Health: CHRONIC SINUSITIS - A CHRONIC HEADACHE

Many people suffer from chronic recurrent or continuous headache due to chronic sinusitis. This is a condition where there is congestion and inflammation of the air sinuses in the skull. Air sinuses are air filled spaces in the bones of the skull. They help to keep the weight of the skull less, serve as air conditioners of the brain substance, maintaining the humidity and temperature of the air entering. They are also said to maintain the pressure of the skull to keep brain floating and dampen the auditory vibrations reaching the skull. The air sinuses tend to get infected and inflamed from infection in the surrounding areas of the brain. Most common cause of the inflammation of the brain substance is recurrent cold. Recurrent cold due to allergy or other causes produces congestion of the air spaces. If there is an obstruction in the nose due to polyps or a deviated septum, this also causes sinusitis. Infections of the teeth, throat, nose or ears can reach the air sinuses directly or via the blood stream and cause inflammation. Any trauma to the face or head can introduce germs which can reach the air sinuses and infect them. Viral infections are a major cause for sinusitis. It is these viruses which cause the common cold and infect the air sinuses also. Apart from this it can be caused by bacteria like streptococcus pneumonia, Haemophilus influenza, e.t.c. In immune depressed people, like those suffering from HIV/AIDS, renal failure, diabetes, e.t.c., sinusitis can also be caused by fungal infections. Smokers are more prone to this condition. Like any infection in the body, sinusitis can also be acute or chronic in nature. Chronic sinusitis, i.e., the one persisting for more than 4 weeks becomes a source of chronic headache. The pain in the head is mostly located over the site of infected sinus. It can be over the forehead in the middle or sides. Pain can be felt over the sides of the cranial vault or middle. The pain felt by an individual is throbbing in character. It is greatest in the morning but remains continuously present all the time. When one looks down it is augmented. The affected person may have no other feature except this severe persistent headache. Hence it may be confused with migraine or tension headaches which occur due to mental tension. Some individuals experience loss of smell sensation due to chronic sinusitis. Apart from this, in case of bacterial sinusitis there may be fever with rigors. If left untreated, there is risk of the infection reaching the coverings of the brain causing meningitis or to the brain substance causing an abscess. This may manifest as convulsions, loss of consciousness and various neurological abnormalities. Diagnosis is based on clinical features. In individuals complaining of chronic headache and having history of recurrent cold like running of nose or sneezing, diagnosis of sinusitis becomes fairly easy. In other individuals with chronic unexplained headache, sinusitis is always thought of as being the underlying cause. Imaging techniques like x-ray of the skull and computerized tomography help in confirming the diagnosis of chronic sinusitis. Treatment consists of taking a complete course of suitable antibiotic like amoxicillin or amoxicillin and clavulanic acid combination. In addition an anti-inflammatory drug is used to reduce the inflammation of the air sinuses. Steam inhalation done 2 or 3 times every day is very useful for patients with chronic sinusitis. It helps to liquefy the secretions and drain them, thus relieving the congestion present in the air sinuses. Drinking warm water is also beneficial. Surgery is done in severe advanced cases of chronic sinusitis to clear the congestion of the air sinus. One should avoid exposure to allergy producing substances, thus allergic rhinitis and resultant sinusitis can be prevented. Similarly, any infection occurring anywhere in the ear, nose or mouth should be promptly treated to avoid chronic sinusitis. E-mail-rachna212002@yahoo.co.uk