Sinuses
Sinuses If your body''''s breathing system were a theater ensemble, the Tony Awards should go to your sinuses. They''''re the supporting cast--without which you''''d be gasping for air. Every minute of every day, they''''re delivering a command performance.
Though these eight air-filled cavities--located behind and around the nose and eyes--may be a long way from the
| Where They Are If you''''ve ever had a sinus headache, you probably have a good idea of where your mucus-producing sinuses are located. The frontal sinuses are above your eyes and nose and behind your forehead. You also have maxillaries, which are pyramid-shaped sinuses, located inside each cheekbone. The ethmoids are multicompartmental sinuses lying behind the maxillaries and between the bony orbits of your eyes. |
 | Sinuses of the nasal passage: side view (top) and front view (bottom) |  |
lungs, they''''re actually their best guardians. They perform like filters, protecting the lungs from invading viruses, allergens, dust, dirt, or any airborne particles. They also moisten dry air that could irritate the lungs as well as cool very hot air and warm extremely cold air that could shock the lungs. Other special duties: They give the voice resonance, and--because they''''re actually cavities carved out of solid bone--they make the skull lighter than it would be otherwise. All those caves in your skull make it easier for you to hold up your head.
They''''re also mini mucus manufacturers. The membrane-lined cavities of the respiratory system create between a pint and a quart of mucus a day. This sticky secretion traps particles that enter the nasal passage, while the cilia--microscopic hairlike filaments--sweep those particles toward the back of the nose.
Stuffed to the Gills
When you consider the array of maladies that can clog your sinuses, it''''s amazing that they are ever clear at all. Who among us hasn''''t suffered the stopped-up discomfort of a cold or the wheezing, sneezing and dripping of an allergy?
When it comes to head-throbbing aches, the top affliction is sinusitis--a disruption of normal sinus drainage that results in facial pain, greenish nasal and postnasal discharge, extreme fatigue and head congestion. Thanks to this annoying infection and inflammation, the sinuses rival the lower back for causing the most pain and discomfort of any body part.
In fact, nearly 40 million Americans suffer chronic sinus problems, with sinusitis being the number one chronic condition of women ages 30 to 45 and the second-highest chronic condition for women over 45. Even if it isn''''t an ongoing problem, many women are likely to be struck sometime by the severe form of the infection known as acute sinusitis, which can last from ten days to several months.
Millions of cases of sinusitis are caused when colds, bronchitis, asthma, allergies, the flu or airborne irritants cause the drainage openings of the sinuses to swell or get blocked. Fluid accumulates and microorganisms infect the sinuses. About 80 percent of cases are caused by bacteria, and viruses cause 20 percent.
Another culprit is the climate. Damp weather usually aggravates sinusitis. When the barometric pressure drops--which generally happens before a rainstorm--anyone who has a history of sinusitis problems is likely to have a flare-up.
When you have a common cold, sinusitis problems may start when your breathing is obstructed, causing the nasal mucous membrane to become inflamed and swollen. The cold virus inactivates the cilia of the nasal membrane, causing the mucus in the nose and sinuses to stagnate rather than flow.
The ostia, which are drainage ducts the size of pencil lead, connect the sinuses to the nasal passages. When these tiny ducts are clogged with mucus and can no longer drain properly, the sinuses become a breeding ground for bacteria.
The mucous membrane and its cilia are left damaged and weakened following a bout of sinusitis. Sometimes--especially in polluted or dry air--the membrane never completely recovers, leaving it much more susceptible to future infections.
When It Comes and Stays
Chronic sinusitis is when you have either ongoing sinusitis that lasts longer than three months or at least three or more sinus infections in a six-month period, says Robert Ivker, D.O., clinical instructor in the Departments of Otolaryngology and Family Medicine at the University of Colorado School of Medicine in Denver and author of Sinus Survival.
The number of people with chronic sinusitis is climbing--partly because of the increasing number of pollutants in both the indoor and outdoor air, says Dr. Ivker. "The nose and sinuses are our bodies'''' primary air filters, and the air we filter is getting dirtier and more toxic. Try rubbing sandpaper over the back of your hand 23,000 times a day. Can you imagine the quality of that skin? The same things happen to the membranes of the nose and sinuses."
Although a bout of sinusitis can be a roadblock to comfortable living, there are many ways for you to pull the plug on congestion and breathe easier. Here are some hints from doctors.
Get all steamed up. Steam is just what the doctor ordered to loosen up a mucus-packed nose and help drain the sinuses, says Anthony J. Yonkers, M.D., professor and chairman of the Department of OtolaryngologyHead and Neck Surgery at the University of Nebraska Medical Center in Omaha. "You should go into a steamy shower and just stay there for a while."
Bow over vapor. Another way to get steamed is by leaning over a pot of piping hot water with a towel over your head. Do it four times a day for five to ten minutes, says Alexander C. Chester, M.D., clinical professor of medicine at Georgetown University Medical Center in Washington, D.C. Adding a few drops of eucalyptus oil can pack some decongesting punch as well. The oil is available at many health food stores, but only use it as an inhalant, since eucalyptus oil is poisonous if it''''s ingested.
Warning: If you heat a pot of water on the stove, be careful, because a rush of rising steam can give you severe burns. Be sure to take the pot off the stove. If it''''s covered with a lid, lift the lid to release any built-up steam before you lean over the pot.
Ax the antihistamines. Don''''t use antihistamines--they thicken and dry mucus, says Dr. Ivker. "The thicker the mucus, the harder it is to drain from the sinuses."
Do decongest. Take single-action tablets that contain only decongestants, such as pseudoephedrine (Sudafed), says David Zwillenberg, M.D., otolaryngologist at Thomas Jefferson University Hospital in Philadelphia. Decongestants constrict the blood vessels, put air through the nose and alleviate pressure.
Don''''t overdo. Using a decongestant nasal spray for more than three days can make you stuffier than you were before, says Dr. Yonkers. "Any long-term use of decongestant sprays causes a chemical rebound problem with the lining of the nose. This means that your nose becomes congested again, making you want to use the spray again and again, until you are caught up in a long cycle."
Take a hike. Getting at least 20 minutes of aerobic exercise three times a week could help you breathe easier, notes Dr. Yonkers. "One of the problems with sinusitis is that you have decreased oxygen levels in the tissue. This helps certain bacteria grow better. By increasing the metabolic rate, you might change that."
Salt your schnozz. To help flush the sinuses, Dr. Ivker recommends irrigating them with saltwater. Mix one-third teaspoon of noniodized table salt with one cup of lukewarm water and a pinch of baking soda. Bottled water without chlorine is preferred, says Dr. Ivker. Stir well, until the salt and baking soda are completely dissolved, and pour the solution into a shot glass. Tilt your head back slightly and to the left. Then, slowly pour half of the water into your right nostril. The water will flow out of your left nostril or down the back of your throat if your left nostril is clogged. Spit out the water if it goes down your throat. Repeat this procedure on the left side. You can also try a commercial saltwater mist spray like Ocean or Ayr for a similar effect.
Stop smoking. Cigarette smoke contains irritants that damage the nasal lining, says Dr. Yonkers. "If you smoke at home, the smoke sits around your house, and you re-breathe it. If you must smoke, do it outside and keep your home air sacred. The same goes for the car."
Pop out of bed. Getting too much shut-eye can exacerbate congestion, says Dr. Chester. The lying-down position increases nasal congestion, because drainage is slowed. Propping your head up with several pillows or raising the head of your bed may help.
Don''''t make a spectacle of your sinuses. Eyeglasses sometimes pinch the nasal bridge and aggravate nasal congestion, says Dr. Chester. Try contact lenses or looser-fitting glasses.
Call for reinforcements. If all else fails, your doctor can help cut a sinus infection short with antibiotics. For acute sinus infections, first-line therapy is usually prescription medicines like amoxicillin (such as Amoxil) or erythromycin (such as E-Mycin) for ten days. In chronic cases you might be given antibiotics and decongestants for at least a month. As a last resort, surgical drainage might be used to widen your sinus openings.
| What Makes a Cold a Cold? Believe it or not, the runny nose, sore throat and dry cough that may accompany a cold are not caused by one of the some 200 cold viruses that are floating around out there. They''''re actually a reaction to the body''''s fight against the viruses. Once the infection starts, fluid and mucus accumulate as a result of successive waves of white blood cells flowing to the area to fight off infection. You catch a cold by breathing in virus-containing droplets that are sneezed or coughed into the air or by rubbing your eyes or nose after touching some virus-contaminated object. For the most part a cold lasts about five days, but when stuffy nose and congestion hang on longer than that, you may have acute sinusitis, notes Alexander C. Chester, M.D., clinical professor of medicine at Georgetown University Medical Center in Washington, D.C. The infection can spread to other mucus-lined areas, causing laryngitis, bronchitis or other infections. "The membranes of the nose are damaged by the virus, which causes a bacterial infection. You''''ll want to see a doctor about taking antibiotics." |
The Uncommonly Annoying Cold
It''''s bad enough that you end up looking like Rudolph the Red-Nosed Reindeer and sounding like Elmer Fudd; why does the common cold have to be so, well, common? Chances are, this year you''''ll be struck by cold viruses--and succumb to humanity''''s most prevalent sickness--at least twice and up to four times.
When a nasty virus stops you cold, try the following tips.
Wash up. Since colds are transmitted by hand-to-face contact, it''''s a good idea to wash your hands frequently. Try not to touch things that you know someone with a cold has touched, says Dr. Yonkers. "Everyone worries about people sneezing around them in the office, because they think that they''''ll breathe in germs and get infected. But if you touch the doorknob that they just touched and put your hand to your eye or nasal chamber, it''''s much more likely that you''''ll be infected."
Be extra aware in the air. One of the more common places to pick up cold viruses is in airplanes, notes Anne Simons, M.D., assistant clinical professor of family and community medicine at the University of California, San Francisco, and author of Before You Call the Doctor. Because so many people are packed together in planes, and the flight attendants are handing out and collecting cups and utensils, be especially careful about hand-to-face contact when you''''re flying.
Don''''t forget that flying with a cold can cause a short-term blockage between the sinuses and the nose, notes Dr. Yonkers. If you have to fly with a cold, use nasal spray and take decongestants to shrink your nasal lining before the plane takes off.
Spice it up. Spicy foods make the nose run, which helps loosen mucus and moisten the lining of the nose, says Dr. Yonkers. Try eating spicy Mexican foods or a spoon of horseradish.
Drink up. Drinking at least six glasses of water a day is important, according Dr. Chester. "Anything that will keep the membranes hydrated and the mucus from drying out is a very good idea."
C''''s the day-saver. Vitamin C can be a sure cold fighter, notes Dr. Chester. "The theory is that it has a decongesting effect; that''''s why it aborts a cold." He recommends taking 2,000 milligrams a day--in doses of 500 milligrams taken four times a day. This is far above the Daily Value of 60 milligrams, so you should check with your doctor before taking higher amounts.
Get souped up. You might have thought that it was an old wives'''' tale, but chicken soup really does work on colds, says Dr. Zwillenberg. Having a steaming bowl of chicken soup every day cuts down on the amount of time that people show symptoms.
Allergies: Alien Invaders
If you''''ve never so much as sniffled during hay fever season, and you''''ve hugged many a dog or cat without sneezing, count yourself lucky. For tens of millions of Americans, allergies aren''''t just something to sneeze at; they''''re also something to cough, wheeze and be miserable over.
Allergies are tricky things. They can develop at any age. The dust on your nightstand that never bothered you before might suddenly have you sniffing and coughing.
Although allergies tend to run in families, the cause isn''''t clear. All doctors know is that the immune system mistakes otherwise harmless things like pollens, molds, dusts and animal dander for invaders. Aggravated into reaction, the immune system then mounts different defensive reactions against them. Those reactions cause symptoms such as runny nose, watery eyes and nasal congestion.
| Mucus Revelations Trying to read your mucus isn''''t as interesting as reading, say, People magazine, but it could help you find out what''''s wrong with you. With the common cold and allergies your mucus is thin, clear or white. But the nasal secretions of a sinus infection are an unmistakable thick, greenish yellow. How do you distinguish a cold from an allergy? There''''s no difference in mucus color, but other symptoms can tell you. With an allergy the symptoms are likely to be sporadic rather than constant, often involving sneezing and itching. A cold, on the other hand, is more likely to be accompanied by a headache, sore throat and low-grade fever. |
If you''''re coughing and sneezing for what seems like no reason, you just might have an allergy. Your doctor can take a medical and environmental history, including information about pets, bedding, living conditions and seasonal variations in symptoms. All this information helps the doctor detect what you are allergic to.
If itchy eyes and a drippy nose are driving you to distraction, here are a few simple suggestions from doctors.
Be a dust buster. Because dust and dust mites are major allergens, it''''s smart to get rid of as many sources of these irritants as possible, says Dr. Chester. Use washable curtains and tight-weave rugs that don''''t hold dust. Also, avoid collecting knickknacks, because they can accumulate dust, and change the filters in your air conditioner and heating systems monthly. In addition to washing your sheets and pillowcases as frequently as feasible, you should wash your mattress pad, bedspreads and blankets every month.
Flush out the mold. Having a vaporizer in your bedroom is good for keeping your nasal tissues moist, but don''''t forget to clean it every three days to prevent the buildup of allergy-causing molds, says Dr. Zwillenberg. Rinse it with a weak bleach solution made from one teaspoon of bleach and one quart of water or use a 50-50 solution of vinegar and water.
Have a bleach party. Another way to avoid molds is by washing areas around sinks and bathtubs with bleach, says Dr. Simons. You can use straight bleach or make a diluted solution by adding some water to the bleach.
Take a nonsleeping pill. To ease nasal congestion and dripping, try a nonsedating prescription antihistamine such as terfenadine (Seldane), loratadine (Claritin) or astemizole (Hismanal), says Dr. Zwillenberg. Some of these might make you drowsy. "But they''''re much less sedating than regular antihistamines."
Get a dryer. If pollen is your poison, it''''s a good idea not to line-dry clothing, says Dr. Zwillenberg. "Clothes dried outside tend to trap pollen. It''''s just one more irritant to deal with."
See also Nose, Respiratory System
