The Snoot! Cleanser Guide to Nose and Sinus Relief

An Overview of Common Maladies and Supporting Research On Causes and  Possible Treatments.

This page and its links outline some of the most frequent issues that sinus sufferers experience and provides some helpful links to documents, articles, books and websites that we found of interest and thought you might too.  This is by no means an exhaustive list, and we will be adding information periodically so check back in now and then for more new information!

Your air intakes face many challenges, and their health depends on many sensitive parts. In theory, your nose and sinuses process air smoothly, allowing you to breathe with ease. Unfortunately, the reality of nose and sinus functioning does not always live up to the theory. In practice, many problems confront your nose and sinuses, interfering with your ability to breathe. Failures that occur include diverse illnesses, injuries, and defects.

With so many vulnerabilities susceptible to failure, it seems amazing that these delicate parts work at all. However, nose and sinus failures are a very common fact of life. Your nose and sinuses, with their many intricate parts, their sensitive mucous tissues, their constant exposure to environmental hazards, and their difficult performance demands, are subject to a variety of failings. Problems can start from environmental conditions, from inadequate hygiene practices, or from shortcomings of the body. Each problem has a unique set of causes and aggravators, symptoms, and approaches to symptom management.

The actual construction of your air intakes depends on a number of vulnerable parts. Weaknesses include tiny ostial openings, sensitive mucous linings, delicate balances of moisture and pressure and temperature, fine adjustments of salinity and chemistry, and the operations of many biological cells which include bones, cartilage, muscles, blood, nerves, epithelia, skin, and hairs. Substantial faults in the structure of the upper respiratory system pose complex problems.

Some nose and sinus problems are biological in nature, caused by infectious agents or by your body itself. Other nose and sinus problems result from injury or contamination. Challenges include harsh environmental conditions, tough physical demands, abrasive chemical irritations, infectious biological pathogens, and even stressful life pressures.

When your nose and sinuses fail to work properly, you suffer from symptoms that are uncomfortable and that have damaging side effects. Pain, discomfort, congestion, accompanying illnesses, and costs to yourself and to society accumulate. Everday actions become difficult, and productivity declines. Workers take days off and students stay home from school. As athletes, musicians, yoga practitioners, and everyday people know, breath is fundamental to existence.

There are many different reasons why the nose and sinuses stop working as advertised. Some maladies are common, while others are rare. The most common ailments that result in nose and sinus symptoms include chronic rhinosinusitis, acute rhinosinusitis, cold, flu, allergies, infections, physical obstructions, and stress. These causes often occur together in groups.

Rhinosinusitis

Rhinosinusitis is the inflammation of the nose and sinuses. Mucus fails to clear through the narrow ostia, and the nasal and sinus cavities build up with pressure or pain. Thicker mucus, slower cilia, blocked ostia, and compromised immune function all result in the symptoms of rhinosinusitis. These symptoms build upon each other, so that clogged cavities become even more clogged, thick mucus becomes even thicker, and mucous linings and other cells become damaged.

Symptoms of the nose and sinuses often occur together – sinusitis is usually accompanied by rhinitis – so sometimes the term rhinosinusitis replaces the individual terms. Symptoms include congestion, excessive or unusual mucus discharge, headaches, soreness or pain, irritation, coughing, post-nasal drip, malaise, dizziness, and halitosis. Other possible symptoms include fever, fatigue, toothache, and loss of smell. Not a small list! And these are just some of the symptoms – the more you learn about rhinosinusitis or share stories with your fellow sufferers, the more symptoms you will discover.

The two main illness distinctions are chronic rhinosinusitis and acute rhinosinusitis. Chronic rhinosinusitis lasts for several months or even years, and can have infectious or structural causes. Acute rhinosinusitis typically lasts for two to four weeks, and is usually viral. Typical causes of rhinosinusitis include allergens, viruses, bacteria, biofilms, fungi, polyps, chemical irritation, and tooth infection. Biofilms are extensive structures of microorganisms that protect the contaminating agents. Microbial colonies form intricate networks that provide defense against your immune system, and even against drugs. A biofilm can increase the resistance of microbes to antiobiotics by a factor of one thousand.

Each sinus has a peculiar response to congestion. Some of the sinuses are especially prone to poor drainage – primarily the large maxillary sinuses behind your cheeks, followed by the ethmoid sinuses around your eyes. The frontal and sphenoid sinuses get inflamed less often, but more severely. The more frequently inflamed sinuses drain through relatively tiny openings that become clogged more easily. Chronic conditions of the ethmoid sinuses are often worse in the late morning, while conditions of the maxillary sinuses get worse throughout the day. Acute conditions of the frontal sinuses or sphenoid sinuses can indicate a serious medical problem.

Check out these links for more information regarding sinusitis diagnosis and treatment: 

·      The diagnosis and management of acute and chronic sinusitis, Prim Care. 2008 Mar;35(1):11-24, v-vi.

·      Review of current guidelines related to the diagnosis and treatment of rhinosinusitis, Curr Opin Otolaryngol Head Neck Surg. 2008 Jun;16(3):226-30.

·      Antibiotics and topical nasal steroid for treatment of acute maxillary sinusitis, JAMA. 2007 Dec 5;298(21):2487-96.

·      Acute sinusitis—to treat or not to treat?, JAMA. 2007 Dec 5;298(21):2543-4.

·      IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults, Clin Infect Dis. 2012 Apr;54(8):e72-e112. Epub 2012 Mar 20.

·      Chronic rhinosinusitis and biofilms, Otolaryngol Head Neck Surg. 2005 Mar;132(3):414-7.

·      Nasal saline irrigations for the symptoms of chronic rhinosinusitis, Cochrane Database Syst Rev. 2007 Jul 18;(3):CD006394.

·      Primary-care-based randomised placebo-controlled trial of antibiotic treatment in acute maxillary sinusitis, Lancet. 1997 Mar 8;349(9053):683-7.

·      Effectiveness and safety of short vs. long duration of antibiotic therapy for acute bacterial sinusitis: a meta-analysis of randomized trials, Br J Clin Pharmacol. 2009 Feb;67(2):161-71. Epub 2008 Sep 19.

·      Intranasal steroids for acute sinusitis, Cochrane Database Syst Rev. 2009 Oct 7;(4):CD005149.

·      Rhinitis and sinusitis, J Allergy Clin Immunol. 2010 Feb;125(2 Suppl 2):S103-15.

 

Cold

The cold virus infects your upper respiratory tract. Of the common ailments, none is more frequent a nuissance than the common cold. Cough, sore throat, fever, and runny nose leave you feeling tired and unhappy. During a cold, as with other ailments, mucus production goes into overdrive as your body attempts to flush out invasive pathogens from your upper respiratory tract.

All of that fluid swashing around your face can clog the nose and sinus cavities. Excess mucus interferes with attempts by the cilia to clear your airways. When your nose and sinuses get congested, they leave you even more prone to infection. Approximately 0.5% to 2% of common cold cases develop into rhinosinusitis.

While the common cold is unlikely to have severe consequences, it can still make you weak and uncomfortable. The upper respiratory symptoms combine to make it hard for you to breathe. Even an ordinary illness like the cold can make a mess of your upper respiratory system.

Flu

Influenza, or the flu, is a different virus which carries substantially more serious consequences than the common cold. Flu is spread by coughing or sneezing, nasal secretions, and other contact with contaminated air or surfaces. A single sneeze emits up to 40,000 droplets in a fine mist that infects through inhalation.

Symptoms of the flu have some overlap with cold symptoms, but differ in important ways. Flu symptoms include cough, sore throat, irregular body temperature, headache, muscle pain, fatigue, fever, chills and general discomfort. Flu can result in associated respiratory problems such as pneumonia. Complications of the flu can result in rhinosinusitis.

When you suffer from the flu, your nose and sinuses will be deeply unhappy. Many people opt for flu shots to avoid the virus, however there are so many strains that it is impossible to accurately produce a vaccine that addresses the exact strain that makes the rounds each year. Even in this day and age, influenza can cause serious harm. Flu symptoms pose a threat to overall health, and have an immediate impact on nose and sinus conditions.

Allergy

Allergens fill the environment, challenging your body to react. When your immune system gets overwhelmed, you will face symptoms that can mimic other maladies. Irritants include smoke, dust, pollen, insect stings, plants, animals, foods, medicines, and certain other substances. Many allergens act through inhalation, similar to airborne viruses and bacteria.

Among numerous other symptoms, allergies often result in congestion, which spells unhappiness for your nose and sinuses. Allergens cause inflammation known as allergic rhinosinusitis. When you suffer from allergies, your body itself is responsible for the reaction that bothers your sinuses.

Allergies are sometimes difficult to identify and manage. If you have allergies, they can play an insidious role in undermining your facial comfort. Allergic reactions can directly or indirectly impede your ability to breathe clearly.

Fungus

Distinct from other life forms, fungal infections include molds, spores, yeasts, and slimes. These microbiotic organisms are responsible for many important parts of the ecosystem, but they can also infect you and produce unpleasant nose and sinus symptoms.

Fungi sometimes cause rhinosinusitis and related symptoms. Immune deficiencies make fungal rhinosinusitis more likely. Fungal rhinosinusitis can be acute or chronic, and it can grow from the fungus itself or from bodily reactions. Allergic fungal rhinosinusitis frequently occurs together with asthma and nasal polyps. The nasal and sinus cavities often contain fungi, especially in rhinosinusitis sufferers. Researchers are currently investigating the role of fungi in rhinosinusitis, as well as possible treatments. Fungal rhinosinusitis may account for one-fifth to one-quarter of chronic nose and sinus inflammation cases.

It is easy to overlook fungal infection when so much more attention is paid to viral and bacterial pathogens and to allergens. However, fungi are widespread and significant particles in the air we breathe. Fungal contamination of the nose and sinuses is a lesser-known but important source of distress.

Lifestyle

While many symptoms associated with nose and sinus discomfort have external causes such as allergens, viruses, bacteria, and fungi, it is also possible for your nose and sinuses to respond negatively to personal and social issues. Major lifestyle influences include stress levels, health choices, and your hygiene and environment.

Stressful situations can acutely strain your body, increasing mucus production in your nose and sinuses. Common motions evidenced by people under stress include squeezing the bridge of the nose between the eyes, and rubbing the temples. These gestures alter the pressure and flow of congested fluids, relieving the effects of stress.

Other stressful factors in nose and sinus comfort include specific behaviors involving the face, head, and body. Blowing your nose can result in viscous fluid entering the maxillary sinuses. While sneezing and coughing do not add enough pressure in the nose or thin the mucus to the point that it enters the sinuses, nose blowing actually deposits nasal fluid into the sinuses. This can also result in contamination by viruses, bacteria, and inflammatory agents.

Overall, lifestyle plays an overlooked yet important role in nose and sinus health. Stress, nutrition, exercise, breathing capacity, and other spheres such as posture combine to better or worsen your health. Smoking and second-hand smoke increase exposure to the causes of acute and chronic rhinosinusitis. Other irritants include car exhaust, pollution, and fumes from paint or perfume.

Check out these links for more information regarding lifestyle, environmental and dietary impact upon sinus issues:

·      Nose blowing propels nasal fluid into the paranasal sinuses, Clin Infect Dis. 2000 Feb;30(2):387-91.

·      Secondhand smoke as a potential cause of chronic rhinosinusitis: a case-control study, Arch Otolaryngol Head Neck Surg. 2010 Apr;136(4):327-34.

·      The relationship between body posture and pressure in occluded maxillary sinus of man, Rhinology. 1989 Sep;27(3):161-7.

·      Relationship between milk intake and mucus production in adult volunteers challenged with rhinovirus-2, Am Rev Respir Dis. 1990 Feb;141(2):352-6.

·      Milk consumption does not lead to mucus production or occurrence of asthma, J Am Coll Nutr December 2005 vol. 24 no. suppl 6 547S-555S.

 

 

 

Here is our full list of helpful links: 

Academic Articles

The diagnosis and management of acute and chronic sinusitis, Prim Care. 2008 Mar;35(1):11-24, v-vi.

The relationship between body posture and pressure in occluded maxillary sinus of man, Rhinology. 1989 Sep;27(3):161-7.

Review of current guidelines related to the diagnosis and treatment of rhinosinusitis, Curr Opin Otolaryngol Head Neck Surg. 2008 Jun;16(3):226-30.

Nose blowing propels nasal fluid into the paranasal sinuses, Clin Infect Dis. 2000 Feb;30(2):387-91.

Secondhand smoke as a potential cause of chronic rhinosinusitis: a case-control study, Arch Otolaryngol Head Neck Surg. 2010 Apr;136(4):327-34.

Chronic rhinosinusitis and biofilms, Otolaryngol Head Neck Surg. 2005 Mar;132(3):414-7.

Nasal saline irrigations for the symptoms of chronic rhinosinusitis, Cochrane Database Syst Rev. 2007 Jul 18;(3):CD006394.

Primary-care-based randomised placebo-controlled trial of antibiotic treatment in acute maxillary sinusitis, Lancet. 1997 Mar 8;349(9053):683-7.

Effectiveness and safety of short vs. long duration of antibiotic therapy for acute bacterial sinusitis: a meta-analysis of randomized trials, Br J Clin Pharmacol. 2009 Feb;67(2):161-71. Epub 2008 Sep 19.

Intranasal steroids for acute sinusitis, Cochrane Database Syst Rev. 2009 Oct 7;(4):CD005149.

Rhinitis and sinusitis, J Allergy Clin Immunol. 2010 Feb;125(2 Suppl 2):S103-15.

Relationship between milk intake and mucus production in adult volunteers challenged with rhinovirus-2, Am Rev Respir Dis. 1990 Feb;141(2):352-6.

Milk consumption does not lead to mucus production or occurrence of asthma, J Am Coll Nutr December 2005 vol. 24 no. suppl 6 547S-555S.

Use of the Rhinosinusitis Disability Index (RSDI) in rhinologic disease, Am J Rhinol. 2001 Jan-Feb;15(1):15-20.

The epidemiology of chronic rhinosinusitis in Canadians, The Laryngoscope. Volume 113, Issue 7, pages 1199–1205, July 2003.

Antibiotics and topical nasal steroid for treatment of acute maxillary sinusitis, JAMA. 2007 Dec 5;298(21):2487-96.

Acute sinusitis—to treat or not to treat?, JAMA. 2007 Dec 5;298(21):2543-4.

IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults, Clin Infect Dis. 2012 Apr;54(8):e72-e112. Epub 2012 Mar 20.

The persuasive appeal of alternative medicine, Ann Intem Med. 1998; 129:1061-1065.

Natural treatment of chronic rhinosinusitis, Alternative Medicine Review. Volume 11, Number 3 2006.

Books

Atlas of Upper Respiratory and Head and Neck Infections, Itzhak Brook.

Sinusitis from Microbiology to Management, Itzhak Brook.

Rhinosinusitis: A Guide for Diagnosis and Management, Erica R. Thaler, David W. Kennedy.

Websites

Sinusitis, Wikipedia.

Sinus Infection, emedicinehealth.

Treatment Options for Sinus Infections, Medtronic.

Alternative Medicines for Sinusitis, TLC.

How to Tap the Nose to Relieve Sinus Pressure, eHow.

Yoga Poses for Sinus Pressure, LoveToKnow.

Best and Worst Foods for Your Sinuses, MSN.

Sinusitis and Food, Sinus Problem Info.

Sleeping Well with Sinus Problems, Everyday Health.

Sinus Medication Side Effects, eHow.

Epidemiology and Diagnosis of Sinusitis, Sinusitis Understood.

Anatomy of Sinusitis, Sinusitis Understood.

Pathophysiology of Sinusitis, Sinusitis Understood.

Sinusitis, A.D.A.M. Medical Encyclopedia.

Sinusitis: A Treatment Plan That Works, sinuses.com.

Balloon sinuplasty, Wikipedia.

ENT-Surgery under consideration of optimal nasal air flow, Zuse Institute Berlin.

Mucus, Wikipedia.

SINUS: Pain, Pressure, Drainage, American Academy of Otolaryngology-Head and Neck Surgery.

SINUSITIS, Roger Knapp.

Chronic Sinusitis, Medscape.

Sinus Conditions, Centers for Disease Control and Prevention.

Sinusitis – Surgery, University of Maryland Medical Center.

Should I have surgery for sinusitis?, WebMD.

 

 

Information provided by Snoot!

October, 2012