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New drugs and better understanding
are winning the fight against a disease
that once was accepted as a chronic burden.
Sinusitis Can Be Cured
by Noah D. Fabricant, M.D.
y head is full, Doctor, my nose is blocked;
I can't breathe." This complaint and sim
ilar ones are heard in many doctors' offices
all over the country.
A generation ago the attitude of most Americans
toward sinus disease was a negative one. Many
believed, "Once a sinus, always a sinus," and that'
one sinus operation always leads to another. This
situation has changed. Sinus operations are few
today, and sinusitis itself is much easier for physi
cians to handle and cure than it used to be.
The sinuses are small cavities that lead directly
to the interior of the nose. There are eight of them,
four on each side of the nose, placed together in
intimate relationship. One pair is in the forehead,
another in the hollow of the cheekbones, while a
third pair is in the upper recesses of the nose.
The other group consists of a honeycomb-like nest
of sinus cells lodged in either side of the nose.
The sinuses are lined by the same type of
mucous membrane that covers the inside of the
nose. Any disease that affects the mucous mem
brane of the nose may affect the sinuses. Con
sequently, infection moves easily from the nose to
the sinuses, and from one sinus to another.
Sinus disease begins during the late stages of
a common cold, and blends with it so gradually
that most people are unable to distinguish between
the head cold and the beginning of the sinus infec
tion. That was the problem facing Robert Brown,
only 43, and in the prime of life. He thought he
had "just a cold." For several days his nose and
throat had been itching, his eyes watering. He
went to bed early one night, and after a restless
sleep awoke with a slight fever, a running nose,
and a dull pain in one of his upper molars.
The thought that it might be anything more than
a toothache didn't enter his mind, but Robert
Brown had an acute maxillary sinusitis, the com
monest of all sinus problems. When his dentist
ruled out the possibility of an infected tooth, he
went to the doctor for relief from a sinus infection
he had never expected.
Nose and throat physicians speak of two chief
forms of sinus disease, acute and chronic. The
acute form usually follows a head cold and shows
up in stuffiness, itching, pain, and other symptoms,
depending on which set of sinuses are affected.
When any of the sinus passages become blocked
by the swelling of the membranes, the infected
area becomes tender or painful. But some sinusitis
attacks that persist for weeks or months are caused
by allergy rather than infection.
When drainage and ventilation of the nose are
neglected or the infection becomes virulent, the
course of sinus disease may last for months and
even years as a chronic condition. The diagnosis
of chronic sinusitis should never be left to a well
meaning but poorly informed friend. He is not
in a position to give sound advice, nor is the infor
mation he offers likely to be reliable. A complete
medical history, a thorough clinical examination,
and X rays of the sinuses are necessary to make a
definite diagnosis of sinus infection.
Sinusitis isn't as difficult to cure as many people
think. Acute sinus infections are overcome by clear
ing the ventilation and drainage of the nose, and
by using drugs. With many to choose from, physi
cians can select the drug that works best against
the particular bacteria producing the trouble. Rest
in bed, and nosedrops to help the patient breathe
freely, are also valuable. Irrigation of the sinuses
is sometimes required.
Oeveral methods are useful for combatting
allergic sinusitis. One simple way is to
avoid those things that make the problem
worse. Sometimes such foods as strawberries, eggs,
or chocolate may bring on sneezing. If that seems
to be the case, these foods should be avoided. The
same can be said about house plants, dust, furs, or
animal dander, and many of the other things to
which a person may be sensitive. A method of
identifying the substances that cause allergy is
by scratch and skin tests. v
So much for technical terms. Take the case of
the sea captain who retired, and developed an
allergic sinusitis followed by a severe attack of
asthma. His physician found the cause only after
he had traced the trouble to the captain's sleeping
on a new feather pillow. Then there's the case of
the high-school girl who awoke one morning to
find her cheeks swollen, her lips ballooned out,
and her fingers puffed to double their size. The,
cause-and-effect search began, and her doctor
finally narrowed the reason down to a dish of sea
food she had eaten the night before. Now her diet
excludes clams, oysters, and lobsters.
In some instances, control of allergic sinusitis
requires the injection of a series of gradually in
creasing doses of the causative substance the
patient is sensitive to. Many symptoms are relieved
by the older antihistamine drugs and the newer
steroid hormones. In general, the success of treat
ment is measured largely by a thorough under
standing of the allergic oauses.
If you have a chronic sinus infection, your doctor
may use a variety of measures, including shrinkage
of the nasal passages, gentle suction to remove
excessive discharge, certain forms of heat appli
cation, irrigation of the sinuses, and treatment with
sulfonamides or antibiotics. These will provide
relief and even cure. Most chronic conditions
quickly respond to conscientious attention, but
some require surgery.
Though sinus disease still has a few unsolved
aspects, the prospect for preventing and treating
it is full of promise.
Family Weekly, November SO, IKS 21