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Body Watch : Sinusitis Sufferers Can Help Themselves

September 26, 1995|KATHLEEN DOHENY | SPECIAL TO THE TIMES

You feel so stuffed up that you're convinced your head weighs an extra five pounds. And, no matter how often you blow your nose, the congestion returns. Your face, throat and teeth hurt.

All typical symptoms of sinusitis, an inflammation or infection of the sinuses that accounts for more than 16 million doctor visits a year.

Sinus problems can occur any time of year, but fall and winter months can be peak season, partly because of weather changes. Spring is also a common time for sinus problems, especially if you have allergies, says Dr. Robert Eitches, an allergist at Cedars-Sinai Medical Center and UCLA assistant clinical professor of pediatrics. But the misery can be minimized.

How It Starts: When the eight air-filled cavities called sinuses (located above the eyebrows, in the cheekbones, between the eyes and behind the nose) work properly, they're an efficient drainage system. They circulate air and produce mucus, which sweeps away debris from the nose and drains it through openings into the nose and back of the throat.

But a cold, other infection or allergy can make the drainage system go haywire. The sinus and nasal linings swell; sinus openings can become blocked. Mucus backs up, bacteria grows, infection sets in.

Who's at Risk: Anyone can have a sinus problem, but some people are more susceptible, says Dr. George B. Stoneman, an otolaryngologist at Good Samaritan Hospital and USC associate clinical professor of otolaryngology. Among them: people with allergies or nasal polyps, those sensitive to smog or smoke and children with middle-ear infections.

The ethmoid sinuses (between the eyes) and the maxillary sinuses (near the cheeks) are most often infected, Eitches says.

Do-It-Yourself Care: "A short sinus infection after a cold will probably clear on its own," Eitches says.

Among self-care measures recommended by experts: an over-the-counter decongestant, saline nasal spray, a pain reliever such as ibuprofen, an antihistamine if allergies are a problem. "Use warm compresses where the pain is," Eitches says. "Massage the area."

Not all sinus infections respond to self-care. "If you have a headache, with colored mucus lasting more than five days, that's probably a sinus infection that needs treatment," Eitches says.

Caveat: Left untreated, a sinus infection could lead to complications such as eye problems or meningitis, although that is unusual, Stoneman says. When in doubt, call the doctor.

Professional Help: A doctor will obtain a medical history and ask about allergies and other predisposing factors. An X-ray or CT scan might be done.

A doctor might also use a special viewing tube, or endoscope, to examine the nasal passages and sinus openings to determine the severity of the infection or whether you have anatomical problems.

Sinusitis is considered chronic if it persists for six to eight weeks or if there are four or more bouts a year, each lasting 10 days or longer. If sinus problems recur, a doctor should evaluate a patient for underlying problems such as allergies or asthma.

Treatment often involves several approaches.

* An antibiotic, usually a broad-spectrum type, prescribed for 10 days to two weeks or even longer. "We treat longer than we used to," Stoneman says. It can require two to three weeks of antibiotic use, even up to six weeks for chronic sinus problems.

* A decongestant, especially a formula with an expectorant or "mucus-thinner."

* An antihistamine if there are allergies.

* A steam inhaler.

* A nasal steroid spray.

Preventive Care: To minimize sinus problems, drink several glasses of water a day. Avoid exposure as much as possible to dust, pollution and pollen, as well as to tobacco smoke. Use an over-the-counter nasal saline spray before an airplane flight.

Some physicians prescribe a steroid nasal spray for long-term use.

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