Sinusitis refers to an inflammation of the sinuses, which are airspaces within the bones of the face. Sinusitis is most often due to an infection within these spaces.

Description
The sinuses are paired air pockets located within the bones of the face. They are:
1. The frontal sinuses; located above the eyes, in the center region of each eyebrow
2. The maxillary sinuses; located within the cheekbones, just to either side of the nose
3. The ethmoid sinuses; located between the eyes, just behind the bridge of the nose.
4. The sphenoid sinuses; Located just behind the ethmoid sinuses, and behind the eyes.

The sinuses relate to the nose. They are lined with the same kind of skin found elsewhere within the respiratory tract. This skin has tiny little hairs projecting from it, called cilia. The cilia beat constantly, to help move the mucus produced in the sinuses into the respiratory tract. The beating cilia sweeping the mucus along the respiratory tract helps to clear the respiratory tract of any debris, or any organisms which may be present. When the lining of the sinuses is at all swollen, the swelling interferes with the normal flow of mucus. Trapped mucus can then fill the sinuses, causing an uncomfortable sensation of pressure and providing an excellent environment for the growth of infection-causing bacteria.

Types of sinusitis
1. Acute, which lasts up to 4 weeks
2. Subacute, which lasts 4 to 12 weeks
3. Chronic, which lasts more than 12 weeks and can continue for months or even years
4. Recurrent, with several attacks within a year
Symptoms of sinusitis

Early stages:
• Nasal congestion with green, yellow (sometimes blood-tinged) discharge.
• Feeling of pressure inside the head.
• Eye pain.
• Headache that is worse in the morning or when bending forward.
• Cheek pain that may resemble a toothache.
• Postnasal drip.
• Cough (sometimes) that is usually nonproductive.
• Disturbed sleep (sometimes).
• Fever (sometimes)
• Fatigue.

Late stages:
• Complete blockage of the sinus openings, blocking the discharge and increasing pain.

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CAUSES

• Infection (usually initiated by a cold or other upper respiratory infection). The infection may be complicated by a bacterial invasion of organisms that normally inhabit the nose and throat.

• Irritation of the nasal passages from allergies, smoking, harsh sneezes with the mouth closed, chilling, swimming (especially jumping into the water without holding the nose).

Acute sinusitis usually follows some type of upper respiratory tract infection or cold. Instead of ending, the cold seems to linger on, with constant or even worsening congestion. Drainage from the nose often changes from a clear color to a thicker, yellowish-green. There may be a fever. Headache and pain over the affected sinuses may occur, as well as a feeling of pressure which may worsen when the patient bends over. There may be a pain in the jaw or teeth. Some children, in particular, get upset stomachs from the infected drainage going down the back of their throats and being swallowed into their stomachs.

Chronic sinusitis occurs when the problem has existed for at least three months. There is rarely a fever with chronic sinusitis. Sinus pain and pressure are frequent, as is nasal congestion. Because of the nature of the swelling in the sinuses, they may not be able to drain out the nose. Drainage, therefore, drips constantly down the back of the throat, resulting in a continuously sore throat and bad breath.

RISK INCREASES WITH
• Illness that has lowered resistance.
• Smoking.
• Exposure to cold, damp weather outdoors and dry heat indoors.
• Exposure to others in public places.
• Immunosuppression due to illness or drugs.
• Swimming in contaminated water.

PREVENTIVE MEASURES
Prompt treatment of respiratory infections.
POSSIBLE COMPLICATIONS
• Meningitis or brain abscess (rare).
• Infection of bone.

Ayurvedic management:

In Ayurveda, this condition can be correlated to Dushta Pratishyaya, where the main dosha affected is Kapha. The Ayurvedic approach to sinusitis treatment is multifaceted and can involve a combination of detoxification processes through Panchakarma, oral medicines, dietary and lifestyle modifications. Therapies like Nasyam, Lepanam, Thalam, Vamanam, Shirodhara are commonly practiced depending on the dosha predominance and severity.

This treatment involves massage with oils to the face, neck, and shoulder area using a herbal oil infused with an herbal formulation to reduce Kapha in the body. This is followed by a steam to liquefy the solidified mucous and a few drops of a medicated herbal oil in each nostril. The dosage of drops in the nose is increased in each session, based on the patient’s response to treatment.

This therapy will reduce the inflammation of the mucus membranes and drain the infected mucous accumulated in the sinuses and the healing process begins. The therapy will be followed by immune modulatory herbal medicines to prevent future recurrence.