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Sinus, Polyps & Allergy

Sinus :: Nasal polyps :: Allergy

Sinus

Sinus is a sac or air filled cavity found within the bone or tissues. Sinuses or paranasal sinuses are group of four pairs of sinuses located above the eyes (frontal sinuses), within the cheekbones (maxillary sinuses), between the eyes (ethmoid sinuses), behind the eyes (sphenoid sinuses).

Sinusitis refers to inflammation of the sinuses. It occurs because of viral, fungal, or bacterial infection within the sinus spaces. When you suffer from cold or other viral infections, excess amount of mucous is secreted as a result the drainage system of the sinuses gets blocked and mucous gets trapped in the sinuses leading to inflammation of sinuses. Acute sinusitis is an infection of the sinuses usually caused by a bacteria resulting from the upper respiratory tract infection. Chronic sinusitis refers to long-standing or recurrent inflammation of the sinuses caused by a bacterial or fungal infection.

Sinusitis can be caused by viral infections such as cold, allergies, nasal polyps, hay fever, and other abnormalities of nose and sinus cavities. Patients with sinusitis may experience bad breath, cough, fever, nasal congestion discharge of mucous, toothache, and swelling of the face. Other symptoms include nausea, headache, sore throat, and pain behind the ears. Acute sinusitis may be caused due to common cold and allergies and the symptoms may last up to 4 weeks. Chronic sinusitis results from asthma or allergies and recurrent acute sinusitis where the symptoms may last up to 3 months or longer.

Your doctor may examine your nose to look for the signs of infection, inflammation and also for signs of polyps. Diagnostic tests such as nasal endoscopy or rhinoscopy are done to diagnose sinusitis where the sinuses are viewed through a fiber-optic scope, CT scan and MRI scan of the sinuses may be required to confirm the condition. In chronic or recurrent sinusitis other tests such as allergy testing, blood tests, ciliary function tests, nasal cytology (analysis of cells), and sweat chloride tests may be required.

Treatment

Your doctor will prescribe oral antibiotics to clear off the bacteria that have infected the sinuses. Drugs such as acetaminophen and ibuprofen are generally prescribed which will provide relief from pain and other symptoms. To relieve nasal congestion, nasal decongestant drops or sprays may be recommended. In case of nasal polyps or allergies, nasal corticosteroid sprays and antihistamines are prescribed to reduce swelling.

If symptoms do not subside even after three months of treatment, then surgery may be necessary to clean and drain the sinuses. Deviated septum or nasal polyps may require surgical repair to prevent the recurrence.

If sinusitis is left untreated it can cause certain complications such as, abscess formation, bone infection (osteomyelitis), meningitis, and skin infection surrounding the eye (orbital cellulitis).


Nasal polyps

Nasal polyps are sac-like fleshy growths that grow in the lining of the nose or sinuses resulting in inflammation of the mucous membranes. It occurs from the other respiratory diseases that last for a long time such as allergic rhinitis, chronic sinusitis, asthma, and aspirin allergy. Nasal polyps are more common in people with non-allergic rhinitis and non-allergic asthma. They usually tend to grow back even after the surgical or medical treatment.

Patients with nasal polyps often develop cold that will last for several months. Other symptoms include, breathing through mouth, blocked nose, running nose, and loss or decreased sense of smell and taste.

Your ENT doctor performs nasal endoscopy by placing a small camera into the nose for a better view of the nasal passages to confirm polyps. A CT scan shows cloudy spot that confirms nasal polyps. Therefore, it may be required as a part of diagnosis.

Treatment for nasal polyps includes medications such as nasal steroid sprays, corticosteroids, antileukotriene medications (for individuals with aspirin allergy), nasal saline (for sinus infections and allergic rhinitis), and allergy shots or injection which will also be required to prevent polyps that block the airway. Antibiotics may be recommended in case of bacterial sinus infection.

Surgery may also be recommended by your doctor in severe cases to remove the nasal polyps. The most commonly suggested procedure is 'functional endoscopic sinus surgery' (FESS). It is performed using an endoscope which helps to view nasal cavities better and may also be combined with medical therapies to prevent the recurrence. Removal of polyps by surgery makes it easier to breathe through nose.


Allergy

Allergy is an inflammatory response produced by the body's immune system to foreign substances that enter the body. Allergens are allergy producing substances such as pollens, dust mites, molds, animal dander, foods, insect stings, and certain medicines. Allergies can occur at any age and are very common in people who have a family history of allergies.

The most common allergic disorders include:

  • Allergic rhinitis (hay fever) is an inflammatory disease of the nasal mucous. It is caused due to indoor allergens such as dust mites, animal dander, or molds. You may develop symptoms such as sneezing, nasal congestion, itchy nose and eyes, running nose, and sore throat. The risk factors for developing allergic rhinitis include smoking, pollution, infection, and hormonal imbalance

  • Asthma is a chronic lung disease that causes inflammation and narrowing of the air passages resulting in wheezing, shortness of breath, coughing, and chest tightness

  • Allergic conjunctivitis or allergic eyes is an inflammation of the membranes covering the surface of eyeball and eyelid. The inflammation causes redness of the eye, watery or itchy eyes and swelling of the membranes

  • Allergic eczema or allergic dermatitis is an allergic rash, commonly associated with allergic rhinitis or asthma resulting in rashes around the eyes and face

  • Allergic shock or anaphylaxis is a severe reaction which is life- threatening affecting different areas of the body. The condition is often caused by substances that are injected or foods, and results in skin discoloration, nasal congestion, and shortness of breath, wheezing, and swelling of the throat

Consult your doctor or an allergist to seek treatment option. Your allergist will first obtain a detailed medical history and examine you before the treatment is started. Skin tests and other allergic tests will be required to identify the exact cause of allergy.

Following the tests the treatment will be started which includes:

  • Prevention: Prevention or avoidance is the best treatment for allergies. If the cause of the allergy is identified it should be eliminated or avoided. For example if you are allergic to some food or animal fur it should be removed or kept away. If you are allergic to tobacco smoke, avoid smoking to prevent allergy

  • Medications: Decongestant sprays may be recommended by your doctor. Steroid nasal sprays can also be given which will ease your breathing ability. Antihistamines may be needed to relieve the symptoms.

  • Allergy shots: If your allergist identifies specific allergy. Allergic shots are prepared by the allergen itself and are injected into the body. This enables to decrease your sensitivity to allergens and provide resistance to tolerate the allergens that trigger the allergic reactions. It also stimulates the immune system to fight against allergens

  • Treatment for asthma: Anti-inflammatory drugs (corticosteroids) such as Flovent, Pulmicort, Aerobid, and Azmacort reduce the inflammation and lessen the risk of acute asthma attacks. Bronchodilators such as Alupent, Metaprel, Brethaire, Ventolin, Serevent, and Alupent increase the width of the air passages and ease in breathing

Tips to prevent allergies

  • Avoid exposure to allergens that trigger allergy at home such as pets, mold, and dust mites
  • Wash bed sheet and pillows cover with warm water and use allergy resistant pillow covers
  • Avoid smoking and use of tobacco
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