Nasal Congestion and Sinusitis Problems

Acute Sinusitis

Acute sinusitis is an inflammation of the nose and the mucous membrane lining the sinuses caused by various viruses and bacteria. During this inflammation, the mucosa swells, which can block the sinus openings. As a result, the sinuses fill with inflamed mucus. This condition leads to severe pain in the face, fever, and nasal congestion. Antibiotics and anti-inflammatory medications are used in its treatment. If the condition lasts longer than three months, it is referred to as chronic sinusitis.

Nasal Polyps

Chronic sinusitis, allergies, and chronic rhinitis are some inflammatory conditions that can lead to the growth of tissue in the nose and sinuses, resulting in the formation of polyps. In patients with genetic predisposition, polyps can fill the nasal passages completely, making it impossible for the patient to breathe through the nose. Treatment is usually surgical. These patients undergo endoscopic sinus surgery.

Endoscopic Sinus Surgery

In cases of sinusitis and polyps (nasal tissue growth) that do not improve with long-term medication, an endoscopic system is used to access the sinuses through the nostrils. The sinus cavities are cleaned, and the openings are enlarged. This procedure is called endoscopic sinus surgery. Different techniques are applied depending on the sinus that needs to be treated. Patients are typically discharged from the hospital on the same day or the next day.

Nasal Allergy

Rhinits is the inflammation of the mucous membrane that lines the inside of the nose. When this inflammation is caused by allergic factors, it is referred to as allergic rhinitis.

It is typically characterized by severe nasal congestion, intermittent sneezing attacks (at least 3-4 times), eye watering, and itching in the nose. Treatment includes avoiding allergens, using medication, and, if necessary, surgery to reduce the size of the turbinates (nasal polyps).

What can I do to protect myself from allergies?

1. Reduce the number of carpets and rugs in your home, and have someone who will frequently clean with a vacuum cleaner, other than the allergic person. A vacuum with an allergen filter is the best option.
2. Do not lay rugs on concrete floors; dust mites can accumulate.
3. Use synthetic polyester pillows instead of feather pillows.
4. Cover mattresses with plastic covers.
5. Frequently use air conditioners and dehumidifiers; dust mites thrive in warm, humid environments.
6. Another common cause of allergies is pet dander. Follow these steps:

• Get a pet that sheds less dander.
• Keep pets outside the house as much as possible.
• Wash your hands after touching the pet.
• Find someone (who is not allergic) to bathe your dog once a week. However, ask whether bathing your dog weekly could damage its skin.
• Find someone (who is not allergic) to bathe your cat every week with a special solution that removes saliva from the fur.

7. Molds are another common indoor allergen. Like dust mites, they grow in warm, humid environments. To minimize exposure to indoor mold:

•  Use dehumidifiers and air conditioners when the air is warm and humid.
• Avoid areas in your home that are prone to mold; stay away from old paper products, old books, newspapers, or magazines, humidifiers, houseplants, and aquariums.
• Find someone (who is not allergic) to clean and remove dust from these items.

8. Pollen and mold are common outdoor allergens, especially from early spring to mid-fall. To reduce exposure to outdoor allergens:

• Minimize activities such as lawn mowing or leaf raking.
• Avoid being outside on days with high pollen or mold levels.
• Close windows on days with high pollen or mold levels (and use the air conditioner in hot weather).

Terfenadine and astemizole can cause heart rhythm abnormalities in people with severe liver disease or those taking certain antibiotics or antifungal medications. Other potential side effects include narrowing of the airways and wheezing, which can resemble asthma symptoms.

Your doctor may also prescribe non-prescription nasal sprays. Decongestant nasal sprays can provide relief for a few days, but using them for more than 4-5 days may cause a rebound effect (worsening of symptoms). Other nasal drops contain sodium cromoglycate, which prevents the release of irritants called histamines from mast cells. These drops may also contain ipratropium, which blocks a natural substance called acetylcholine, important in mucus production. As a result, your doctor may prescribe nasal sprays containing low doses of corticosteroids.

This spray can stop an allergy attack, but it may take more than a week to reach maximum effectiveness. If antihistamines, nasal sprays, and environmental controls do not work, or if the medications cause side effects, you may consider immunotherapy. For immunotherapy to be effective, your doctor must identify the allergen causing the symptoms. Initially, small amounts of allergens are injected under the skin. The dose is gradually increased, typically on a weekly basis, and the treatment may last for years.

Allergens most responsive to immunotherapy include ragweed, grass, house dust mites, and cat dander. Symptoms usually improve within 6 months, but doctors may recommend treatment lasting 4-5 years. However, immunotherapy may not always be effective.