Sinus Trouble

"Sinus," like "vitamins," is the current layman's medical fad, a subject of conversation dear to sufferers, who like to give each other such advice as "Don't let a nose and throat doctor touch your sinuses; if you do, you'll have trouble the rest of your life." Such a remark, heard "almost every day," bothers Nose & Throat Specialist Russell Clark Grove of Manhattan. To prove it false, he published last week a popular handbook on sinus diseases (Sinus; Knopf; $2).

Bony Caverns. The nasal sinuses are four pairs of hollow cavities in the bones of the lower forehead, the cheekbones, and the bones that lie behind the bridge of the nose. These bony caverns are called the frontal, maxillary or antrum, ethmoid and sphenoid sinuses. They open into each half of the nasal cavity, like rooms off a corridor. Each sinus is lined with delicate membranes, which are furred with tiny hairs (cilia) and covered with sheets of warm mucus.

The sinuses are useful for: 1) warming up cold air before it reaches the lungs; 2) engulfing bacteria in germ-repelling mucus; 3) acting as a sounding board for the voice. Infections of the sinus mem branes are caused by a number of bacteria, including the staphylococci, streptococci, pneumococci.

Popularly known as "sinus," the disease should really be called "sinusitis," for it is an inflammation like bronchitis or laryngitis. One or more bony cavities may be invaded at a time. The infections may arise as a result of frequent colds, infected teeth, diseases such as pneumonia or influenza, too much swimming, may be aggravated by smoking or drinking. Said Dr. Grove: "Probably the most important single factor in the development of the chronic form of sinus disease ... is allergy." This includes hay fever, sensitivity to dust, feathers, foods, etc.

Wet & Dry. There are two main forms of sinusitis. The acute form is accompanied by a watery discharge or pus; the chronic form may be wet or may have no pus, no dripping, but a thickening of the membranes, which sometimes become swollen with little buds called polyps.

The first symptoms of the acute form are usually the same as those of a cold--sneezing, wheezing and sniffling. Some people suffer excruciating headaches from swollen sinus membranes, feel as though the skull were in a vise. The pain may occur below or behind the eyes, may return at the same hour every day depending on the accumulation and drainage of fluid.

Since germ-laden pus drips down the back of the nose and throat, some victims of sinus disease are liable to suffer serious trouble in other parts of the body. They may become sickly, irritable, insomniac, develop a cough, tonsillitis, arthritis, earaches.

Nosedrops, Pipes and Drains. Said Dr. Grove: "No disease of the body probably has more forms of treatment than does disease of the nasal sinus. . . . Treatment which produces a 'cure' of one patient's sinus disease will not always produce the same result in another patient." Medical dos & don'ts:

> "Excessive use of solutions containing ephedrine, adrenalin, benzedrine, neosyne-phrine, menthol and camphor is to be condemned." Reasons: 1) such drugs may eventually cause tiny blood vessels in the nose to become swollen with blood; 2) the chemicals may irritate the nasal membranes. Oily drops may be inhaled into the lungs, cause pneumonia. Frequent irrigations with saltwater drops may "waterlog" the membranes, spread infections.

>For acute attacks, rest, liquid diet and drugs to relieve pain are "of the utmost importance." A few days in bed will shorten illness, prevent complications.

>Some like compresses cold, some like them hot. Dr. Grove prefers infra-red lamps, electric pads or hot-water bottles applied to forehead or cheeks. Inhalation of medicated steam, especially if it contains benzoin, is valuable too.

> "Irrigation of the antrum"--flooding it out with salt solution--used to be very popular, but should be avoided unless absolutely necessary. It must, of course, be done by a doctor.

> A few people have tried sprays or tablets of various sulfa drugs, but they do not seem to give any lasting relief.

>Sometimes germs can be taken from a patient's nose, and a vaccine made. Vaccination is a complicated business, but may produce good results if done with great care.

> There is no special climate which is good for all sinus sufferers. Patients with "dry" sinus trouble often feel better in a dry climate, like that of Arizona or New Mexico. Those with dripping sinusitis may be irritated by dry air and dust, "are often better at the seashore." Changes in season usually bring suffering to sinusitis victims.

> Surgery--rooting but polyps, or carving windows in clogged nasal passages--is often "underdone . . . not completed." Scar tissue may grow in, choke up the opening. When done thoroughly, an operation may bring great relief in breathing. But, said Dr. Grove, since there are eight nasal sinuses all told, fixing one may not cure or prevent disease in the others.

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