Inside the facial bones of the skull are small, hollow chambers called sinuses. Our sinuses consist of four groups. The maxillary sinuses are located in the cheekbones, along the sides of the nose are the ethmoid sinuses, behind the ethmoid sinuses are the sphenoid sinuses and above the eyes are the frontal sinuses. Healthy sinuses are filled with air and serve to reduce the weight of the head, provide structure, assist in the voice resonation and drain mucus from the nose. However, when the sinuses become blocked, they can cause significant pain, swelling and lead to recurrent or chronic infections. Sinuses can become blocked when infections, debris, or allergies cause the mucous lining of the sinuses to swell. All the swelling can cause the sinuses to fill with fluid causing the pressure inside them to drop. Any or all of the sinuses may be affected by allergies or infections causing significant pain and discomfort in the cheeks, behind the eyes, forehead and above the teeth.
The medical term for a sinus infection is sinusitis or rhinosinusitis. Infections are usually caused by viruses but occasionally can be caused by bacteria or even fungal organisms. Symptoms of acute infections include green or yellow mucous from the nose, sharp pains, headaches and fever. Sinus infections that last longer than two months are considered chronic. Chronic sinusitis symptoms may be more subtle than those of acute infections and often include head congestion, drainage down the back of the throat, fatigue, and reduced sense of taste and smell. Sinusitis is often diagnosed with a thorough history and physical exam by a medical provider. Certain imaging tests and endoscopic evaluations can be helpful when the diagnosis is not straightforward or if other conditions need to be ruled out. Once diagnosed, sinus infections may be treated with antibiotics and/or nasal sprays that include corticosteroids or an antihistamine. Sinus surgery or balloon sinuplasty, an in-office procedure that improves sinus drainage are often considered when first line therapies are not effective.
Disorders of the nasal passageways can also cause blockage and unwanted symptoms of pain and congestion.
Some of the common causes of nasal blockage include:
- Deviated septum – The nasal septum which divides the two nasal passageways may be deviated or off center due to trauma or poor development after birth. Significant deviation can lead to breathing difficulties, chronic congestion, frequent sinus infections, and nosebleeds. Surgery can correct problems caused by a deviated septum.
- Perforated septum – Trauma to the septum can also cause it to be punctured leading to frequent nosebleeds, chronic nasal discharge, and breathing difficulties. Skin grafts or plastic membranes can surgically repair a perforated septum.
- Nasal polyps – Abnormal growths of tissue called polyps can cause nasal blockage by obstructing or partially obstructing the nasal passageways, causing congestion, breathing difficulties and contributing to infections. Removal of the polyps are recommended not only for symptom relief but to make sure the polyps are not cancerous.