Sample Section

Dr. Wickham - The Book




    Your head is full of holes!

    Below, above, between and even behind your eyes , your skull bone is riddled with spaces called sinuses. All these sinuses are connected together by small holes and tubes, making a complex interconnecting system rather like a cave explorers nightmare in miniature. The exact purpose of the sinuses is obscure, but they certainly lighten the skull, and may  act as resonance chambers for speech.

    Lining this network is a damp membrane similar to that inside your nostrils. The whole system is thus kept constantly moist, and this moisture slowly flows out of the drain holes in the sinuses, into the back of your nose and down your throat. This system is designed to keep the sinuses clean, as any dust or other small particles that may enter, are washed out.

    Unfortunately the system does not always work perfectly. Some people secrete excess fluid into the sinuses, while others may have drainage holes and tubes that are too small to cope with the secretions produced.

    With hay fever, particles to which the person reacts adversely, enter the sinuses and set up an irritation that stimulates the excess production of watery phlegm. A constantly runny nose, and a post-nasal drip then result.

    If bacteria or viruses enter the sinuses, an infection may result. The phlegm produced is no longer watery, but thick and pus like. It is very easy in this situation for the drain holes to become blocked, and the infection then concentrates in a small number of sinuses. Pus is constantly formed by the rapidly multiplying germs, and soon the sinus becomes very painful and tender. Waste products from the infection enter the blood stream, and cause fever, headaches and the other unpleasant sensations of any major infection. You now have sinusitis.

    It is quite easy for sinus infections to spread to the middle ear, as there is a relatively long tube, called the eustachian canal, connecting the back of the nose to the middle ear. Untreated the infection can also spread to the teeth, eyes and even the brain, and abscesses may form.

    To prove the presence of sinusitis an x-ray is taken to see if the sinuses are clear, or full of fluid. Swabs from the back of the nose can be sent to a pathologist, to determine the type of bacteria causing the infection, and the appropriate treatment.

    Treatment usually takes the form of the appropriate antibiotic, and other medications to prevent the production of phlegm and clear the sinuses. Many people find inhalations of steam and nasal decongestant drops beneficial.  In severe cases, it may be necessary to insert needles through the nose into the sinuses to wash out the pus.

    In patients who suffer from repeated attacks of sinusitis, procedures to reduce the likelihood of attacks can be performed by ear, nose and throat surgeons. These vary from burning away the moist membrane lining the nose, to drilling larger drain holes into the sinuses.

    Special nasal sprays available on script from doctors can be used regularly for several months to prevent the lining of the nose from reacting to any allergies.  

    Sinusitis is a very common, and often very distressing condition, but provided treatment is sought promptly, it should not cause any serious complications.