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Sinus and Sinusitis

You're coughing and sneezing and tired and achy. You think that you might be getting a cold.

Later, when the medicines you've been taking to relieve the symptoms of the common cold are not working and you've now got a terrible headache, you finally drag yourself to the doctor. After listening to your history of symptoms, examining your face and forehead, and perhaps doing a sinus X-ray, the doctor says you have sinusitis.

Sinusitis simply means your sinuses are infected or inflamed, but this gives little indication of the misery and pain this condition can cause.

Health care experts usually divide sinusitis cases into

  • Acute, which last for 3 weeks or less
  • Chronic, which usually last for 3 to 8 weeks but can continue for months or even years
  • Recurrent, which are several acute attacks within a year
Health care experts estimate that 37 million Americans are affected by sinusitis every year. Health care providers report nearly 32 million cases of chronic sinusitis to the Centers for Disease Control and Prevention annually. Americans spend millions of dollars each year for medications that promise relief from their sinus symptoms.

WHAT ARE SINUSES?

Sinuses are hollow air spaces in the human body. When people say, "I'm having a sinus attack," they usually are referring to symptoms in one or more of four pairs of cavities, or sinuses, known as paranasal sinuses.

These cavities, located within the skull or bones of the head surrounding the nose, include the

  • Frontal sinuses over the eyes in the brow area
  • Maxillary sinuses inside each cheekbone
  • Ethmoid sinuses just behind the bridge of the nose and between the eyes
  • Sphenoid sinuses behind the ethmoids in the upper region of the nose and behind the eyes
Each sinus has an opening into the nose for the free exchange of air and mucus, and each is joined with the nasal passages by a continuous mucous membrane lining. Therefore, anything that causes a swelling in the nose-an infection, an allergic reaction, or another type of immune reaction-also can affect the sinuses.

Air trapped within a blocked sinus, along with pus or other secretions, may cause pressure on the sinus wall. The result is the sometimes intense pain of a sinus attack.

Similarly, when air is prevented from entering a paranasal sinus by a swollen membrane at the opening, a vacuum can be created that also causes pain.

SYMPTOMS

The location of your sinus pain depends on which sinus is affected.

  • Headache when you wake up in the morning is typical of a sinus problem.
  • Pain when your forehead over the frontal sinuses is touched may indicate that your frontal sinuses are inflamed.
  • Infection in the maxillary sinuses can cause your upper jaw and teeth to ache and your cheeks to become tender to the touch.
  • Since the ethmoid sinuses are near the tear ducts in the corner of the eyes, inflammation of these cavities often causes swelling of the eyelids and tissues around your eyes, and pain between your eyes. Ethmoid inflammation also can cause tenderness when the sides of your nose are touched, a loss of smell, and a stuffy nose.
  • Although the sphenoid sinuses are less frequently affected, infection in this area can cause earaches, neck pain, and deep aching at the top of your head.
Most people with sinusitis, however, have pain or tenderness in several locations, and their symptoms usually do not clearly indicate which sinuses are inflamed.

Other symptoms of sinusitis can include

  • Fever
  • Weakness
  • Tiredness
  • A cough that may be more severe at night
  • Runny nose (rhinitis) or nasal congestion
In addition, the drainage of mucus from the sphenoid or other sinuses down the back of your throat (postnasal drip) can cause you to have a sore throat. Mucus drainage also can irritate the membranes lining your larynx (upper windpipe). Not everyone with these symptoms, however, has sinusitis.

On rare occasions, acute sinusitis can result in brain infection and other serious complications.



Causes of Sinusitis

Diagnosis and Treatment

Prevention and Research



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