ABSTRACT
Sinuses are air filled spaces in the skull that communicate with the nose, situated within the bones between eyes, behind cheekbones, and in forehead. They make mucus, which keeps the inside of nose moist. Sinusitis is a condition in which the cavities around the nasal passages become inflamed. An infection in the nose and upper respiratory tract can spread to the sinuses. Sinuses can get acutely infected during an episode of cold or many times they remain chronically infected due to repeated colds or non clearance of infection. This article provides an overview of the aetiology, diagnosis, and appropriate general & homoeopathic management of this disorder.
INTRODUCTION
Sinusitis is an inflammation of the paranasal sinuses. The inflammation could be caused by a virus, bacteria, or fungus. The infection may also be the result of an allergic or autoimmune reaction – when the immune system attacks healthy cells. Chronic sinusitis is generally accepted to be a common illness incurring considerable costs, despite limited epidemiological data. It is defined as an inflammation of the nasal mucosa and paranasal sinuses for at least 12 weeks which may cause nasal blockage or congestion, mucous discharge, facial pain or pressure, and/or impaired smell. Polyps, which may or may not be present are increasingly recognized as part of the sinusitis pathology.
AETIOLOGY
The sinuses are air-filled spaces in the skull. They are located behind the forehead, nasal bones, cheeks, and eyes. Healthy sinuses contain no bacteria or other germs. Most of the time, mucus is able to drain out and air is able to flow through the sinuses. Sinus infections or sinusitis may be caused by anything that interferes with airflow into the sinuses and the drainage of mucus out of the sinuses.
When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.
Sinusitis can occur from one of these conditions:
· Small hairs (cilia) in the sinuses fail to properly move mucus out. This may be due to some medical conditions.
· Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.
· A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.
RISK FACTORS
· Tumors or growths also can block the sinuses if they are near the sinus opening
· Dehydration, disease, drying medications, and lack of sufficient humidity can cause sinusitis or sinus infection. The drainage of mucous from the sinuses can also be impaired by thickening of the mucous secretions, by a decrease in hydration (water content) of the mucous brought on by disease (for example, cystic fibrosis), drying medications (antihistamines), and lack of sufficient humidity in the air.
· Stagnated mucus provides an environment for bacteria, viruses, and in some circumstances, (for example, AIDS or immunodepression people) fungus, to grow within the sinus cavities.
· tissue irritants such as nasal sprays, cocaine, and cigarette smoke
CLASSIFICATION
Sinusitis may be classified in several ways, based on its duration (acute, subacute, or chronic) and the type of inflammation (either infectious or noninfectious). The term rhinosinusitis is used to imply that both the nose and sinuses are involved and is becoming the preferred term over sinusitis.
· Acute sinus infection (acute sinusitis or acute bacterial rhinosinusitis) usually lasts less than 3-5 days.
· Subacute sinus infection lasts one to three months.
· Chronic sinus infection is greater than three months. Chronic sinusitis may be further sub-classified into chronic sinusitis with or without nasal polyps, or allergic fungal sinusitis.
· Recurrent sinusitis has several sinusitis attacks every year.
· Infected sinusitis usually is caused by an uncomplicated virus infection. Less frequently, bacterial growth causes sinus infection and fungal sinus infection is very infrequent. Subacute and chronic forms of a sinus infection usually are the result of incomplete treatment of an acute sinus infection.
· Non infectious sinusitis is caused by irritants and allergic conditions and follows the same general timeline for acute, subacute, and chronic as infectious sinusitis.
CLINICAL MANIFESTATIONS
There are many signs and symptoms of sinusitis and sinus infections. The following is a summary of predominant ones that may occur. Most patients have several signs and symptoms at the same time. Others may have some symptoms that are intermittent; most do not have all symptoms at once. The signs and symptoms of a sinus infection or sinusitis include the following:
· Headache, Facial tenderness and/or swelling, Pressure or pain due to mucus pressing on sinus tissue or inflammation of sinuses.
· Fever, Postnasal drip, Sore throat , Cough, Tooth pain, Ear pain and Eye pain caused by pressure on surrounding nerves and tissues
· Fatigue, Bad breath, Itching/sneezing and Ulceration.
· Multiple chronic (over one to three months) symptoms usually are a sign of subacute or chronic sinusitis
INVESTIGATIONS
Diagnostic methods may include:
medical history
physical examination
Plain X-ray studies of the sinuses may be misleading and procedures such as CT and MRI scans, which are much more sensitive in their ability to diagnose a sinus infection, are so expensive
Occasionally, nasal secretions are examined for secreted cells that may help differentiate between infectious and allergic sinusitis.
PREVENTION
There are many things you can do to reduce your chance of developing sinusitis or to relieve early sinusitis symptoms. One of the most important is to promote drainage and keep nasal passages clear. Here are some suggestions:
Bathe nasal passages daily. Run water gently into the nasal passages to help clear excess mucus and moisten membranes. Good times to do it are in the morning and at night, During the day, use nasal saline spray to moisten nasal passages.
Drink lots of water. Good hydration helps keep the mucus thin and loose. Have a bottle of water at desk at work or put a glass near the kitchen sink to remind to drink water throughout the day.
Inhale steam. Linger in a hot shower. Or bring water to a boil and pour it into a pan; place a towel over head, and carefully bend over the pan to inhale the steam. To avoid burns, keep distance at first and move in gradually to a comfortable zone.
Avoid dry environments. A humidifier in home and at work place can help prevent nasal passages from drying out. Keep humidifiers clean and free of bacteria and mold.
Sleep with head elevated. Mucus pools in sinuses at night when head is down, so have head propped up with pillows or a wedge during sleep.
Be nice to nose. Blow nose gently, one nostril at a time. Forceful blowing can irritate the nasal passages and propel bacteria-laden mucus back up into your sinuses.
Eat foods with antibacterial properties - To fight the virus, add antibacterial foods like garlic, ginger, and onions to meals.
Try drinking ginger tea. Add raw honey for an extra boost. Honey is packed with antioxidants and has antibacterial and antifungal properties.
MANAGEMENT
Home Managements
Nasal irrigation - One of the simplest, cheapest, and most effective ways to prevent and treat sinus problems is nasal irrigation. Using a homemade solution, can often relieve sinusitis symptoms, reduce reliance on nasal sprays and antibiotics, and improve quality of life. At least once a day, follow these steps:
Stir ½ teaspoon of non-iodized salt and ½ teaspoon of baking soda into 2 cups of lukewarm distilled or previously boiled water (as recommended by the American Academy of Otolaryngology).
Fill a small bulb syringe or Neti-Pot with the saltwater solution.
Lean over bathroom or kitchen sink, insert the tip of the syringe just inside one nostril, and gently squeeze the bulb. The water will run back out the nostril (or possibly the opposite nostril) and into the sink. Use at least one full bulb of solution.
Repeat the procedure in the other nostril. (If the salt solution stings nose, use less salt.)
Thoroughly rinse (with distilled or cooled boiled water) and dry the bulb syringe after each use.
In 2012, the FDA issued a warning about the use of Neti-Pots. The FDA cautions people not to use untreated tap water for rinsing, as contaminated tap water rinses lead to two deaths.
Bacterial and fungal sinus infections usually require antibacterial or antifungal therapy so home treatments without them are often not successful.
Eucalyptus oil can help open up the sinuses and get rid of mucus. One study Trusted Source has found that the main ingredient in eucalyptus oil, cineole, helped people with acute sinusitis recover faster.
Ease facial pain with warm compresses - Applying moist, warm heat may help soothe sinus pain. Place warm, damp towels around your nose, cheeks, and eyes to ease facial pain. This will also help clear the nasal passages from the outside.
HOMOEOPATHIC MANAGEMENT
There is no cure for this chronic sinusitis in modern medicine expect symptomatic relief. If the attacks are recurrent it can lead to middle ear infections ,inflammation of the voice box (Pharygnitis) prolonged stagnation of mucus in the sinus lead to abscess formation which can lead to inflammation of brain structures a critical condition.
With our homoeopathic remedies we can prevent the tendencies of further attacks in future by developing your own immunity, increase the resistance power, to prevent further complication and getting rid of the complaint permanently without side effects.
Homoeopathic prescribing accounts for concomitant symptoms in addition to the predominant pathology, therefore the same main diagnosis may be treated with different remedies in different patients ('individualisation'). The prescribed drugs ('remedies') are under constant debate. They are produced by alternating steps of diluting and agitating a starting substance ('potentiating').Homoeopathy has an excellent scope as it can improve your quality of life –reduce your discomfort improve your concentration in work hence increase your work output during the acute attacks of sinusitis and also prevent chronicity. By reducing the intensity and frequency of the attacks it can prevent complications of sinusitis and surgery. Some frequently used homoeopathy medicines in sinusitis are Kali-Bichromicum, Thuja, Hydraitis, Lycopodium, Mercury, Pulsatilla, Silicea, Arsenic, Medorrhinum.
Indicated Remedies | Indications |
Belladonna | Throbbing pains in the front part of the head that come on suddenly and tend to leave suddenly only to return are characteristic of children who need this medicine. |
Sulphur | Rarely indicated at the beginning of a sinusitis condition. Children begin sneezing and then develop sinusitis from the least exposure to cold air. Their nasal discharge is thick and yellow. The nostrils become very sore from the acrid discharge, and their nasal passages become sensitive to cold air. |
Kali bich | The distinguishing feature of children with sinusitis who need this medicine is that they have a thick, stringy nasal discharge. They have extreme pain at the root of the nose that is better by applying pressure there. The bones and scalp feel sore. Dizziness and nausea when rising from sitting and the severe pain may lead to dimmed vision. |
Mercurius | These children feel as though their head was in a vise. The pains are worse in open air, from sleeping, and after eating and drinking. The pains are also aggravated by extremes of hot and cold temperature. The scalp and the nose become very sensitive to the touch. Their teeth feel long and painful, and they may salivate excessively. |
CONCLUSION
Patients with sinusitis treated with 'classical' homeopathy showed marked health and quality of life improvementsThe natural Homoeopathic mode of treatment aims at rebuilding the body’s immunity to Sinusitis. The Homeopathic treatment for sinusitis can completely cure the chronicity and recurrence of Sinusitis. Chronic Sinusitis stands the best chance of being cured by Homeopathy. The Homoeopathic treatment of sinusitis is far superior as it does not resort to any strong medicines or antibiotics. The homoeopathic medicine for sinusitis is mild and has the additional benefit that it does not cause any side effect at all.
