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Thursday, February 16, 2012

What are sinuses



What are sinuses?
Sinuses are paired air cavities or air spaces (pockets) in the cranial (head) bones. And they are connected to the nose on the facial part of the skull where air passes and mucus drains... However sinuses are also referred to as "paranasal sinuses". Sinuses are often confused with sinusitis... The huge difference between the two is that sinuses are natural cavities in your body found in the front of the skull, whereas sinusitis is a condition that usually occurs when one or more of these cavities become inflamed due to blockage of the small tubes attached to the nasal passages.  When we refer to sinusitis or a “sinus attack” it is usually a reference to an inflammation or infection to one or more of the cavities, which stops proper drainage.

Types of sinuses -

Sinuses vary according to location in the facial bones of the skull - they can become inflamed individually or collectively. When these sinuses become infected it is known as sinusitis.

There are four pairs of cavities:
Ethmoid (between the eyes) sinuses… These sinuses are located behind the bridge of the nose and at the “root” of the nose between the eyes. We are all born with ethmoid sinuses and as we grow, they also grow. When these cavities become inflamed, you have ethmoiditis.

Frontal (forehead) sinuses… These are sinuses located above the eyes in the region of the forehead and only develop around seven years of age. When frontal cavities become inflamed, you have frontal sinusitis.   

Maxillary (cheekbones) sinuses... These sinuses are found in either side of the nostrils in the cheek bones. They are present at birth and grow as we grow. Inflammation of maxillary cavities due to bacterial, viral and other irritants is called antritis.

Sphenoid (behind the eyes) sinuses... Sphenoid sinuses lie deeper in the skull behind the ethmoid sinuses and the eyes. We only develop sphenoid sinuses during adolescence. Inflammation of these cavities due to any irritant is called sphenoiditis.  

Why do we have sinuses...

We naturally have sinuses for the following reasons -  Each sinus cavity has an opening (ostium) which opens into the nasal passages for free exchange of air and mucus. The mucus linings in the sinus cavities are continuous with the mucus linings of the nasal passages. The mucus linings have ciliated epithelium (cells with fines hairs) that moves the mucus from the sinus cavities to drain into the nasal passages. Air trapped in an obstructed sinus, along with other secretions, may cause pressure on the sinus wall. And this pressure may result in the intense pain of a sinus attack. When air is prevented from entering a paranasal sinus by a swollen membrane at the opening, a vacuum can be created that can also causes pain. Note that when air is prevented from entering the nasal cavities due to swollen membranes a vacuum is created causing intense pain (sinus attack).

NASAL SPRAYS  & SOLUTIONS :-  SINUSPRAYS  are custom compunded antibiotic, anti-inflammatory, and anti-fungal nasal sprays formulated to provide the most effective treatment of recurrent sinusitis.Available by prescription only. Sinusprays provide fast, direct, topical treatment –without clostly, cumbersome equipment.  As easy to use spray bottle safely delivers the customized medication in the potimum dosage directly to the infection – minimizing obsorption into the blood stream.  Effective and non-invasive, treatments generally take only 5 minutes and are conducted 2 to 5 times per day over a 4 to 12 week period, depending on the severity of the infection.

Treatment of Chronic Sinusitis Through IV Antibiotics   

Chronic sinusitis infections are commonly known to be of a polymicrobial nature. Often there are two or even more bacteria involved. A single oral agent usually does not have the capability of covering all the organisms involved in chronic sinusitis. We use "broad spectrum" antibiotics, but no antibiotic can cover all the possible types of bacteria. In addition oral agents may fail due to less than optimal concentration of medications that can be achieved in the bloodstream to affect the local infection site. This mainly happens because of decreased absorption in the gastrointestinal tract. Decreased absorption can occur because of the co-administration of other oral agents, interaction with certain foods and illness. The reduced concentration of medicine via oral agents has difficulty attacking the infection, especially when the infection also affects the bone surrounding the sinus cavities. Intravenous antibiotics can overcome many of the drawbacks involving oral agents. The concentration of antibiotic in many cases is more stable. The antibiotic is not affected by variables in the gastrointestinal tract because it bypasses and directly enters the bloodstream. Absorption problems are minimized. Since some of the infection is in the surrounding bone a higher concentration of medicine is necessary. Intravenous induction will increase the concentration and can be sustained over longer periods of time. The use of multiple antibiotics at the same time helps to insure a broader spectrum of action, thus attacking many forms of bacterial infections simultaneously. With the wide range of intravenous medications available it is easier to select the correct combination without worrying about stomach upset problems. There is a certain population of patients who will find major relief and possibly a cure to chronic sinusitis through the administration of antibiotics via intravenous methods. Other patients still needing surgery will find that IV antibiotics will greatly reduce the inflammation in the sinuses. This will allow the surgeon cleaner access to perform his tasks. Post surgical recovery has proven easier on these patients. One nice thing is that you only get stuck once. The "catheter" is left in to be used as the pathway for the medication.


In conclusion,  the use of IV antibiotics is a necessary step in the goal of managing the long-term effects of chronic sinusitis.


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