{"id":25,"date":"2013-12-08T20:55:29","date_gmt":"2013-12-08T18:55:29","guid":{"rendered":"http:\/\/www.entent.co.za\/?page_id=25"},"modified":"2015-05-06T00:38:30","modified_gmt":"2015-05-05T22:38:30","slug":"allergy-and-sinus","status":"publish","type":"page","link":"https:\/\/www.entent.co.za\/?page_id=25","title":{"rendered":"Allergy and Sinus"},"content":{"rendered":"\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
What is sinusitis?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0Sinusitis is defined as inflammation of the sinus cavities. Sinuses are the hollow cavities within the bones of the face. They are lined by mucous membranes that normally produce mucous\/fluid. This fluid drains into the nose and is swallowed throughout the day (under normal circumstances, you should not be aware of this fluid).When the drainage of the sinuses are blocked, an infection can develop.<\/td>\n<\/tr>\n
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\u00a0What is the difference between rhinitis and sinusitis?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0Just as sinusitis is the inflammation of the sinus cavities, rhinitis is the inflammation of the nasal passages. They almost always go hand in hand, but severity of either is variable.<\/td>\n<\/tr>\n
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\u00a0What causes this inflammation?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0This is a very good question and is the underlying cause of both rhinitis and sinusitis.Anything that irritates the lining incites the inflammatory pathways.All the following result in similar symptoms:
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Allergy \u2013 inhaled or otherwise
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Infection \u2013 Viral, bacterial and fungal. Infections can be caused by viruses such as the common cold or influenza. These are the most common causes. Bacterial infections are the types of infections that respond to antibiotics. Less commonly however, sinus infections are caused by fungus or moulds.
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Pollution including cigarette smoke
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Temperature change or humidity change
\nThe cause of the inflammation will determine the best management. However, most often the symptoms are a sum total of all factors, so to unravel the cause is not always straight forward. Severe or long standing inflammation blocks the sinuses and predisposes to infection \u2013 see above)<\/td>\n<\/tr>\n
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\u00a0What are the symptoms of rhinitis?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0Can roughly be divided into irritative (runny nose, sneezing) or congestive (post nasal drip, blocked nose) symptoms.<\/td>\n<\/tr>\n
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\u00a0What are the Symptoms of Sinusitis?<\/strong><\/span><\/td>\n<\/tr>\n
\u00a0These symptoms are more intense compared to rhinitis and include
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Facial pain and pressure over the involved sinus(es)
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Nasal congestion
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0discoloured nasal discharge
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Decrease in smell and taste sensations
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Fever
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Headache
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Bad breath
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Fatigue
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Cough
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Teeth pain
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Ear pressure or pain
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Post nasal drip
\nSymptoms above tend to be more often associated with acute sinusitis (subacute and chronic sinusitis have less severe symptoms)<\/td>\n<\/tr>\n
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\u00a0How are sinus infections differentiated?<\/strong><\/span><\/td>\n<\/tr>\n
\u00a0Most of the time, sinus infections are differentiated on how long the infection has been going on:
\nAcute sinusitis:<\/strong>\u00a0Infection (any cause) is present for less than four weeks. Symptoms include facial pain or pressure over the involved sinus, discoloured nasal discharge (green, yellow, milky or gray), nasal congestion, headache, fever, post-nasal drip and cough.
\nChronic sinusitis:<\/strong>\u00a0Infection present for eight weeks or more. Symptoms consist of nasal congestion, post-nasal drip, milder headaches,\u00a0chronic cough\u00a0and fatigue.
\nRecurrent sinusitis:<\/strong>\u00a0Defined as three or more sinus infections per year. These may be due to an incompletely treated chronic sinus infection, or new infections.<\/td>\n<\/tr>\n
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\u00a0What is the role of allergies?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0Allergies predispose a person to developing sinus infections, as they cause inflammation and thus sinus blockage.<\/td>\n<\/tr>\n
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\u00a0How is allergy evaluated?<\/span><\/strong><\/span><\/td>\n<\/tr>\n
\u00a0Allergy is evaluated according to the suspected allergen.
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Food allergy, although they can be evaluated by blood tests, is best done by elimination-challenge diets. This helps for the reactions not covered by the blood tests (non IgE mediated reactions)
\n<\/span>\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Inhaled allergens are best tested by either skin prick tests or RAST blood tests. Both have advantages and disadvantages. The RAST is more accurate, but also more expensive. The skin prick tests are very cost effective, but are interfered with by medicines that allergy sufferers are commonly on. Common inhaled allergens are house dust mite, grass pollens, tree pollens, moulds, animal dander, weed pollens, feathers. These are usually geographically dependant.
\n<\/span>Even if done correctly, a negative allergy test does not exclude an allergy, but excludes an allergy to that particular allergen.
\nKeep an allergy diary.<\/td>\n<\/tr>\n
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\u00a0What else can cause or predispose to sinus infections?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0Other\u00a0factors include:<\/p>\n
    \n
  • Anatomical or structural abnormalities within the nasal passages and sinuses, such as a deviated septum (divides the nasal passage into two sides) and other bony abnormalities that may prevent the sinuses from draining.<\/li>\n
  • Problems with low immune function eg. as a result of a genetic problem (such as\u00a0cystic fibrosis), as a result of infection (such as\u00a0HIV\/AIDS<\/span>), as well as other diseases that affect antibody levels (such as\u00a0multiple myeloma).<\/li>\n
  • Gastroesophageal reflux disease\u00a0(GERD)<\/li>\n
  • Non-allergic rhinitis or vasomotor rhinitis.<\/li>\n
  • Age and pregnancy<\/li>\n
  • Underlying thyroid or other metabolic or medical conditions.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
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\u00a0How are the anatomical abnormalities found?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0These abnormalities are usually picked up with a good clinical examination including a flexible nasendorhinoscopic procedure performed by an ENT specialist and confirmed on\u00a0CT scan.<\/td>\n<\/tr>\n
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\u00a0How are these abnormalities treated?<\/span><\/strong><\/span><\/td>\n<\/tr>\n
\u00a0These abnormalities are most effectively treated with surgery, such as\u00a0septoplasty.<\/span>\u00a0Because the underlying problem is primarily an inflammatory condition, this must be treated first and surgery reserved for anatomical abnormalities not responsive to treatment or if complications have occurred.\u00a0<\/strong><\/td>\n<\/tr>\n
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\u00a0How are Sinus Infections Diagnosed?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0A sinus infection is suspected in a person with the above symptoms and consistent findings on examination. A CT scan is usually done if anatomical problems or complications suspected (x-rays of the sinuses are NOT necessary). Imaging studies are very helpful in people with chronic or recurrent infections \u2013 and this almost always is a CT scan and NOT a plain x-ray.<\/td>\n<\/tr>\n
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\u00a0How are Sinus Infections Treated?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0The main treatment for sinus infections is antibiotics. While acute sinus infections usually respond to antibiotics alone, chronic sinus infections are often caused, at least in part, by inflammation in the nasal passages and sinuses. Therefore, other medications are needed to reduce this inflammation so that the infection can drain from the sinuses. Nasal (and sometimes oral) steroids, mucolytics and decongestants are used.<\/td>\n<\/tr>\n
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\u00a0What general measures can I take?<\/span><\/strong><\/td>\n<\/tr>\n
\u00a0I strongly recommend regular saline irrigation and steaming with certain volatile oils, eg. menthol, eucalyptus. Remember, the “fitness” of your sinus mucosa is determined by your overall fitness. In other words the speed at which the lining of your nose returns to normal after being irritated is also influenced by your cardiovascular fitness level. Excercise and eat well and it will improve your sinus health.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

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What is sinusitis? \u00a0Sinusitis is defined as inflammation of the sinus cavities. Sinuses are the hollow cavities within the bones of the face. They are lined by mucous membranes that normally produce mucous\/fluid. This fluid drains into the nose and is swallowed throughout the day (under normal circumstances, you should not be aware of this … Continue reading Allergy and Sinus<\/span> →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":21,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.entent.co.za\/index.php?rest_route=\/wp\/v2\/pages\/25"}],"collection":[{"href":"https:\/\/www.entent.co.za\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.entent.co.za\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.entent.co.za\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.entent.co.za\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25"}],"version-history":[{"count":2,"href":"https:\/\/www.entent.co.za\/index.php?rest_route=\/wp\/v2\/pages\/25\/revisions"}],"predecessor-version":[{"id":203,"href":"https:\/\/www.entent.co.za\/index.php?rest_route=\/wp\/v2\/pages\/25\/revisions\/203"}],"up":[{"embeddable":true,"href":"https:\/\/www.entent.co.za\/index.php?rest_route=\/wp\/v2\/pages\/21"}],"wp:attachment":[{"href":"https:\/\/www.entent.co.za\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}