic only if it persists for more than 90 days. It can be caused by a variety of bacteria or even fungi. It is rare in normal healthy individuals unless there is an aggravating factor. Pus from an infected untreated tooth, particularly in the upper jaw, can burrow into the maxillary sinus.

Some people have a deviated nasal septum (the partition between the two halves of the nose is not straight). This can be present from birth. It may develop as a result of injury. The small openings draining the sinuses may become blocked by the bent nose. Allergies, which are untreated and chronic, can cause permanently swollen nasal mucosa. This can form grape-like swellings called polyps. Children sometimes insert stones, peas, erasers and other objects into their nose. They can remain wedged, unsuspected and undiagnosed, causing a permanent nose block and sinusitis. Swollen adenoids can also perpetuate sinusitis.

Treatment of sinusitis is likely to succeed only if the aggravating factors are removed. Drainage of the infected material also has to be facilitated. This can be done by using nasal drops. Saline nasal drops are the safest and can be used as often as required. Nasal drops containing chemicals like oxymetaxoline, xylometazoline or ephedrine should be used 3-4 times a day only for the first three to four days, if at all.

Although immediate relief is obtained, in the long run habituation occurs. The nose does not open up even when the drops are used.

Continuous use can also cause rebound congestion. If the nasal mucosa is permanently swollen because of chronic allergy, the newer, non-absorbed steroid nasal sprays are helpful. Steam inhalations and humidifiers also help with liquefaction of the secretions and drainage.

Pain over the sinuses, fever and headache all respond well to paracetemol, which is sold under a variety of trade names. The dose of paracetemol is 500mg three to four times a day for adults and 10-15mg/kg/dose for children.

Sinusitis because of allergy or a viral infection does not need antibiotics. Antbiotics should be used for bacterial infections. Eradication of an infection is difficult, as sinuses are closed spaces. Antibiotics have to be carefully selected and need to be given for 10-14 days for a complete cure. Immunisation covers two of the organisms (H. Influenza and pneumococcus) which can cause sinusitis. This means that children who have been completely immunised are unlikely to be infected by these organisms.

Decongestants and mucous liquefying agents are also helpful if used in addition to other medicines. Antihistamines are not useful, as they tend to dry up the secretions, making them sticky and adherent.

Sinusitis, allergies and respiratory ailments all decrease in frequency and intensity with regular aerobic exercise, like 40 minutes of jogging, swimming or running daily.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Sources: The Telegraph (Kolkata, India)