What Are Sinuses?
Sinusitis are hollow cavities in the scull. They are available in everyone from the birth, and complete their development in the adolescence period. Their total number can reach 16-18. Especially those in the cheeks and temples are the largest ones. Each sinus has a pinhead-wide hole that opens into the nose. The inside of the sinus is covered by the same tissue in the nose, and the mucus on it moves constantly by means of small hair.
The sinuses and nose produce about 600 ml of mucus per day. This secreted fluid first moves from the nose to the nasal region and then is swallowed by the person involuntarily.
Sinuses lighten the skull, play a role in shaping the voice, clean the bacteria and dust particles, humidify the inhaled air and purify it from particles. For doing this, they need a sound mucous membrane, strong hair-like structures called the cilium (its singular form is cilia), and functional holes.
What Is Sinusitis?
Any problem in the physiology of the sinuses causes mucus accumulation in the sinus. Mucus accumulation continues as long as the pathology continues, and serves as a reservoir for bacteria, which leads to inflammation, and consequently, to the onset of SINUSITIS. Pathologies that lead to sinusitis– ALLERGIC RHINITIS: The sinus mucosa swells due to allergy and blocks the sinus ostiums, causing sinusitis.
– SMOKING: Long-term smoking disrupts the function of the cilium on the tissue that covers the sinus; and consequently disrupts the self-cleaning function of the sinuses, leading to the onset of sinusitis.
– NASAL POLYP: Polyps in the nose, known as nasal polyps, disrupt the mucous membrane, and as a result, cause sinusitis by disrupting both the cilium and the cleaning function.
-IMMUNE SYSTEM DISEASES: In some syndromes and diseases such as cystic fibrosis (in the pediatric age group) and immotile cilia syndrome, cilia movements in the sinus mucosa are disrupted and the resultant condition leads to the onset of sinusitis.
-MICROBES: Some viruses and bacteria cause sinusitis by worsening edema in the sinuses and blocking the sinus ostiums.
What Complaints Does Sinusitis Cause?
The most important complaints caused by sinusitis are nasal congestion and persistent post-nasal drainage. Contrary to popular belief, sinusitis does not cause a considerable headache.
Headache is caused by acute (newly developed) sinusitis only. There is a headache, tension, and a feeling of fullness especially in the temples. There may be under-eye bags. There are recurrent coughing spells.
If these complaints last less than 3 weeks and respond to the treatment, it is called acute sinusitis. Its symptoms include nasal discharge usually light-yellow in color, which is accompanied by headache. If the complaints last for more than 3 months and do not respond to treatment, it is called chronic sinusitis. Headache is not common in chronic sinusitis and the symptoms include dark-yellow-colored nasal discharge.
Findings obtained with a medical examination and the complaints expressed by the patient are adequate for diagnosis. In nasal endoscopy, there is an intensely edematous mucosa, and dark or light-yellow-colored nasal discharge.
There may be under-eye bags. The conchae in the nose are mostly swollen. Post-nasal drainage is observed most of the time. When a definitive diagnosis cannot be made during a normal ENT examination, radiological examinations (such as sinus radiography, sinus tomography) may also be needed.
Treatment Of Sinusitis
Drug therapy is the initial treatment of sinusitis. Keeping the nose open is the most important step of the treatment. The nose should be cleaned with physiological saline solution, and some nasal sprays can also be used for this purpose.
In addition, oral tablets called nasal decongestant, cortisone nasal sprays, syrup or oral tablets that facilitate mucus discharge can be used. If the sinusitis is thought to be bacterial, antibiotic treatment should be administered, and an ideal antibiotic treatment lasts for a minimum of 10 days.
Patients are followed up with antibiotic treatment for 2 to 3 weeks; and if the complaints do not regress, a sinus tomography should be performed. If the pathology is observed to continue on the sinus CT images, the possibility of surgery arises.
Today, sinusitis surgeries are performed in the form of ENDOSCOPIC SINUS SURGERY. Endoscopic sinus surgery is surgical procedure performed completely intranasally under local or general anesthesia, which is intended to ensure physiology by opening the place where the pathology exists.
There is always the possibility of recurrence despite surgical operations, especially in cases of sinusitis accompanying allergic rhinitis.
The patient should be followed up at regular intervals and the medical treatment that he/she needs should be performed from time to time. In my practice, I follow the patient with the post-operative allergy treatment and wash the nasal cavity with serum at regular intervals.