Located over the forehead, between the eyes, over the cheeks and behind the nose, the sinuses are air cavities in the skull that are surrounded by bone and lined with mucous membranes, the “skin” that covers the inside of the nose and sinuses. This membrane has glands that produce mucous, and hair cells (“cilia”) that move the mucous and filter the air. The sinuses and the nasal cavity—whose job it is to warm and filter the air as it passes through the nose during breathing—produce 1 liter of mucous daily, which naturally moistens the nose and throat and helps in the initial process of food digestion. When the mucous gets trapped in the sinuses and/or the sinuses are not breathing well, sinus pressure and possibly sinus infections will occur.
Are some people more prone to sinus problems?
People with poorly breathing sinuses have variations in normal anatomy that narrow the natural sinus doors. This impedes optimal airflow into the sinus, and hampers mucous getting out of the sinus. Individuals with structurally narrow sinus doors are more prone to sinus symptoms when exposed to allergens, viruses or simple changes in barometric pressure, as these factors increase nasal swelling and block the doors even further. Sinus patients can often predict when we will have precipitation, because of the increased sinus pressure they feel.
What are the symptoms of chronic sinusitis?
When mucous gets stuck and blocks the sinuses, the sinus lining will swell and cause pressure over the affected sinus. Sinus symptoms usually are located over the sinus that is inflamed at the time. It is common to have pressure between, under, over and behind the eyes, since they are surrounded by the sinus cavities. Not everyone with chronic sinusitis has trouble breathing through the nose, and not everyone with trouble breathing through the nose has sinus problems. In addition, not everyone with chronic sinus pressure gets recurring sinus infections. Sinus patients each have their own pattern of symptoms that they will describe with variations of those discussed above.
What treatment options are available?
The first treatment option for chronic sinusitis is to conservatively try to get the sinuses to breath better. This can often be done by using a simple nasal irrigation (like a neti pot) and a prescription nasal spray.
If conservative management does not help the patient’s symptoms, a CT scan can be done to evaluate his or her anatomy to see what is blocking the sinus doors. (A CT scan does not produce a diagnosis of chronic sinusitis, as this condition is diagnosed clinically, based on the patient’s history and symptoms.) After the sinus anatomy is evaluated, options are discussed to better open the sinus doors. In most patients, a simple balloon catheter is used to widen a sinus opening so it can function better. Some patients can even have this procedure (which is called balloon sinuplasty, a similar concept to angioplasty) done under local anesthesia in the ENT’s office. Afterwards, no packing or balloons are left in the nose.
To find an excellent ENT doctor who is right for you, please call our Physician Referral Service at 866.804.1007.