The complaint I have always heard in places like Istanbul where the weather is changeable is “I have sinusitis”. So what does this common complaint mean?
Our sinuses are air-filled bone cavities located in the front of our head and directly adjacent to the airway in the nose. An adult human has sinuses located in four different anatomical locations. These; They are called the frontal sinus on the forehead, the ethmoid sinus around the eyes, the maxillary sinus on both cheeks, and the sphenoid sinus near the skull base. All of them are bone cavities filled with air in almost different anatomical shapes and vary from person to person. The bony surfaces are covered by a mobile layer that can produce secretions similar to the mucous membrane in the nose.
The sinuses are filled with air, as they are an element of the upper respiratory tract, as well as making our head lighter, which contains many dense anatomical tissues. We can compare it to a soccer ball. If we fill the inside of the soccer ball with any substance, it will not be suitable for its function as it will be too heavy, we can think of the sinuses in this way. In short, they make our head lighter on the body. Since the epithelium in them has the same character as the inside of the nose and shows continuity, they also serve the same function functionally. Therefore, when we have a cold, upper respiratory tract infection such as a cold or flu, the epithelium lining our sinuses is also affected. In fact, every cold is also a sinusitis. That’s why we hear the phrase “I have sinusitis” a lot.
If there are conditions such as bone curvature (deviation), swelling of the nasal concha or allergies in the nose, the infections of this region, including the sinuses, become more chronic, lasting longer and clogging the openings of the sinuses opening into the nose. All of their sinuses have connections to the nose with a hole, a channel or more complex anatomical diversity. Every time we breathe, the air inside the sinuses also moves, and together with the nasal membranes, they warm and humidify the air going to our lungs. So they work like a kind of air conditioner. Therefore, in diseases of these air-filled spaces, our ability to breathe is also affected.
Location and Importance of Sinuses
In the ENT area, there are six sinus cavities inside our facial bones. They are located in the anterior part of the face, adjacent to our brain tissue and the upper jawbone. In fact, they divide our heads into two separate parts. Its neighbors are the most important nerve, the optic nerve, and the most important vein is the main carotid artery to the brain.
So, what use are these sinus cavities, which are adjacent to such important and vital tissues?
It is necessary to pay attention to these anatomical vital neighborhoods in sinusitis surgeries in the ENT discipline. The first and indeed the most important function is to lighten our head, which is full of soft tissues and is quite heavy. We can compare it to a soccer ball. If we fill the air space inside the ball with a substance, it will become heavy and far from suitable for play. It looks like a ball like a cannonball on the muddy ground of the old Taksim Stadium. If we fill part of it with a substance and the rest with air, it will become lighter and more functional. Thanks to the sinuses and the air in them, our head, which is at the top of our body, as a lighter structure, does not put weight on the spinal cord and allows them to be positioned in a suitable structure without too much restriction on head movements.
Another important feature is that the respiratory epithelium may be covered in it and the air that passes into our lungs every time we breathe, touches more contact surfaces and ensures that it goes to our lungs in a clean way by being heated, humidified and cleaned. The sinuses provide heating and humidification of the air passing with the nasal concha, like an air conditioner. Thus, the cleaned air gets rid of harmful particles and microbes and goes to the lungs.
What Does Sinus Do?
The first and indeed the most important function of the sinuses is to lighten our head, which is full of soft tissues and is quite heavy. All of them are bone cavities filled with air in almost different anatomical shapes and vary from person to person. Thanks to the sinuses and the air in them, our head, which is at the top of our body, as a lighter structure, does not put weight on the spinal cord and allows them to be positioned in a suitable structure without too much restriction on head movements.
Another important feature is that it is covered with respiratory epithelium. Every time we breathe, the air passing through our lungs touches many more contact surfaces and helps it to go to our lungs in a clean way by being heated, humidified and cleaned. In short, the sinuses provide heating and humidification of the air passing through the nose like an air conditioner. Thus, the cleaned air is purified from harmful particles and microbes and goes to the lungs. As you can see, they make our head lighter on the body, and they also help the nose functionally, as the epithelium in them has the same character and continuity as the inside of the nose.
What is Sinusitis?
Sinusitis is the condition in which the sinus cavities are filled with liquid instead of air and these holes are blocked. The bony surfaces are covered by a mobile layer that can produce secretions similar to the mucous membrane in the nose. According to the duration of sinusitis, it is divided into two as acute or chronic. In its simplest form, acute sinusitis is a type of periodic sinusitis that lasts from 10 days to 12 weeks, while chronic sinusitis is a type of inflammation that lasts longer than 12 weeks and is related to the person’s body rather than periodic factors.
Sinusitis can occur at any time of the year, but is more common in the period from December to March. Heat, humidity and pollution in the air play an important role in the formation of such diseases.
What is Acute and Chronic Sinusitis? Why Does It Happen?
Acute sinusitis is periodic and may recur from time to time. It is a short-term inflammation of our sinuses, especially in the fall and winter, of the membranes surrounding your nose and sinuses. This interferes with our ability to drain mucus from your nose and sinuses. That’s why we hear the phrase “I have sinusitis” a lot. It is seasonal and common. It can affect one out of every 8 people, especially during the colder months. Acute sinusitis is most often due to the viral infection that causes the common cold. But it can also be due to non-infectious causes. For example, allergies and severe weather changes.
In chronic sinusitis, a permanent picture occurs as the mucous membranes lining the sinuses grow and the fluid character becomes more intense. The cause of chronic sinusitis is not always as clear as acute. Risks of chronic sinusitis include year-round allergies, weak immune system, frequent colds and smoking.
If there are special conditions such as bone curvature (deviation) in the nose, swelling of the nasal concha or allergies; the infection becomes more frequent, long-lasting and becomes chronic with the obstruction of the openings of the sinuses into the nose. All sinuses have connections that open into the nose with a hole, a channel, or more complex anatomical diversity.
Every time we breathe, the air inside the sinuses also moves, and together with the nasal membranes, they warm and humidify the air going to our lungs. As I just mentioned, they work like a kind of air conditioner. Therefore, when these air-filled spaces become inflamed, our ability to breathe is also affected.
Deviation leading to nasal congestion, enlargement of the nasal concha, adenoid especially in children, polyps due to allergic sinusitis and adhesions in the nose due to previous surgeries are unfortunately factors that facilitate the development of the disease. So the definitions should be made accordingly. Otherwise, if a film is taken immediately in every acute sinusitis situation, everyone should have sinusitis surgery.
“Do I have sinusitis?” The question is one of the most frequently asked questions, especially in the winter season. Since the tissue layer in the nose is continuous, all diseases that affect the upper respiratory tract, such as colds and colds, come with inflammation of the sinuses.
What are the Symptoms of Sinusitis?
It causes complaints of facial and headache, nasal congestion, decreased sense of smell, yellow-green nasal discharge and redness around the nostrils, which appear with a sense of pressure in the head. In addition, symptoms such as lethargy, reluctance to work, fever, spread to the lower respiratory tract, cough and hoarseness may also occur.
How Is Sinusitis Treated?
With the cooling of the air, an increase is observed in diseases such as colds and sinusitis in the upper respiratory tract. The most common concern of our patients is whether they have sinusitis or the fear of having sinusitis. The reason for this is the perception that sinusitis is a chronic disease and can be treated with surgery. Although it is partially true, with the development of therapeutic drugs and techniques in recent years, a decrease in sinusitis surgeries has been observed.
The biggest mistake made in the market is to take a sinus computed tomography when acute sinusitis starts. In the acute period, the sinuses that are filled with fluid look like chronic sinusitis and an air appears as if a decision to be made for surgery is required. This is very wrong, always taking the sinus film after the treatment provides a more accurate result. In fact, if the patient is examined with an endoscope during the examination, it will be seen if the patient has findings such as bone curvature (deviation) and allergic concha enlargement that will show chronic sinusitis and facilitate its occurrence.
Even this is not a situation that requires filming immediately. A film should always be taken after a good medical treatment and treatment recommendations should be made accordingly. Ideal environmental conditions; For example, 45% humidity, air temperature that does not change much, and fresh air increase resistance to diseases.
What Precautions Can Be Taken Against Sinusitis?
When the disease starts, it is necessary to start treatment immediately and to use treatments that will ensure the ventilation of the sinuses as much as possible and drain the fluid inside. One of the simplest, cheapest and most effective ways to prevent and treat sinus problems is nasal irrigation.
You can usually relieve sinusitis symptoms, reduce dependence on nasal sprays and antibiotics, and improve your quality of life. There are many things that can be done to reduce the chance of sinusitis developing or to relieve the symptoms of early sinusitis. One of the most important is to support a runny nose and keep the nasal passages open.
Do not over-treat sinusitis
With the cooling of the weather, an increase is observed in diseases such as cold and sinusitis in the upper respiratory tract. The most common concern of our patients is whether they have sinusitis or the fear of having sinusitis. The reason for this is the perception that sinusitis is a chronic disease and can be treated with surgery. Although it is partially true, with the development of therapeutic drugs and techniques in recent years, a decrease in sinusitis surgeries has been observed.
Sinuses are cavities that allow us to feel lighter by circulating respiratory air in the cavities with a systematic physiological movement. At the same time, they warm and humidify the air we breathe, allowing them to go to our lungs in a cleaner filtered form. They have simple tasks that affect our daily lives. All of the sinuses have holes that open into the nose. The breath taken from the nose goes to the lungs by circulating through all the sinuses through these holes.
The disease we call sinusitis, either acute or chronic; It is the event that these holes are blocked and the sinus cavities are filled with liquid instead of air. While it fills with infected fluid in acute sinusitis, it creates a more permanent picture with the enlargement of the mucous membranes lining the sinuses and the fluid character becoming more intense in chronic sinusitis. When the disease starts, it is necessary to start treatment immediately and to use treatments that will ensure the ventilation of the sinuses as much as possible and drain the fluid inside.
The biggest mistake made in the market is to take a sinus computed tomography when acute sinusitis starts. In the acute period, the sinuses that are filled with fluid look like chronic sinusitis and an air appears as if a decision to be made for surgery is required.
This is wrong and always taking the sinus film after the treatment will give a more real result. In fact, if the patient is examined with an endoscope during the examination, it will be seen if the patient has findings such as bone curvature (deviation) and allergic concha enlargement that will show chronic sinusitis and facilitate its occurrence.
Even this is not a situation that requires filming immediately. A film should always be taken after a good medical treatment and treatment recommendations should be made accordingly. Otherwise, if a film is taken immediately in every acute sinusitis situation, everyone should have sinusitis surgery.
