Sinus & Allergy Awareness
August 23, 2010
Stephen Mitchell MD, Otolaryngology
Jim Lancaster MD, Internal Medicine
news notes via www.webmd.com
What Causes Sinus Problems?
What to do when good sinuses turn bad.
If you are plagued by sinus problems, take a moment to consider these valuable parts of your head. What can turn good sinuses into problem sinuses?
Your sinuses are hollow air spaces within the bones between your eyes, behind your cheekbone, and in the forehead. They produce mucus, which helps keep the inside of your nose moist. That, in turn, helps protect against dust, allergens, and pollutants.
Interesting Sinus Facts
No one is completely sure why we have sinuses, but some researchers think they keep the head from being too heavy.
Sinuses are also are responsible for the depth and tone of your voice. This explains why you sound like Clint Eastwood when your sinuses are all stuffed up.
If the tissue in your nose is swollen from allergies, a cold, or environmental triggers, it can block the sinus passages. Your sinuses can't drain, you may feel pain, and you will be at much higher risk of sinus infections.
There are eight sinus cavities in total. They are paired, with one of each in the left and right side of the face.
Common Sinus Problems
Each sinus has a narrow spot, called the transition space (ostium), which is an opening that's responsible for drainage. If a bottleneck or blockage occurs in the transition of any of the sinuses, you're at risk of developing a sinus infection. Mucus backs up behind the blockage, and acts as a breeding ground for bacteria.
An Extra Sinus
About 10% of people have an extra sinus, which raises their risks for sinus infections. The extra sinus "effectively narrows that transition space," says Ford Albritton, MD, FACS, chairman of otolaryngology at Presbyterian Hospital of Dallas.
Deviated Nasal Septum
Another common issue is a deviated nasal septum, the thin wall of bone and cartilage inside your nasal cavity that separates your two nasal passages. Ideally, your septum is situated in the center of your nose, equally separating the two sides. But whether from genetics or trauma (like a 6th grade fist fight), in about 80% of people, the nasal septum is displaced to one side, making one nasal passage smaller than the other. A deviated septum is one reason some people have chronic sinus issues. A deviated septum can also lead to obstructed breathing and snoring.
More widely, certain people just have variations in their anatomy that creates a longer, narrower path for the transition spaces to drain. "It's pure genetics, since it's the way we've inherited how our sinuses are put together and how easy or difficult it is for them to stay open or become blocked," Albritton says.
Sinus Sensitivity and Allergies
Finally, there are certain people who have sensitivity to things in the environment and to the foods they eat. This sensitivity triggers a dilation of blood vessels in the nose, and sometimes releases chemicals from cells in the nose that cause swelling.
Does drinking red wine or eating certain foods cause your nose to swell? This is a type of allergic reaction or food sensitivity that can make the sinuses ripe for infection. The inflammation causes tissue swelling that prevents the sinus cavities from clearing out bacteria. The blocked mucus creates a breeding ground for bacteria, which increases your chances of developing a sinus infection.
If you test positive for allergies, your physician can prescribe medications to control your symptoms and reduce the risk of developing an infection. People with sinus problems and allergies should avoid environmental irritants such as tobacco smoke and strong chemical odors, which may increase sinus problems.
Who Is Prone to Sinus Problems?
People who have very narrow sinus cavities can have a bottleneck for drainage so that any swelling or infection creates a blockage that causes sinus infection. "If your sinus passageways are narrow to begin with then what happens is if you get any kind of inflammation whether it's from pollution, allergy or infection, the sinus shuts down, the mucus sits there and pools, and you become infected," says Jordan Josephson, MD, author of Sinus Relief Now (Penguin), and an attending physician at Lennox Hill Hospital in New York City.
Those with allergies and food sensitivities are predisposed to sinus infections since the offending allergens like cigarette smoke, pollution or food triggers enter the body and turn on cells, make proteins and release chemicals that cause the sinuses to swell.
Also, those with lowered immunity (as when you've had a cold) may be at higher risk for developing sinusitis. Since your immune system helps fight infection, when its lowered from any cause they can't keep bacteria or viruses away. Then bacteria have an easier time coming in and causing a full-fledged infection.
Protecting Your Sinuses
Try these tips to reduce inflammation and prevent sinus problems:
If your sinus problems are related to allergies, consider these steps:
Allergy Basics: What is an Allergy?
Allergies are an abnormal response of the immune system. People who have allergies have an immune system that reacts to a usually harmless substance in the environment. This substance (pollen, mold, animal dander, etc.) is called an allergen.
Allergies are a very common problem, affecting at least two out of every 10 Americans.
What Happens During an Allergic Reaction?
First, a person is exposed to an allergen by inhaling it, swallowing it, or getting it on or under their skin. After a person is exposed to the allergen, a series of events create the allergic reaction:
What Are the Symptoms of an Allergic Reaction?
Common symptoms of an allergic reaction to inhaled or skin allergens include:
Other exposures can cause different allergic reactions:
The severity of an allergic reaction's symptoms can vary widely:
Most symptoms of an allergic reaction go away shortly after the exposure stops.
The most severe allergic reaction is called anaphylaxis. In anaphylaxis, allergens cause a whole-body allergic reaction that can include:
Anaphylaxis is life-threatening and requires immediate medical attention. Symptoms can progress rapidly, so head for the emergency room if there's any suspicion of anaphylaxis.
Does Everyone Have Allergies?
No, not everyone has allergies. People inherit a tendency to be allergic, although not to any specific allergen. When one parent is allergic, their child has a 50% chance of having allergies. That risk jumps to 75% if both parents have allergies.
Allergic Reaction Causes
Almost anything can trigger an allergic reaction.
Finding the Cause of Allergies
How do people find the cause of allergies? Most learn to recognize their allergy triggers; they also learn to avoid them in the name of allergy prevention.
An allergy specialist (allergist) may be able to help you identify your triggers. Several different types of allergy tests are used to identify triggers.
People with a history of serious or anaphylactic reactions may be prescribed an auto-injector, sometimes called a bee-sting kit. This contains a premeasured dose of epinephrine (EpiPen is one brand name). You carry this with you and inject yourself with medication immediately if you are exposed to a substance that causes you to have a severe allergic reaction.
There is some evidence that breast-fed infants are less likely to have allergies than bottle-fed infants.