Chronic sinusitis is a complicated variety of diseases that have chronic inflammation of the sinuses in common. The causes are multifactorial. They may include allergy, dust mite allergy, environmental factors such as dust or pollution, bacterial infection, or fungus (either allergic, infective, or reactive). Non allergic factors such as Vasomotor rhinitis can also cause chronic sinus problems.
Symptoms include: Nasal congestion; facial pain; sinus headache; fever; general malaise; thick green but usually yellowish mucous discharge; feeling of facial 'fullness' worsening on bending over and aching teeth.
Very rarely, chronic sinusitis can lead to Anosmia, which is the inability to smell or detect odors.
In a small number of cases, chronic maxillary sinusitis can be brought on by the spreading of bacteria from a dental infection. This can happen after root canals or extractions. Sinus Cure Report
Some attempts have been made to provide a consistent nomenclature for subtypes of chronic sinusitis. A task force at the American Academy of Otolaryngology - Head and Neck Surgery / Foundation along with the Sinus and Allergy Health Partnership have broken Chronic Sinusitis into two main divisions, Chronic Sinusitis without polyps and Chronic Sinusitis with polyps (also often referred to as Chronic Hyperplastic Sinusitis). And recent studies which have sought to further determine and characterize a common pathologic progression of disease have resulted in the expansion of the proposed subtypes. Many patients have demonstrated the
presence of eosinophils in the mucous lining of the nose and the paranasal sinuses. The name Eosinophilic Mucin RhinoSinusitis (EMRS) has come into being. Cases of EMRS may be related to an allergic response, but allergy is often not easily documentable, resulting in the further subcategorization of allergic and non-allergic EMRS.
A more recent, and still debated, development in chronic sinusitis is the role that fungus might play. Fungus can be found in the nasal cavities and sinuses of most patients with sinusitis, but it can also be found in healthy people as well. So it remains unclear if fungus is a factor in the development of chronic sinusitis and if it is, what the difference may be between those people who develop the disease and those who do not.Sinus Cure Report
Chronic Sinusitis Treatment
A nasal irrigation and flush promotes sinus cavity health, and patients with chronic sinusitis including symptoms of facial pain, headache, halitosis, cough, anterior rhinorrhea (watery discharge) and nasal congestion found nasal irrigation to be "just as effective at treating these symptoms as the drug therapies." In other studies, "daily hypertonic saline nasal irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis," and is "recommended as an effective adjunctive treatment of chronic sinonasal symptoms." and irrigation is recommended as an "effective adjunctive treatment of chronic sinonasal symptoms." This substantiates my use of Nasaline for my chronic sinusitis and complete avoidance gtherafter to drugs, sinus medications etc.
These are the standard medical approaches which I don't agree with-
"For chronic or recurring sinusitis, referral to an otolaryngologist may be indicated for more specialist assessment and treatment, which may include nasal surgery. However, for most patients the surgical approach is not superior to appropriate medical treatment. Surgery should only be considered for those patients who do not experience sufficient relief from optimal medication." I have talked to many post surgery patients who continued to have the same sinus problems and told me that sinus surgery did not work for them. Nasaline or other nasal irrigation should be tried first.
A new treatment of sinusitis is a type of surgery called FESS - functional endoscopic sinus surgery, whereby normal clearance from the sinuses is restored by removing the anatomical and pathological obstructive variations that predispose to sinusitis. This replaces prior open techniques requiring facial or oral incisions and refocuses the technique to the natural openings of the sinuses instead of promoting drainage by gravity, the idea upon which the Caldwell-Luc surgery was based.
Another recently developed treatment is Balloon Sinuplasty™. This method, which is similar to balloon angioplasty used to "unclog" arteries of the heart, utilizes balloons in an attempt to expand the openings of the sinuses in a less invasive manner. Its final role in the treatment of sinus disease is still under debate.
Based on the recent theories and studies on the role that fungus might play in the development of chronic sinusitis, newer medical therapies include topical nasal applications of antifungal agents. And much of the original research indicating fungus took place at the Mayo Clinic and they have since patented this treatment option. Although there are some licensing battles taking place over these drugs as a result of the patent, they are currently available for other uses and therefore can be compounded by pharmacies or even by the patient. Sinus Cure Report
Other Sinus Surgery Approaches
A number of surgical approaches may be used, either by endoscopy or conventional incision through nose, mouth or external skin. Once incisional entry is gained into the paranasal sinus, surgery can be extended to another sinus or other adjacent anatomical structures; e.g. internal maxillary artery, pterygopalatine fossa and sphenopalatine ganglion.
Phage therapy: And since the discovery of spontaneous bacterial lysis (from bacteriophages) by Frederick Twort and by Felix d'Herelle, phage therapy (treatment with bacterial viruses) has been used with miscellaneous bacterial infections in otolaryngology, stomatology, ophthalmology, dermatology, pediatrics, gynecology, surgery (especially against wound infections), urology, and pulmonology. Treatment with phages was developed in the Soviet Union in parallel to the western development of antibiotics. Currently phage therapy for chronic sinusitis is available at the Phage Therapy Center, Tbilisi, Republic of Georgia, or in Poland but not in the United States.
Sinus Cure Report