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Thread: Sinusitis: A Treatment Plan That Works for asthma and allergies too

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    Sinusitis: A Treatment Plan That Works for asthma and allergies too

    Wellington S. Tichenor, M. D.
    New York, New York

    What is Sinusitis?

    Sinusitis is an inflammation or infection of the air pockets on either side of and behind the nose. It can be caused by bacteria, viruses, fungi (molds) and possibly by allergies. About 15-20 % of the population has a chronic sinusitis (meaning lasting longer than 3 weeks). It can cause a tremendous amount of suffering. I had sinusitis for years. I kept working but felt like I wanted to die. I felt like no one understood what I was going through, my wife would always say: "I can't believe you complain so much about something as trivial as a sinus infection", and then she got one... and she started complaining!

    Sinusitis causes a wide variety of symptoms which can often be confused with other medical problems or dismissed as being due to a "cold". There may commonly be single symptoms such as a post nasal drip, stuffiness, or pressure around the nose, but can also be a combination of the these symptoms associated with a runny nose, clear or colored mucus, a cough, a sore or irritated throat, pain in the teeth, headache, or fever. Additional symptoms which sometimes occur are hoarseness, a decreased sense of smell, and fullness of the ears, but they can be extremely varied as you will see in the FAQ section.

    Sinus infections must first be diagnosed accurately, and then subsequently need to be treated with antibiotics, and prescription nasal sprays, as well as decongestants and often medications to thin the mucus. I also suggest that people use a vaporizer at night, and occasionally nasal irrigation, as well as Aspirin (if you can tolerate it), and I am sure that your friends and relatives will attempt to force you to take all kinds of non-drug remedies. Believe me, it gets overwhelming . We will try to sort it out for you.

    If sinus infections are not treated early, they may become chronic. Early means no later than 2-3 weeks after the symptoms first start - the cold that lingers may not be just a cold. The longer you wait to treat sinus problems, the more difficult they become to treat, the more likely complications will ensue, and the more likely surgery may be necessary as opposed to medical treatment.
    Sinus CT Scans
    The following is designed to enable you to develop a basic understanding of sinus anatomy as well as CT scans, both normal and abnormal. We will review several CT scans, but start with a drawing to start to orient you.
    There are four sets of sinuses: maxillary, ethmoid, frontal and sphenoid sinuses. We will examine most of them in the following series of drawings and CT scans. The initial concepts are a little difficult to understand, but will become clearer when we get to the CT scans.

    LEGEND: F - Frontal sinuses, E - Ethmoid sinuses, M - Maxillary sinuses, O - Maxillary sinus ostium, SS - Sphenoid sinus ST- Superior turbinate, T - Middle turbinate, IT- Inferior turbinate, SM- Superior meatus, MM- Middle meatus, SR - Sphenoethmoidal recess, S- Septum, ET - Eustachian tube orifice, A - Adenoids .
    In the first graphic representation, the three overlapping flaps of tissue, called turbinates (inferior - IT, middle - T, and superior - ST ) protect the openings of the sinuses, and allow humidification, filtration and warming of air. The frontal (F) sinus is seen in this view, but is not usually involved to any great extent in sinusitis. The sphenoid sinus (SS) is also seen in this view, and is sometimes involved in sinusitis. The sphenoid sinus drains into the sphenoethmoidal recess (SR)

    In the second graphic representation, the maxillary sinuses (M) drain through the maxillary sinus ostia (O) into the middle meatus (MM). It should be noted that in this graphic diagram, the opening at O appears to be extremely large. In actuality, it is the size of a pin head and actually follows a rather circuitous route as you will see on the CT scans which follow. The ethmoid sinuses (E) drain into both the middle meatus as well as into the superior meatus (SM).

    The middle meatus (MM) is bounded by the middle turbinate (T) and the inferior turbinate (IT). (There is also a superior turbinate (ST), but that is relatively unimportant.)

    Another important structure is the "ostiomeatal unit" which is the outflow tract from the sinuses and includes the ostium of each sinus as well as the meati. When blocked, the ostiomeatal unit can cause obstruction of the sinuses, analogous to putting a plug in a bathtub.

    The frontal sinuses (F) are occasionally important, but will not be dealt with to any great extent in this discussion. The septum (S) creates a barrier between the two sides of the nose. If it is deviated to a great enough extent, an obstruction can occur. Occasionally, there may be a perforation (hole) in the septum, which can cause problems with the architectural support of the nose.


    • Treatment
    • Complicating Factors
    • Surgery
    • Complications
    • Fungal Sinusitis
    • Pediatric Sinusitis
    • Frequently Asked Questions


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    Last edited by trimurtulu; 02-09-2009 at 09:11 PM.

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    That's really a useful and informative post....
    Health,Nutrition,Fitness And Diet Answers for Healthier Life....

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    Really helpful information on allergies.
    We can get some more treatment with herbal remedies as well as i have used it and proved good.

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    thanks a lot

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