Sinuses

Synonyms

Sinus, nose, sinuses
Medical: Paranasal sinus

definition

The sinuses are, as the name suggests, next to the nose in the bony face.

The paranasal sinuses usually come to the fore when they become inflamed and sinusitis (= inflammation of the sinuses) occurs. The paranasal sinuses fulfill important functions that also have to do with warming and humidifying the air we breathe.

Anatomical composition

If our facial skulls were entirely filled with bones and not by such cavities as the paranasal sinuses, our head would be very heavy and we would not be able to hold it upright for long.
Therefore one can ascribe to them the task of weight loss. The cavities of the paranasal sinuses, together with the main nasal cavity, act as a kind of resonance space for improved voice and language formation.
Singers in particular suffer severe restrictions in their profession due to a sinus infection.

The paranasal sinuses include the paired maxillary sinuses (maxillary sinus), the frontal sinus (frontal sinus), the pair of ethmoid sinuses with their ethmoid cells (ethmoid sinus and the sphenoid sinus (sinus sphenoidales). lined.
Since all the paranasal sinuses are connected to the main nasal cavity, the hairs (cinema cilia) also beat in the direction of the ducts (ostia).
The maxillary sinus is located on both sides of the main nasal cavity in the upper jawbone (maxilla) and almost completely fills it. It is one of the largest sinuses. The maxillary sinus is connected to the main nasal cavity via a crescent-shaped opening (hiatus semilunaris). This is located just below the middle turbinate (Concha nasi media). Seen from the jaw cavities, the drainage point is located quite high up, which makes the transport of secretions (e.g. in the case of a cold) more difficult.
Furthermore, the zygomatic bone delimits the paranasal sinuses.

Inflammation of the maxillary sinuses (maxillary sinusitis) affects them to a particularly severe extent.

Figure sinuses

1. Frontal sinus -
   Frontal sinus
2. Ethmoid cells -
   Cellulae ethmoidales
3. Maxillary sinus -
   Maxillary sinus
4. Sphenoid sinus -
   Sphenoid sinus
5. Thin septum -
   Septum sinuum frontalium

You can find an overview of all Dr-Gumpert images at: medical illustrations

The sinuses

Frontal sinus

The frontal sinus (Frontal sinus) lies above the main nasal cavity and delimits the eye sockets (orbit) from above.
There is also a connection to the main nasal cavity via the crescent-shaped structure (Hiatus semilunaris) in the middle nasal passage (Meatus nasi medius), slightly above the opening of the maxillary sinus.
Inflammation of the frontal sinus (frontal sinusitis = frontal sinus inflammation) particularly endangers the eye socket (orbit). If too much mucus and pus form, it breaks through into the orbit and the inflammation can spread to the eye (orbital phlegmon, orbital inflammation).

For more information, see: Frontal sinus

Ethmoid sinuses

The Ethmoid sinuses (Ethmoid sinus, ethmoid cell) consist of eight to ten pea-sized, pneumatized capsules.
The anterior capsules open into the middle and the posterior capsules into the upper nasal passage (infundibulum ethmoidale). The ethmoid cells are less inflamed than the maxillary sinus or frontal sinus, but one of the anterior ethmoid cells can push into the middle nasal passage (bulla ethmoidales), whereby the middle turbinate (concha nasi medius) is pushed towards the nasal septum.
A bulge in the middle nasal passage makes it difficult to breathe through the nose and can block the other openings in the sinuses.

Sphenoid sinus

The Sphenoid sinus (Sinus sphenoidales) has access to the upper nasal passage through a small opening (Recessus sphenoidales; Apertura sinus sphenoidales) above the main nasal cavity.
In the case of inflammatory processes in the sphenoid sinus, it is particularly important to prevent it from spreading to its vicinity. One of the most important neighbors is namely Pituitary gland (Pituitary gland), the important one Hormones produced. If inflammation spreads to them, life-threatening illnesses can occur.

For more information, see: Sphenoid sinus

Sinus diseases

Sinus pain

Sinus pain can have a number of causes.
Often times, this pain is associated with a cold, but it can also be present without a cold. Although the sinuses are connected to the nasal cavity, the opening is often clogged because they are small in circumference compared to the size of the sinuses.

Especially with colds, ventilation problems and bacterial infections occur. This can be painful and should be treated by a doctor. This pain, which occurs in so-called sinusitis, can be aggravated by leaning the head forward.

If there is no cold with existing pain in the paranasal sinuses, then a chronic inflammation is usually to blame. This also clogs the openings in the nasal cavity and creates good conditions for bacterial infection. For this reason, both forms should be treated.

The aim of the therapy is to re-ventilate the paranasal sinuses. For this purpose, a decongestant nasal spray can be administered or the nose can be rinsed. In severe cases, cortisone can also be given. If an existing bacterial infection is suspected, antibiotics are used.

Learn more about: Sinusitis

Sinusitis

Sinusitis is usually the bacterial inflammation of the sinuses. The mostly purulent inflammation causes the mucous membranes to swell, which obstructs the outlets and prevents the purulent mucus from draining away.

You can find more information under our topic: Sinusitis

Sinuses and pain in the teeth

The maxillary sinuses, which are part of the paranasal sinuses, are in great spatial proximity to the deep-lying tooth components such as the root or the nerve of the upper jaw.
Because of this proximity, pathological processes that are located in the maxillary sinuses can easily be transferred to the teeth. This also applies to the pathological processes that take place in the teeth and can easily reach the maxillary sinuses.

A sinus infection is therefore often accompanied by throbbing or stabbing toothache. The toothache is then often accompanied by typical symptoms such as a stuffy nose or sore throat.
The other way around, tooth root inflammation can also cause an inflammation of the maxillary sinus. These usually last a very long time and do not include any typical symptoms. If this is the case, a doctor must be consulted, as the focus of inflammation must be eliminated.

Find out more about this: Sinusitis and toothache

Sinuses and pain in the jaw

Inflammation of the sinuses can also spread to the jaw through the temporomandibular joint. This results in pain when moving within the joint and possibly toothache due to inflammatory processes that spread.

Because of this, a doctor should be seen to prevent further progression and prevent more serious problems.

For more information on the subject, read below: Pain in the temporomandibular joint

Sinuses and pain after alcohol

The consumption of alcoholic beverages can lead to a runny or blocked nose. The reasons for this have not been fully clarified.

However, the increased production of nasal secretions and the swelling of the mucous membrane can lead to impaired ventilation of the sinuses. This increases the likelihood of a sinus infection, which is usually accompanied by a feeling of pressure and pain.
It can also lead to changes in breathing, which further irritates the mucous membranes.

Polyps in the sinuses

The popularly named nasal polyps are swollen, bilateral enlargements (hyperplasia) of the nasal mucosa or the mucous membrane of the paranasal sinuses.
They are called polyps because the enlargement of the mucous membrane looks like a fungus on a tree trunk.
The enlargement of the mucous membrane usually starts from the maxillary sinus (maxillary sinus) or the ethmoid sinus (ethmoid sinus) and grows in the direction of the middle nasal passage. The nasal passages can be almost completely closed when the growth is pronounced.
The exits (ostia) of the paranasal sinuses located there can be affected by the nasal polyps and almost completely closed. The quality of life can be significantly reduced by polyps.

You can find more information under our topic: Polyps

Therapy for diseased paranasal sinuses

What home remedies are there?

Various home remedies can be used to relieve sinus discomfort when the first signs of symptoms appear. For example, it makes sense to inhale warm vapors to let the irritated mucous membranes swell. To do this, put eucalyptus oil or chamomile flowers in a bowl with hot water and inhale the vapors under a towel for 10 to 15 minutes several times a day. Warming infrared light directed at the sinuses can also accelerate the healing process. However, the use of heat only makes sense if it is perceived as pleasant. In the case of very severe inflammation, the symptoms can also be exacerbated by heat. Other home remedies for sinus treatment are poultices made from warm water and eucalyptus oil or lemon, in which a linen cloth or washcloth is soaked and then placed on the sinuses. A very important home remedy for sinus infections is to drink a lot of fluids to liquefy the mucus. Herbal and peppermint teas can also have a decongestant effect. In addition, care should be taken to ensure that the humidity in the living rooms is sufficient and that cigarette smoke is avoided in the area, as it irritates the mucous membranes.

If the symptoms of sinus infection do not improve despite the use of home remedies, a doctor should be consulted so that the disease can be completely cured and a chronic course can be prevented.

Rinse, inhale, clear your sinuses

There are several ways to clear mucus from your sinuses and make breathing easier. Saline solutions, which you can either buy ready-made at the pharmacy or make yourself, are suitable for rinsing the sinuses. There are so-called nasal showers that can be used for this. You can also put the rinsing solution in a small bowl, cover one nostril and suck up water with the free nostril. The solution flows through the nose and comes out through the mouth. Rinsing the sinuses makes it easier to snort off the secretion and the salt water also has a disinfecting effect. Flushing should always be done over a sink, as the amount of mucus that will wash out of your sinuses can be unpredictable. The sinuses should not be rinsed more than four times a day.

Inhaling steam or essential oils can also open the sinuses, moisten irritated mucous membranes and clear the nose of mucus.To do this, you fill a bowl with boiling water (possibly with the addition of essential oils), bend over this with a towel over your head and inhale the rising steam. Inhaling two or three times a day for a few minutes can effectively relieve the symptoms of a cold or sinus infection. It is important to rinse the inhaler or bowl well after inhaling and then let it dry as there are bacteria that need little moisture to multiply. Particularly in infants and children, caution should be exercised with essential oils, as they can irritate the airways and trigger an asthma attack, which can lead to shortness of breath in an infant or child.

Expectorants can also be used to remove secretions from the sinuses. Various preparations are available without a prescription in pharmacies or drugstores, such as capsules with the active ingredient Cineolewhich has an expectorant and anti-inflammatory effect within a short time. A cold bath at body temperature can also help clear the sinuses.

However, one should not overdo it with measures to clear the sinuses, as the mucous membranes can be irritated quickly and nosebleeds can occur.

Sinus surgery

Due to its anatomy, an operation in the sinus area is a very demanding surgical measure that should be carefully considered. An operation can improve the quality of life in the case of chronic sinusitis; in the majority of cases an operation improves the state of health, especially in people for whom medicinal treatment of the sinusitis does not work. However, in many cases the symptoms return after the operation, for example nasal polyps that have been removed can grow back after a while. An operation on the paranasal sinuses always involves risks, for example important structures for moistening the nose can be damaged during the operation, which is why dry mucous membranes often occur after the operation. In rare cases, structures near the sinuses can also be injured. This creates the risk of meningitis, inflammation of the eyes or blindness. Temporary consequences of a sinus surgery can be an impairment of the olfactory ability or the bleeding.

Since chronic sinusitis can have many different causes, it must be decided on an individual basis what type of surgery can help alleviate the symptoms in each individual case. A reduction in size of the turbinate is rarely carried out today, the typical surgical measure nowadays is a so-called functional endoscopic operation of the paranasal sinuses (in short: FESS). Constrictions or nasal polyps can be removed. This method is very gentle and hardly painful; usually only a day's hospitalization is required after the procedure. The nasal septum can also be operated on endoscopically. There is also the option of shrinking swollen mucous membranes in the area of ​​the paranasal sinuses using laser technology. By reducing the swelling of the mucous membranes, one hopes for a milder course in phases of infection, since blockages in the area of ​​the paranasal sinuses do not occur so quickly. In rather simple cases of chronic sinusitis, a so-called balloon dilatation can be performed. A balloon is inserted into the nose using a catheter and slowly inflated at the entrance to the sinuses, which allows narrowed openings to be expanded. This method is relatively simple and involves few complications, but it is questionable whether this operation will have any long-term benefit.

Even with a chronic sinus infection, a surgical procedure is often not expected to completely disappear; the frequency and severity of the symptoms can be alleviated, but most of those affected must continue to receive therapeutic care even after an operation.