Paranasal Air Sinuses - Conditions, Symptoms
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Paranasal Air Sinuses : It's Conditions

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 7 Apr 2014 - 16:19.
The conditions affecting the Paranasal air sinuses can be divided into two categories namely the uncommon and the most common.
Uncommon Category:

Tumors of the sinuses fall into the uncommon category. These include benign tumors and malignant tumors:

The benign tumors:

  • Transitional Papilloma: In this condition there is a thickening of the epithelial surface leading to infolding and papilloma formation which can become malignant. Excission and exenteration of the mass is the only choice for treatment of this type of tumor.
  • Localised Ivory Osteoma: Usual site for this type of tumor is the frontal sinus. Because of its hard consistency like an ivory it is named as ivory osteoma.
  • Cancellous Osteoma: When present, it affects the maxillary and ethmoidal sinuses. It may remain silent. Pain and headache are the main symptoms.
  • Malignant Tumors: These commonly affect the Maxillary and the Ethmoidal.Sinuses. The commonest variety is the Squamous Cell Carcinoma (roughly 80%). This tumor can be primary within the sinus or secondary by way of extension from the alveolus. Palate or the ethmoid. Nasal obstruction, blood stained nasal discharge and lachrymations are the earliest symptoms. Tooth ache and pain over the face can make their presence like in any case of sinusitis.
Most Common Category:

Sinusitis is the most common condition, which can affect any of the four Paranasal air sinuses either unilateral (one side) or bilateral (both sides). It is so common that probably there is no person who might not have experienced sinusitis.

As the name implies sinusitis means inflammation of the sinus. The condition derives different names depending on which sinus is inflamed like Maxillary sinusitis if the maxillary sinus is involved, Frontal sinusitis if the frontal sinus is affected and the respective names if the other two sinuses are affected. Again, each type of sinusitis can affect either one side or both sides.

In some cases more than one sinus may be affected like a combination of maxillary and frontal sinusitis. Of all the types of sinusitis the most commonly encountered variety is the maxillary, followed by frontal and the other two sinuses like ethmoidal and sphenoidal sinusitis. The latter two conditions are not as common as the first two types.
Inflammation of a sinus may be caused by viral, bacterial or fungal infections. Sinusitis can be acute (sudden onset and short lived) or chronic (long standing with periodic exacerbations of acute spells). An acute sinusitis can be due to a variety of bacteria often followed by a viral infection of the upper airways like common cold. Though rare, chronic maxillary sinusitis can occur after a tooth infection.
A simple attack of common cold can lead to sinusitis and the modus operandi consists of a cycle of events, which finally lead to sinusitis. It all starts with common cold when the mucus secreted in the nasal cavities first thin and later thick and sticky, blocks the openings of the sinuses. When this happens, the air inherently present in the sinuses called air sinuses is absorbed into the blood stream leading to a decrease in pressure inside the sinuses. This in turn leads to a negative pressure which is painful.
This phenomenon draws fluids into the sinuses. Accumulation of fluid in the sinuses serves an ideal breeding place for bacteria to grow and multiply. This process triggers the arrival of the White Blood Cells (WBC), the body’s natural fighters to fight with the invading bacteria.
The vicious cycle continues and the victim gets a full-fledged attack of sinusitis that presents with the following symptoms:
Symptoms: Sinusitis presents itself with symptoms, which are common whether the condition is acute or chronic. Initially there will be pain and tenderness (a sign elicited by the doctor when he applies pressure on the area of the sinus affected). This follows swelling over the area affected.
However, symptoms depend on which sinus is affected. For example, Maxillary Sinusitis produces pain over the upper cheeks, tooth ache and headache; where as Frontal sinusitis presents itself with headache over the forehead. Ethmoidal sinusitis produces pain and headache behind and between the eyes often described by the patient as splitting headache over the forehead. The pain produced by the Sphenoidal sinusitis has no well-defined areas of pain and may be felt on the back or the front of the head.
A person with sinusitis whether acute or chronic has a general feeling of being sick (malaise). If fever and chills make their presence felt, it is an indication that the infection has moved to the next level. The nasal mucus membrane is red and angry looking with discharge of thick and sticky mucus. This may turn into yellow or green colored pus that finds its way like a constant drain requiring frequent blowing of the nose which in turn leads to pain and irritation in the nose.
Investigations include total WBC count and X-Ray Para nasal Air sinuses. Treatment depends on the cause and extent of involvement. Appropriate antibiotic coverage and steam inhalations are the mainstay of treatment.
*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.