Introduction:SINUSITIS SYMPTOMS

Acute or chronic inflammation of the mucosal lining of paranasal sinuses, most commonly the maxillary sinus.

CLINICAL FEATURES

Symptoms

Fever (during acute stage).

Pain

Cheek and infra-orbital region (maxillary sinusitis).

Frontal headache (frontal sinusitis).

Nasal bridge, behind eyes (ethmoidal sinusitis).

Nasal discharge

Tenacious.

ETIOLOGY

Predisposing and precipitating causes

Nasal, pharyngeal, or dental infection.

Nasal obstruction.

Deviated nasal septum.

Hypertrophied turbinates.

General diseases

Measles.

Influenza.

Whooping cough.

Environmental

Poorly ventilated houses.

Overcrowding.

Lowered body resistance.

Exposure to extreme cold.

Nasal douches during early stages of inflam- mation.

Excessive blowing of nose during acute infec- tion.

Yellowish-green muco-pus.

Pain and discharge worse on stooping.

Breath offensive, if foetid discharge.

Post nasal drip, which irritates.

Patient has to clear his throat frequently.

Nasal obstruction

Of variable degree.

Slowly progressive.

Difficult hearing (due to eustachian catarrh).

Nasal twang of voice.

Anosmia, or unpleasant odour.

Bleeding from nose.

Signs

Tenderness over affected sinus on applying pressure.

Anterior rhinoscopy

Nasal mucosa red, oedematous.

Mucopurulent discharge middle meatus running down to pool on floor of nasal cavity.

Posterior rhinoscopy

Pus in posterior nares.

Polypi may be found in conchae.

COMPLICATIONS

Osteomyelitis.

Orbital cellulitis.

Mucocele.

. Bronchitis.

INVESTIGATIONS

X-Ray of paranasal sinuses may show

Mucosal thickening.

. Early polyp formation.

Homogenous haziness, with fluid levels in in- fected sinus.

PROGNOSIS

. Good with treatment.

Recurrences are common.

MIASMATIC CLEAVAGE

Predominant sycotic disorder.

THERAPEUTIC AIM

– To cure.

GENERAL MANAGEMENT

Rest in a warm, well-ventilated room during the acute stage.

Steam inhalation.

– Treat predisposing cause.

• Improve general health.

• Valsalva manoeuvre for Eustachian catarrh.

MEDICAL TREATMENT

Symptomatic

Hydrastis.

Kali bichromicum.

Kali hydriodicum.

Kali muriaticum

Natrum muriaticum.

Kali iodatum: colds from every exposure from damp. Nose red, swollen, acrid, watery discharge. Eyes smart and lacrymate. Catarrhal headaches with inflammation of the mucous membrane of the frontal sinuses, eyes, throat, and chest. Forehead heavy, dull, and stupid. Violent sneezing, eyes bloated, profuse lachrymation. Violent acrid coryza. Nose tender, face red, uneasy. Tongue white. Nasal voice; violent thirst.

Mercurius solubilis: Creeping chilliness in the beginning of a cold. Much sneezing, fluent discharge, corrosive. Acrid, offensive matter flows from nose greenish, foetid pus. Nose red is shining. Catarrhal inflammation of the frontal sinuses. Hoarse voice, dry, rough, tickling cough. feels bad in a warm room, yet cannot bear the cold. Taste sweet, salty, metallic, and putrid. Creeping chilliness. Profuse offensive sweats, and worse from sweating. Swollen, flabby tongue, tooth notched. Offensive breath, offensive salivation.

Pulsatilla: Better adapted to nervous, timid, young weepy female, craves sympathy, craves cold air, better motion. Old catarrh with loss of smell, thick yellow discharge, better in open air. Stuffed up at night and copious flow in the morning. Fluent in open air; stopped up in house.

Kali bichromicum: catarrh with thick yellow or greenish, ropy, stringy mucous discharges, or tough and jelly like. Discharge offensive. Adherent mucus, which can be drawn out into long strings. Plugs in nostrils, dryness of nose with pressive pain at root of nose, which can be covered by a coin.

Intercurrent

Tuberculinum Personal or family history of tuberculosis. Always catching cold. Always tired. Worse in warm room.

Short indications

Early state: Bell, or Merc 30

Headache. Thick purulent, blood stained discharge: Kali-bi. 30

Right sided sinusitis with right headache: Sang.

Left sided affection: Spig.

Sensitive to cold > wrapping head: Sil.30

Discharge thick yellow green blood stained: Aur-m 30 4hourly.

Reference: Annual Report 2001 2002

CCRH.

Disease related clinical trial, in general area to evaluate the action of homeopathic drugs in Sinusitis.

Observation

The following medicines in varying potencies help in improving and achieving symptomatic relief:

Belladonna.

Natrium muriaticum.

Hepar sulphuris.

Reference: Annual Report 2001 2002 CCRH.

Drug related clinical trial, in tibal area to evaluate the action of following drugs on sinusitis. Anemopsis california, Anthemis nobilis, Aurum muriaticum, Justicia adhatoda, Lemna minor, Mentholum, Quillaya, Sanguinarium nitricum, Saponaria, Sinapis nigra, Theridion.

Observation

The most prescribed of assigned medicines

Justicea adhatoda.

Lemna minor.

Sinapis nigra.