Sinus problems are
the number one reason cited by patients for visiting their physician.
No wonder with environmental pollutants and allergy sensitivity
increasing everyday. Today we know that most sinus disease is caused
when the cilia - the very tiny "hairs" in the nose and chest stop
beating. These wonderful machines act like oars, moving 16 strokes
each second to propel bacteria, dirt, and cancer causing poisons
out of the nose and chest, before they have a chance to enter the
body. Many cancers form where there are few cilia, emphasizing their
importance. The treatment of choice for sinus disease is to have
the body return the cilia to their normal function, beating 16 times
per second.
Know what the BEST
treatment is for early morning sneezing? If you start sneezing on
awakening, it is because the nose is trying to get rid of the particles
that accumulated there at night. If the nasal cilia are working
properly, they beat at 16 beats a second and get rid of these particles
and then you don't need the sneezing. The best treatment in breakfast
in bed! You see, by drinking hot tea before you get out of bed,
the body gets warmed up, the cilia speed up and the sneezing, hacking
is avoided.
In the nose and chest
are millions of tiny "oars" or cilia. They act in coordination to
move out the dust and bacteria from the nose to the back of the
throat where it can be swallowed and disposed of in the stomach.
In the chest, the cilia beat to move the germs and dust out of the
chest, up the windpipe to the throat where it is swallowed. When
this system works you don't get sinus disease. When the system fails
in the chest you get a cough, the cough takes over to get rid of
the dirt and germs in the bronchial passages.
Protection from infection
is achieved by the presence of lysozymes, immunoglobulins and phagocytes
in the mucus solution. Movement of the bacteria by mucus flow reduces
opportunity for penetration of the cell. Dilution of bacterial products
makes them less toxic. Mast cells and globulins are carried in the
mucous layer. If the cilia don't move the blanket, then the cells
and defense can't be delivered where they are needed. Thus, the
mucociliary defense system consists of cells that transport mucous
and cells that secrete mucous. Both are essential to health. Remarkably,
the ciliary movement is coordinated so that an effective wave propels
the mucus in a specific direction.
Sinus cilia beat toward
the natural sinus opening. Nasal cilia beat backward . Nasal mucus
propels into the nasopharynx and is swallowed for disposal into
the stomach. In the child this course directs the mucus with its
bacteria, debris and foreign matter over the adenoids where lymphocytic
defenses can act. The deep crypts and rugae of the adenoids create
a larger surface area for greater effect in order to defend the
body.
With a virus infection,
the cilia are slowed down by the virus chemicals. This allows bacteria
that normally would be swept away by the cilia to enter the body.
Therefore, anything you can do to encourage good cilia movement
is helpful. Hot chicken soup works! Hot tea is good. Compresses
to the sinus/nasal area helps. Breathe·Ease™ is a formulation that
has been shown to aid cilia better than regular saline. It has an
advantage over saline in that there are no preservatives such as
benzalkonium and the mixture is buffered to avoid any burning sensation.
The refillable spray bottle it comes with can be used for spray,
drops or to irrigate or wash. Without the burning, this solution
can be used regularly by kids.
When you feel a sinus
infection coming on, rest, hot soup and tea, hot compresses applied
to the sinus area: above the eyes for the frontal sinuses, between
the eyes for the ethmoid sinuses, and below the eyes for the maxillary
sinuses.
If this is not effective,
there is an attachment to most standard WaterPik type devices (pulsating
sinus irrigation) which can be used to restore nasal cilia, remove
nasal pus, and thin the secretions. The attachment reduces the pressure
to just the right pressure of 5 PSI - the water stream is about
an inch high. The saline goes in one side of the nose and out the
other. This is a natural way of healing the sinus condition. Even
children as young as 5 years find this a pleasant treatment.
Some people get symptoms
after exposure to downtown smog or dust at work. The use of the
irrigator is advised much like washing the hands to remove dirt.
By irrigating in this manner, the nose doesn't have to do the work.
It is especially useful for Firefighters to use after the smoke
of a fire.
Cilia are generally
activated by increasing temperature up to 40 C, so hot compresses
over the sinus area are beneficial. However above 40 C cilia are
inactivated and hence the deleterious effects of hot steam nasal
inhalation. Long term dry steam inhalation, (sauna), is suspected
of being harmful.
For people with serious
sinus disease, this pulsating device has proven extremely useful
. For example, patients with Cystic Fibrosis have very poor ciliary
action and so develop serious sinus disease. The pulsating saline
irrigator can remove the pus and act like a normal cilia.
A good medication
for nasal congestion is Sudafed Long Acting, 120 milligrams every
12 hours.
The term mucocliliary
clearance refers to the system of the cilia and the blanket of mucus.
This is a table of medicines and factors that increase clearance
which is good, and medicines that slow mucociliary clearance, which
is bad.
Environmental factors
In World War 1, those
who initially survived chlorine gas attacks sustained severely reduced
MCC. This led to absence of MCC as a defense mechanism, and these
victims died of respiratory infection.
Industrial toxins
include chlorine, sulfur dioxide, cupric compounds, and many others.
Pathologic effects
of dust exposure may include MCC disorder, and disturbance of regional
immunity and the acid-base balance of tissues. These are reported
by to be in direct proportion to the length of exposure to excessive
dirt and dust.
The Kuwait oil fires
released polyelie aromatic hydrocarbons and nickel and vanadium
into the atmosphere. Results of this contamination are now being
studied with indications of effects on MCC. and an increase in respiratory
infections.
Formalin vapor and
solutions below 0.25 % will inhibit MCC and cause symptoms. Chromium
and chromates are known to be ciliotoxic and harmful to workers
in mining and industry. In addition, certain areas of Saudi Arabia
have chromium in the sand with an associated high incidence of sinus
disease and chest disease. Workers in plating and sanding industries
should wear protective inhalers and use pulsating saline irrigation
to remove these chemicals and help restore the nasal ciliary action.
Smoking does not give
consistent results, even in the laboratory. One interesting phenomenon
is the patient who has swollen nasal membranes after he stops smoking.
Some patients return to smoking to overcome the congestion and blockage.
What may be the mechanism here is that the smoke acted as an irritant
to the cilia, inducing movement. With the cessation of smoking,
the stimulus is reduced and the cilia stop, leading to the feeling
of obstruction.. In these patients I find decreased MCC and they
respond to measures to restore normal MCC.
Much has been written
about a common industrial complaint which also involves litigation,
that of multiple chemical sensitivity syndrome. After a single powerful
exposure, the individual in now sensitive to products not previously
offensive. After the insecticide was sprayed in her office, now
perfume, soap powder and small amounts of dust clog her nose and
make her cough. In my experience, some of these cases are characterized
by the first offender acting as a strong ciliotoxic substance, now
the cilia are no longer defending the body and removing the dust
and other particles so that the dust just lays there, multiplies
and reaches a symptom producing level. I see this after a Skydrol
or a Chlorine Gas inhalation.
Sinus Headaches
and Sinus Pain Are Not Always What They Seem
It is common for patients
to complain of sinus headaches. They point to the area over the
eyes (where the frontal sinuses are) or the area under the eyes
(where the maxillary sinuses are located) and ask for sinus relief.
Actually, the sinuses are rarely painful due to infection. Even
when you are blowing handkerchiefs of yellow pus, there is rarely
pain. But, when there is a painful muscle in the back of the neck,
the pain is radiated to the sinus area. The treatment is to get
the neck well . It is advisable to check the posture at work and
reading - office typist chairs are good, soft couch chairs are bad,
and lighting can be important too. Light from the ceiling or shoulder
is good, glare from in front is bad. In addition, it is advisable
to do neck stretching, gently turn to see who is behind you. And
head leaning onto the shoulder. This is best done in the shower,
with the shower stream hard and comfortably hot for 3 minutes.