In my OPD, I see a few patients complaining that they have “Sinus” (Sinusitis). On probing further, some of them prove correct while most of them prove to be wrong. So do you have sinusitis?
This article is to educate my readers regarding the common complaints experienced by the patients having sinusitis and why they occur.
It is necessary to understand what are sinuses and how they function to recognise the symptoms experienced. There are four groups of sinuses – Maxillary sinuses (behind cheeks), Frontal sinuses (above the eyebrows), Ethmoid sinuses (between eyes) and Sphenoid sinuses (at the back of the head).
The sinuses layered with mucosa continuously produce mucus (slimy fluid) and this mucus is designed to drain towards their respective ostia (doorways of sinuses). From ostia, the mucus follows a predesigned drainage pathway and flow into the back of nose from where it slips into the throat.
Symptoms of sinusitis
1. Headache – Pain, Fullness, Pressure is felt along the eyebrows, forehead, between the eyes, cheeks, top and back of the head. The pain aggravates on bending forward or lying down. Few patients experience upper tooth pain.
The blockage of ostia or drainage pathways leads to accumulation of mucus in the sinuses. Mucus is rich in nutrients and attracts bacteria, whose entry causes conversion of mucus into pus. Pus formation causes inflammation of sinuses causing headache, which is localized to the areas where sinuses are situated.
2. Nasal stuffiness – alternating nasal block, sometimes more during the night while going to sleep.
The pus formed in the sinuses drains along the predesigned pathways, along which the mucus drains. It inflames the pathways causing swelling which narrows the nasal air passageways.
3. Nasal discharge – varying from light yellow to green in colour is the pus formed in the sinuses which drains into the back of the nose, slipping into the throat, forcing throat clearing. The throat clearing ejects the phlegm lodged in the throat into the mouth. Sometimes, this nasal dischargecan be stained with blood spots.
4. Recurrent sore throat – In adult patients suffering from recurrent tonsillitis, the most common culprit is the co-existing sinusitis. The infected nasal discharge slipping into throat also infects the throat causing symptoms.
Sinusitis is a chronic issue, and it is common for few patients to get habituated to the symptoms, not feeling the need to address them anymore. These patients presenting with secondary symptoms like throat irritation, dryness of mouth, bad breath from the mouth, ear pain, ear block, cough etc. or present when their habituated symptoms are aggravated.
So, do you have “Sinus-itis” (itis stands for inflammation)?