Rhinosinusitis (Sinusitis; Followed by Rhinitis) Relief by Simple, Effective Way

Rhinosinusitis (Sinusitis; Followed by Rhinitis) Relief by Simple, Effective Way

When the tiny openings that drain the sinuses get blocked, mucus becomes trapped in the sinuses. Like water in a stagnant pond, it makes a good home for bacteria, viruses, or fungi to grow. If a cold lasts for more than 10 to 14 days (sometimes you may have a low-grade fever), you may have sinusitis. This means an infection of the sinuses. For environmentally caused disease, avoiding exposure to cold air, keeping the air humidified and minimizing exposure to pollutants all help. Steam inhalation techniques, drinking apple cider can help you to find some measure of comfort.

An allergic reaction may occur anywhere in the body but usually appears in the nose, eyes, lungs, lining of the stomach, sinuses, throat and skin. These are places where special immune system cells are stationed to fight off invaders that are inhaled, swallowed or come in contact. Nasal congestion and a runny nose have a noticeable effect on quality of life, energy level, sense of smell and taste, ability to breathe, ability to sleep, and ability to function in general. Mouth breathing also pulls all pollution and germs directly into the lungs; dry cold air in the lungs makes the secretions thick, slows the cleaning cilia, and slows down the passage of oxygen into the blood stream.

In children, common predisposing factors include allergies, exposure to respiratory infections from other children at day care centers, use of pacifiers (sucking increases saliva production, which can help bacteria travel to the middle ear), bottle drinking when lying on their backs (eustachian tubes do not function as well when the baby is lying flat), exposure to second-hand smoke, and adenoid enlargement. In adults, the predisposing factors are most frequently environmental. Smoking is also a major consideration.

Chronic sinusitis begins with an inflammation of the mucous membranes in your sinuses — the air-filled passages around your nose and throat. The inflammation causes fluid buildup eventually plugging the sinus cavity and preventing normal mucus drainage you have chronic sinusitis, you may have difficulty breathing through the nose, experience frequent headaches and tenderness in the face or aching behind the eyes.

Sinusitis can manifest as weeping mucus that drips down the throat, which can cause irritation and prompt coughing. Researchers suggest that sinusitis is more common in people with chronic cough. They placed sinusitis among the top three reasons for chronic cough, along with acid reflux and rhinitis, inflammation of the nasal passages. Chronic cough is defined as a cough lasting over three weeks.

The epithelial cells lining the nasal and sinus cavities play an important role as first responders of the immune system. When they are distracted fighting non-existent parasites, they cannot deal well with the very real microbes continuously coming into the nose and may promote growth of bacteria and fungi in the nose, which is a common finding in those with chronic sinusitis with polyps. Generally the infections will develop in the cheekbone sinus areas and that of the nasal sinus areas.

Study at Georgetown University Medical Center found that an unusual connection between patients with chronic pain or fatigue: prevalent sinus symptoms. Sinus symptoms were nine times more common on average in patients with unexplained chronic fatigue than the control group, and six times more common in patients with unexplained chronic pain. In addition, sinus symptoms were more common in patients with unexplained fatigue than in patients with fatigue explained by a mental or physical illness, suggesting the syndrome of unexplained fatigue is more closely associated with sinusitis than are other types of fatigue.

In fact, rhinitis is the precursor to sinusitis in so many case that expert groups now refer to most cases of sinusitis as rhinosinusitis. Nearly everyone with colds has inflamed sinuses. These inflammations are typically brief and mild, however, and most people with colds do not develop true sinusitis. Rhinosinusitis tends to involve the maxillary sinuses (behind the cheekbones), ethmoid sinuses (between the eyes), frontal (behind the forehead) and sphenoid (behind the eyes) sinuses. The ethmoid sinuses are the most commonly affected sinus group. Patients can have significant inflammatory disease of the sinuses without apparent symptoms.

More research is underway at Mayo Clinic to confirm that the immune response to the fungus is the cause of the sinus inflammation. The researchers distinguish chronic sinusitis -- sinusitis that lasts three months or longer -- from acute sinusitis, which lasts a month or less. They say that the cause of the acute condition is usually a bacterial infection.

Infectious rhinitis may be acute or chronic. Acute infectious rhinitis (e.g., the common cold) is easy to distinguish from other forms of rhinitis because of its temporary nature. Chronic rhinosinusitis is characterized by mucopurulent nasal discharge and associated congestion, olfactory disturbance, sore throat, fetid breath, and malaise. Postnasal drip with resultant cough is a common clinical finding. The general lack of pain and systemic symptoms makes chronic sinusitis difficult to diagnose on the basis of the patient history alone. Because the signs may be nonspecific, chronic rhinosinusitis can be easily confused with perennial allergic rhinitis.

Sinusitis is often preceded by rhinitis and rarely occurs without concurrent rhinitis. Most importantly, computed tomography (CT scan) findings have established that the mucosal linings of the nose and sinuses are simultaneously involved in the common cold (previously, thought to affect only the nasal passages). Otolaryngologists, acknowledging the inter-relationship between the nasal and sinus passages, now refer to sinusitis as rhinosinusitis.

Chronic rhinosinusitis is one of the most common chronic illnesses in Americans under 45 years of age. Approximately 20% of patients with chronic rhinosinusitis develop nasal polyps. Nasal polyps are growths that develop from sinus tissue. The resulting growth may cause the sinus cavities to become blocked. Characteristic symptoms of chronic rhinosinusitis with polyps are same as those observed in chronic rhinosinusitis. Acute bacterial rhinosinusitis in adults is a common malady, with between 30 to 35 million cases a year.

A thorough search to determine the cause of nasal obstruction is essential, and that cause should be addressed. The proper treatment of nasal obstruction is not simply turbinectomy. Clinical studies of rhinosinusitis (RS) have traditionally assessed outcomes in terms of physiologic measurements, including rhinometry, CT scans, IgE levels, and complication rates.

Recovering from sinus surgery is notoriously painful and uncomfortable -- especially when doctors need to remove a packing they placed inside the sinus cavity during the procedure to reduce bleeding. Sinus surgery is usually the treatment of last resort for those who do not respond to drug therapy. But nearly one in 10 of those treated see symptoms return within weeks or months after surgery fails to keep open the nasal passages.

Vaughan, assistant professor of surgery at the School of Medicine believes nebulized antibiotics represent a promising alternative for patients who continue getting sinus infections even after surgery and who have failed, or cannot tolerate, oral or intravenous antibiotics.

Researchers from Brigham and Women’s Hospital (BWH) have found that patients, who suffer from chronic rhinosinusitis (CRS), a long term viral or bacterial sinus infection, can find relief from symptoms which include nasal obstruction, discolored nasal drainage, loss of smell, facial pressure or pain, fatigue and headache, through endoscopic sinus surgery (ESS), a noninvasive outpatient procedure. In addition, study results suggested that ESS helps reduce dependence on antibiotics and antihistamines to mange these symptoms.

Sinus Dynamics uses this nebulized technology in this way. Antibiotics, anti-fungals, and anti-inflammatories are nebulized directly into the sinuses using a 3.2 micron particle size to quickly and easily make it pass the inflammation of the sinus cavity lining and straight to the sinusitis infection.

Although most cases of acute rhinosinusitis are caused by viruses, acute bacterial rhinosinusitis is a fairly common complication. Nasal irrigation with hypertonic and normal saline has been beneficial in chronic sinusitis and has no serious adverse effects. A saltwater or saline, nasal wash helps remove mucus and bacteria from the nose and sinuses. This can temporarily reduce symptoms of nasal congestion and postnasal drip. Nasal saline wash of the nose can be one of the most helpful treatments for both acute and chronic sinus problems.

An inexpensive, safe and easy treatment is an effective method for treating chronic nasal and sinus symptoms – more effective, in fact, than commonly used saline sprays, according to a new study from University of Michigan Health System researchers. One of the greatest benefits of the nasal irrigation we are using is that it is very cheap and very safe.

The study is the first of its kind to show greater efficacy of saline irrigation treatments versus saline spray for providing short-term relief of chronic nasal symptoms, the authors report. Participants in the study who were treated with irrigation experienced a much greater benefit than those who were treated with saline spray, in terms of both the severity and frequency of their symptoms.

“The irrigation group achieved a clinically significant improvement in quality of life in terms of the severity of their symptoms, whereas the spray group did not,” says lead author Melissa A. Pynnonen, M.D., clinical assistant professor in the U-M Department of Otolaryngology. “Strikingly, they also experienced 50 percent lower odds of frequent nasal symptoms compared with the spray group.”

The findings, which appear in the new issue of the Archives of Otolaryngology – Head & Neck Surgery, could be significant for the multitudes of people who suffer from chronic nasal and sinus conditions. In the United States, 36 million people are affected by chronic rhinosinusitis each year, and millions more are affected by other types of allergic and non-allergic rhinitis.

Treatments including antibiotics, antihistamines and anti-inflammatory drugs can be helpful, but for many patients, symptoms persist. “A lot of symptoms still aren’t very well treated,” Pynnonen says.

Treatment with saline irrigations – the flushing of nasal passages with a salt water mixture – often is recommended by otolaryngologists (ear, nose and throat physicians) for a variety of sinus conditions. It has long been used as a treatment following sinus surgery, and more recently is becoming common in non-surgical patients. The authors of this study say their findings suggest that otolaryngologists and primary care physicians should recommend this treatment to their patients more often.

Saline sprays are often used as an alternative to irrigations because spray “is often perceived to be equivalent to and better tolerated than irrigation,” the researchers note. But the effectiveness of sprays has not been proven in clinical trials.

Among the 121 adults in this study – all of whom have chronic nasal and sinus symptoms – 60 were treated for eight weeks with saline irrigation and 61 were treated with saline spray. The severity of their symptoms was measured with the 20-Item Sino-Nasal Outcome Test, and the frequency of symptoms was measured with a questionnaire.

The irrigation group’s average score on the severity test had dropped (improved) by more points than the spray group’s average at intervals of two weeks, four weeks and eight weeks (4.4 points out of 100 lower at two weeks, 8.2 points lower at four weeks, and 6.4 points lower at eight weeks).

Frequency of symptoms also improved in both groups, though more for the irrigation group. While 61 percent of the spray group reported having symptoms “often or always” after the eight-week study, just 40 percent of the irrigation group did. “It’s clear from our results that both treatments led to a decrease in frequency and severity of symptoms, but the difference is that the salt water flush led to substantial improvement,” Pynnonen says.

Both groups experienced adverse effects, with more reported in the irrigation group. Most were minor, however, and none required that the treatment be stopped. The most commonly reported adverse effect was post-treatment drainage.

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