Sinusitis and nasal allergy

Q: Can you explain the difference between sinusitis and nasal allergy?

A: Sinuses are air-filled spaces layered by living skin called mucosa, which produces mucous (clear fluid felt and seen in the nostril). Mucous drains through a small opening (ostium) in a very narrow space in the nasal cavity with the help of cilliary movement on the mucosa (blanket of tiny hair brushing the mucous towards the ostium).

When a patient has a nasal block (due to bent nasal bone or enlarged nasal tissue) leading to inflammation of the sinus mucosa (commonly due to viral infection), the inflammation causes obstruction to the ostium, resulting in stagnation of the mucous.

When the mucous is stagnated for long, it gets secondary infection with bacteria causing pus to flow from the sinuses. This condition is called sinusitis, and it can be acute (sudden short duration of onset) or chronic (long standing). In acute cases, the patient may experience throbbing facial pain with fever and pus from the nose (drips down the throat). In chronic cases, it may just be a constant post nasal drip with the occasional pus and sore throat.

Allergic rhinitis is an immune response of the body when exposed to the inflammation of the nasal passage caused by outdoor allergens such as freshly cut grass or pollen from blooming plants or industrial smoke. It is commonly known as hay fever.

Symptoms include itchy nose (with or without itchy eyes, throat and ears), sneezing, nasal block or runny nose leading to facial pain with ear block and sinus fullness or pressure. Allergic rhinitis can lead to sinusitis if not treated early as the nasal passage gets engorged and obstructs the normal mucous drainage. Allergy is a condition in the human system. Depending on its severity, it can be controlled and sometimes even 'disappear'. What's most important is how well we can keep it under control.

Sinusitis can be cured if we can establish an early permanent mucosal drainage. There are conditions where it is difficult to treat such as cilliary dyskinesia (the mucosal drainage is impaired due to improper cilliary movement) and chronic sinusitis (the sinus mucosa remains diseased for a long period).

To prevent sinusitis:

  • Identify cause of the sinusitis
  • Treat nasal obstruction
  • Keep the environment clean
  • Keep animals away (if they cause an increase in allergy symptoms)
  • Use fewer dust-collecting items in the home
  • Use vinyl pillow and mattress covers, which can reduce your exposure to dust mites

The writer is an ENT Head Neck Surgeon at Tropicana Medical Centre.