Chronic sinusitis Overview
Sinusitis is an inflammation of the lining of one or more of the sinus cavities in the facial bones around your nose. Sinusitis can make life miserable, causing tenderness in your face, aching behind your eyes and difficulty breathing through your nose. Most cases of sinusitis are acute infectious sinusitis, which generally lasts less than four weeks. If the signs and symptoms of sinusitis last more than 12 weeks, or if you have frequent bouts of sinusitis, you may have chronic sinusitis. Chronic sinusitis is one of the most common chronic diseases in the United States, affecting an estimated 33 million people each year. Treatment may be with medications or, in some cases, surgery. Signs and symptoms Chronic sinusitis is not typically accompanied by fever. You may have chronic sinusitis if you have two or more of these major signs and symptoms: Pressure-like pain on your forehead, temples, cheeks, nose, or around or behind your eyes Difficulty breathing through your nose Thick, yellow or greenish discharge that drains into your nose or down the back of your throat Reduced sense of smell You may also have chronic sinusitis if you have one major sign or symptom and at least two of these minor signs and symptoms: Aching in your upper jaw and teeth Headache Bad breath Ear pain Fatigue Cough Causes Your sinuses are hollow spaces within the bones of your face, behind and above your nose. They humidify and warm the air you breathe, aid your sense of smell, and improve the sound of your voice. They also make mucus, which cleans and moisturizes your nasal passages. Inside your sinuses are tiny hairs, called cilia (SIL-e-uh), which constantly sweep mucus out of your sinuses and into your nose and throat. Your sinuses drain into your nose through small openings called ostia (OS-te-uh). When the ostia become blocked, mucus backs up in your sinuses. When your sinuses can't drain, microorganisms such as viruses, bacteria or fungi can multiply and cause infection. Infection causes swelling, which makes it even harder for your sinuses to drain. Common causes of sinus blockage, which can lead to chronic or recurrent sinus infections, are: Respiratory tract infections. Bacterial and viral infections in your respiratory tract — most commonly, colds — can inflame and thicken your sinus membranes, impeding mucus drainage and creating conditions ripe for bacteria growth. Allergy. Your immune system may mistake harmless elements such as pollen, pet dander or dust mites as violent attackers and fight back. The results of this battle mimic signs and symptoms of a cold — stuffy nose, itchy eyes, cough — and may cause congested sinuses. Seasonal allergies may increase your risk during distinct times of the year. If you have allergies to dust mites or pets, your symptoms could appear and reappear at seemingly more random times. Fungi. Fungi can cause a specific type of chronic sinusitis called allergic fungal sinusitis. Nasal or sinus obstructions. Nasal polyps, small growths that resemble grapes, can obstruct the passages from your sinuses to your nose, making proper drainage difficult. The size and shape of the opening between your sinuses and nasal cavity also may obstruct sinus drainage. Other causes of chronic sinusitis include: Immune deficiency disorders, such as HIV/AIDS, which make you more susceptible to chronic sinusitis Cystic fibrosis, which causes your body's secretions to become thick and sticky in your sinuses as well as in your lungs Trauma, such as a fractured facial bone, which may obstruct one or more of your sinus cavities When to seek medical advice Typically, people have several episodes of acute sinusitis before developing chronic sinusitis. If you've had sinusitis a number of times and the condition doesn't respond to treatment, or if your infection has lasted more than three months, ask your doctor if you might have chronic sinusitis. You may be referred to an allergist or an ear, nose and throat specialist. Chronic sinusitis may make asthma symptoms worse in people with asthma and in people who have asthma-like reactions to aspirin and related medications such as ibuprofen. If you experience wheezing or shortness of breath, or if you're concerned about possible aspirin allergy, see your doctor. Screening and diagnosis Chronic sinusitis can be difficult to diagnose because the symptoms may be similar to colds or allergies. Provide your doctor with as much detail about the type and duration of your symptoms as possible. Your doctor may recommend allergy skin tests to determine whether allergies are causing your sinusitis. Allergy skin tests are safe, involve little if any discomfort and usually can be done in a short time. These procedures help in diagnosing chronic sinusitis: Nasal endoscopy. A thin, flexible tube (endoscope) with a fiber-optic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses. Imaging. Images taken using a computerized tomography (CT) scan or magnetic resonance imaging (MRI) can show details of your sinuses and nasal area, including a deep inflammation or infection that may be difficult to detect using an endoscope. Treatment Treatments for chronic sinusitis include: Corticosteroids. If you have intense inflammation of your sinuses, your doctor may prescribe a corticosteroid. Doctors commonly prescribe nasal corticosteroid sprays, but severe inflammatory sinusitis may require oral corticosteroids. Your doctor may prescribe corticosteroid pills to try to shrink the inflamed sinus membranes, then recommend a corticosteroid nasal spray to prevent them from swelling again. Antibiotics. Chronic sinusitis may require a long period of antibiotic treatment. You may need to take antibiotics for a minimum of four weeks, and for as long as 12 weeks. If your condition doesn't improve with medications, your doctor may recommend surgery. Surgically enlarging a narrow sinus passage or removing a bone or polyp that's blocking a passage will allow better drainage, making an infection less likely. Your doctor may perform surgery using a thin, flexible tube called an endoscope. Newer treatments are continually being studied. For example, some studies have examined the role of nasal antifungal medications in treating chronic sinusitis. Initial results looked promising, with as many as 75 percent of people experiencing some relief from their symptoms. More study is needed, however, because another study found no effect from the treatment. Prevention You can reduce your risk of chronic sinusitis by carefully treating allergies and colds. Work with your doctor to get allergy symptoms under control. He or she may suggest medications or allergy shots. These other suggestions may help: Take care of a cold. Drink plenty of fluids when you have a cold. Keep your nasal passages clear by gently blowing your nose, one nostril at a time. Avoid air travel at certain times. Try to avoid air travel during a cold, allergy attack or bout of sinusitis. If you must fly, decongestants may reduce the pressure that can block your sinuses. Avoid irritants. If you're prone to sinusitis, avoid cigarette, cigar and pipe smoke and other air pollutants that can cause your sinus membranes to swell. Alcohol also can cause your sinus membranes to swell. Self-care These steps may help you lessen the symptoms of chronic sinusitis: Spray a saline solution in your nose several times a day. Avoid bending over with your head down. This can increase the pain. Apply warm facial packs. Use a humidifier or inhale steam from a kettle or basin of boiling water, being careful not to scald yourself. Dilute the secretions by drinking lots of fluids. By Mayo Clinic staff DS00232 October 15, 2004 --------------------------------------------------------------------- DUKUNG situs Balita-Anda.Com sebagai Situs Terbaik Wanita & Anak 2004-2005 versi Majalah Komputer Aktif, dengan ketik: POLL ST WAN 2 ke nomor 8811, selama 16 Okt sd. 30 Nov. 2004. Raih sebuah ponsel SonyEricsson K500i, dua buah ponsel Nokia 3100 dan 10 paket merchandise komputerakt!f bagi para peserta polling yang beruntung. Satu nomor ponsel hanya berhak memberikan satu suara dukungan untuk tiap kategorinya. Polling ini berlaku untuk pelanggan Telkomsel, Indosat maupun Excelcom dengan tarif Rp 1.500. --------------------------------------------------------------------- >> Kirim bunga, buket balon atau cake, klik,http://www.indokado.com/ >> Info balita, http://www.balita-anda.com >> Stop berlangganan, e-mail ke: [EMAIL PROTECTED]
