What are the Sinuses?
Sinuses are air-filled chambers inside your skull, behind the forehead, nasal bones, cheeks and eyes. Since all the sinuses are in the vicinity of the nose, the sinuses are also referred to as paranasal sinuses because the term “Para-” means “at or to one side of, beside, side by side,” 1 The sinuses are connected to each other through hollow cavities known as the sinus cavities.
Mucus is produced in your sinuses and then drains through small openings into your nose or back of your throat. The drainage helps keep your nose moist and free of dust, bacteria or other germs.2
The exact purpose of sinuses is a debated topic, but the function of paranasal sinuses include:1 3 4
- Making the head lighter in weight
- Allowing the voice to better resonate
- Protecting the head against facial trauma
- Insulating sensitive structures in the head from rapid temperature fluctuations in the nose
- Humidifying and heating air that enters the body through the nose
- Immunological defense
There are four paranasal sinuses:
- Maxillary sinus on either side of the nostrils, under the eyes, in the cheekbone area.
- The frontal sinuses above the eyes, in the forehead region.
- The ethmoid sinuses in between the nose and the eyes.
- The sphenoid sinuses behind the eyes, close to the center of the head.
REFERENCES
1 The American Heritage Stedman’s Medical Dictionary. Houghton Mifflin Company. 2002. Accessed August 21, 2019.
2 St. Josephs Health. 2019. Accessed August 21, 2019.
3 Gwinnett Medical Center. 2019. Accessed August 21, 2019.
4 Zachary J. Cappello, Arthur B. Dublin. Anatomy, Head and Neck, Nose Paranasal Sinuses. Updated October 27, 2018. Accessed August 21, 2019.
5 Matthew Hoffman, MD. Picture of the Sinuses, Human Anatomy. Reviewed May 26, 2018. Accessed August 21, 2019.
What are turbinates?
Inside the nasal cavity, the turbinates are made up of thin bone and cartilage, forming three ridges that project into the passage. The surfaces of the turbinates are lined with mucus membranes, which help to cleanse, warm, and moisturize outside air as it’s inhaled through the nose.
The turbinates can be chronically enlarged or swollen, which is a condition known as hypertrophy. Some people are born with larger-than-normal turbinates, while others may experience hypertrophy because of chronic allergy or exposure to airborne irritants. A deviated septum can disrupt the flow of inhaled air in a way that also inflames the turbinates.
Hypertrophic turbinates can impede or shut down the flow of air through the nasal passages. This lack of air can trigger the feeling of stuffy nose, and even set off nighttime snoring.
People who suffer from chronically blocked nasal airways should see an Ear, Nose, and Throat (ENT) Doctor to investigate the cause. Find a Doctor →
Sinus Conditions
Congestion (Stuffy Nose)
If you have a stuffy nose, also known as congestion, your voice may sound distorted or nasally when you speak, and breathing through your nose may be difficult. Many believe these symptoms are due to excess mucus in the nose, but it is actually caused by inflamed blood vessels in the sinuses.
This irritation is commonly caused by allergies, a sinus infection, a cold, or the flu.6 You could also be suffering from an issue with your nasal anatomy restricting your air flow. An ENT doctor will be able to better diagnose your stuffy nose.
Some examples of nasal anatomy concerns include:
Cancerous or benign growths that can impede or close off air flow.
The septum is a narrow structure of cartilage and bone that forms the dividing wall between the right and left nasal airways. A deviated septum is the diagnosis when the septum is out of place, either from birth or because of injury. This condition causes narrowing of one airway. Swelling in areas of the nasal passages, including the turbinates, can be triggered by this disruption in air flow.
In order to diagnose a deviated septum, the doctor will perform a thorough physical examination of your nose and airway, as well as discuss your symptoms and level of discomfort. In cases of persistent, severe disruption of the airway, the doctor may recommend a surgical procedure called septoplasty to straighten the septum and allow unrestricted flow of air through your nasal passages.
The nasal valve is located just beyond the nostrils. If the fleshy tunnels that form the airway are narrow or overly flexible, they can collapse inward as you inhale. Nasal valve collapse restricts the flow of air, which causes the stuffy nose sensation.
This condition can be congenital, or can appear and worsen as a person gets older. When examining a patient to determine the presence and severity of nasal valve collapse, the doctor may use an endoscope to capture an image or they may place fingers on the cheek on one side of the nose and gently pull laterally, away from the nose.
If irritated or infected, the turbinates can become swollen, restricting the passage of air. Further up the nasal airways, the turbinates are made up of thin bone and cartilage, forming three ridges that project into the passage.
Sinus Infection (Sinusitis)
A sinus infection (or sinusitis) occurs when the cavities around the nasal passage become inflamed. When healthy, sinuses are filled with air, but when they get filled with fluids, sinuses can get infected. A sinus infection can be caused by bacteria and viruses found in nasal polyps and a deviated septum. There are two types of sinusitis, acute, and chronic.2 3
| Acute sinusitis: Symptoms may last from two to eight weeks3 | Chronic sinusitis: Symptoms may last longer than 12 weeks3 |
|---|---|
Symptoms:
| Symptoms:
|
Allergy-related Sinus Conditions
Allergies are the body’s immune response to foreign substances or allergens. Some examples of allergens are dust, pet dander, pollen, dust, chemicals, some foods and medicines.20
Not all allergies are the same. Here are some common conditions caused by allergies:
Allergy-related sinus conditions include:
Rhinitis is caused when the body reacts to irritants in the air. The body releases histamine that defends the body against the irritants. The symptoms of rhinitis include a stuffy sensation and runny nose, sneezing, itchy, and watery eyes.
Allergic Rhinitis, also known as Hay Fever, can be caused by allergic reactions to inhaled substances like dust, pollen, mold or fungi, pet dander, allergy to food, or medication. The symptoms of hay fever include runny nose, sneezing, itchy and watery eyes, and stuffy nose.[13] If you’re experiencing the symptoms at the same time each year, you could have hay fever.
If you experience allergic reactions during the same season each year, you may have seasonal allergies. Heavy pollen in spring and dusty, dry conditions in autumn are common irritants causing seasonal allergies.
This condition can be the result of exposure to animal proteins, dust mite, mold, and house plants.[6]
Is it a Cold or Allergies?
Use this chart to help determine the cause of your nasal congestion.
| Symptom | Common Cold | Airborne Allergy |
|---|---|---|
| Runny Nose | Common | Common |
| Stuffy Nose | Common | Common |
| Cough | Common | Sometimes |
| Fatigue, Weakness | Sometimes | Sometimes |
| Itchy Eyes | Unusual | Common |
| Sneezing | Usual | Usual |
| Sore Throat | Common | Sometimes |
| Fever | Rare | Never |
If symptoms last a few days to two weeks, you most likely have a cold. But if symptoms last several weeks during a specific pollen season like ragweed or grass, you most likely are experiencing an airborne allergy. Colds are usually caused by a viral infection, and rhinovirus is a very common culprit. There are no effective vaccines for common cold, so concentrate on reliable methods of getting some relief until the cold subsides on its
own.
REFERENCES
1 Kristeen Moore. What Causes a Stuffy Nose? Nasal Congestion. Reviewed Elaine K Lou, MD July 2, 2019. Accessed August 21, 2019.
2 Kimberly Holland. How to Clear a Stuffy Nose: Stuffy Nose Relief. Reviewed Kimberly Judi Marcin April 24, 2017. Accessed August 21, 2019.
3 WebMD. Sinus Infection (Sinusitis). Reviewed Laura J Marin, MD July 9, 2018. Accessed August 21, 2019.
4 American College of Allergy, Asthma and Immunology. Sinus Infection. Accessed August 21, 2019.
5 Jacquelyn Cafasso and Ana Gotter. What are the Symptoms of Hay Fever. Reviewed Deborah Weatherspoon, PhD, RN, CRNA, COI, January 27, 2017. Accessed August 21, 2019.
6 American College of Allergy, Asthma & Immunology. Allergic Rhinitis. 2014. Accessed August 21, 2019.
Symptoms of Sinus Congestion ?
Symptoms of sinus congestion vary from person to person. If you experience any of these symptoms you should talk to your ENT. Find Doctor →
Some Possible symptoms include:
- A stuffy and/or runny nose that lasts more than a week
- Cough
- Fatigue
- Fever (low-grade in adults, but higher in children)
- Thick, yellow or green mucus
- Facial pain, weakness and/or numbness
Common causes of facial problems include infection, conditions that affect the skin of the face, and other diseases. This pain can worsen when bending over.1Sinus infections usually cause swelling, and when that swelling becomes severe, it can even reach your jaw. The same issue can happen when a sinus infection causes tooth or ear pain.If jaw pain is combined with other symptoms, the condition could be acute sinusitis.2
- Bad breath
- Swollen sinuses
- Pressure behind the eyes and cheeks
- A headache that won’t go away:
The feeling of built-up of pressure in your sinuses can cause pain that feels like a severe headache. This headache can manifest itself as deep and constant pain in the cheekbones, forehead, or bridge of your nose. Sudden movements or straining of the head can cause this pain to increase. Other kinds of recurring headaches, like migraines or tension headaches, are often mistaken for sinus headaches. Since the treatment needed depends on what kind of headache you have, it’s important to determine if your symptoms are caused by your sinuses. If a sinus blockage or infection is really the cause, you’ll likely have a fever.3
REFERENCES
1 Healthwise. Facila Problems, Noninjury. September 23, 2018. Accessed August 21, 2019.
2 Breathe America. The Surprising Link Between Jaw and Sinus Pain. November 26, 2018. Accessed August 21, 2019.
3 WebMD. Sinus Headaches. May 6, 2018. Accessed August 21, 2019.
* Khong GC, Lazarova L, Bartolo A, et al. Introducing the new Coblation Turbinator turbinate reduction wand: Our initial experience of twenty-two patients requiring surgery for nasal obstruction. Clin Otolaryngol.2018;43:382-385.
** Leong, S.C., et al., ” COBLATION inferior turbinate reduction: a long-term follow-up with subjective and objective assessment”, Rhinology, Vol 48 No 1:108-12 March, 2010.
*** Woloszko, J., Kwende M., Stalder K.R., ” COBLATION in otolaryngology”, Proc SPIE Int Soc Opt Eng., Vol 4949:341-352 June, 2003.