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Sinusitis

Sinusitis is inflammation of the sinuses, which are small air-filled cavities within the bones of the face surrounding the nose (NIH 2012; NIAID 2012; MedlinePlus 2011; Mayo Clinic 2012a). Sinusitis symptoms include congestion, mucus discharge, and facial pain. The condition affects an estimated 16% of the United States adult population, resulting in millions of primary care office visits each year (Leung 2008; Smith 2012).

Sinusitis should not be confused with rhinitis, which is characterized by inflammation associated with the mucosal surface of the nasal cavity (Hytonen 2012). However, since most cases of sinusitis also include symptoms of rhinitis, the term rhinosinusitis is often used(Fokkens 2005; NIH 2012).

Sinusitis can be acute, subacute, chronic, or recurrent acute; categorization is dependent upon duration and frequency of symptoms (Leung 2008; Radojicic 2010). Acute sinusitis typically causes mild symptoms that resolve on their own, but very rarely may progress into severe or even life-threatening complications, such as a brain abscess (Onisor-Gligor 2012; Boto 2011; Suhaili 2010; Ferri 2012). Chronic sinusitis causes persistent symptoms and is often difficult to treat (Leung 2008).

Conventional pharmaceutical options to reduce inflammation in the sinuses and nasal passages include corticosteroids and decongestants, though some people receive limited, or minimal, symptom relief (Rossberg 2005). Moreover, antibiotics are often needlessly overprescribed since most cases of acute sinusitis are caused by viruses, which do not respond to antibiotics, and chronic sinusitis can be caused by chronic inflammation or anatomic irregularities (Leung 2008; Mayo Clinic 2012c; PubMed Health 2012). The inappropriate use of antibiotics can lead to antibiotic-resistant organisms and an unnecessary increase in antibiotic-related adverse events such as diarrhea (Smith 2012; Guarch Ibanez 2011).

This protocol will describe the human sinuses as well as the causes, risk factors, and symptoms of sinusitis. Conventional treatment options will be examined along with an underutilized drug-free method for relieving sinusitis symptoms. Also, a variety of scientifically studied natural sinusitis therapies will be reviewed.

The Human Sinuses

The paranasal sinuses are 4 pairs of interconnected, mucous membrane-lined cavities that drain into the nasal cavity and are formed within the skull bones that surround the nose (Ogle 2012; NIAID 2012; AAFP 2011). Each of the sinus cavities are named after the particular facial bone(s) that shape(s) them, including (NIAID 2012):

  Name   Location
Frontal sinuses Above the eyes in the brow area
Maxillary sinuses Inside each cheekbone
Ethmoid sinuses Behind the bridge of the nose, and between the eyes
Sphenoid sinuses Deeper behind the ethmoids, above the nose, and behind the eyes

The sinuses circulate air and are lined with specialized cells that produce mucus and cells that possess tiny hairs called cilia (DeMuri 2009). The sinuses contain a thin layer of watery mucus that traps and filters out pathogens and other harmful particles from inhaled air, while the cilia rhythmically pulsate or “beat”, sweeping the stagnant mucus out of the sinuses and into the nasal cavity (AAFP 2008; NIAID 2012). In addition to catching unwanted material before it reaches the lungs, mucus and cilia also work together to warm and humidify the sinuses and nasal cavities so they remain moist and do not dry out during breathing (NIAID 2012; Jurkiewicz 2011). The sinuses also generate high concentrations of nitric oxide, a free radical and immune-mediator, which may serve to maintain sterility, strengthen immune defense against viruses and bacteria, and enhance the efficiency of cilia in clearing excess mucus (DeMuri 2009; Keir 2009).