DISORDERS OF THE SINUSES AND THROAT

The sinuses are cavities in the bone around the nose. There are four pairs of sinuses: the frontal (in the forehead), ethmoid (between the eyes), sphenoid (deeper in the head, behind the eyes), and maxillary (in the cheekbones). They are connected to the nasal cavities by small openings. Normally, air passes in and out of the sinuses and mucus drains through these openings into the nose. Sinusitis is an infection of the lining of one or more these cavities. When the sinus is infected, the membranes of the nose swell and cause a nasal obstruction. Swelling of the membranes of the nose may close off the opening of the sinus and thus prevent drainage of pus or mucus. Pain in the sinus, difficulty breathing through the nose, and fever may result from inflammation itself or from the pressure within the sinuses that result from closure of the opening. The infection can be bacterial, viral, or fungal. A common cold is the most frequent factor in sinusitis. Because the mucous membranes of the nose extend into and line the sinuses, a bacterial infection in the nose easily spreads into the sinuses. Secondary infections from colds, chronic allergic rhinitis, and a dental abscess can cause the sinusitis. If the infection is bacterial, the physician will prescribe a course of oral antibiotic therapy. The patient may take decongestants in the form of drops, sprays, or tablets to open the passages and encourage drainage of the sinuses. Sometimes endoscopic sinus surgery or conventional surgery may be performed.

The pharynx is the segment between the tonsils and voice box. Thus, pharyngitis is another name for a sore throat. The inflammation can be either acute or chronic. A bacterium or virus causes acute pharyngitis. The chronic form can be caused by a continuing infection of the sinuses, lungs, or mouth that spreads to the pharynx. Constant irritations such as smoking, breathing heavily polluted air, or consuming too much alcohol can also cause chronic pharyngitis. The signs of pharyngitis are sore throat, difficulty swallowing, and fever. If a patient has a bacterial infection, the physician will prescribe a course of antibiotic therapy. The patient can relieve the pain by gargling with warm salt water several times a day.

Tonsils are located at the back of the mouth. They filter our harmful microorganisms that could infect the body. When the tonsils become overwhelmed by a bacterial infection, they become inflamed. This infection is known as tonsillitis. Symptoms of tonsillitis are similar to those of the flu. The primary symptom is a sore throat that makes it difficult to swallow. Others are headache and fever. The lymph nodes in the area of neck and jaw may be enlarged. Drinking soothing fluids and gargling with warm salt water several times a day help lessen the pain. If a bacterial infection is the cause of the sore throat, the physician will prescribe a course of oral antibiotic therapy.

Laryngitis is an infection or irritation of the larynx (voice box), which is located at the top of the trachea (windpipe). The symptoms of laryngitis are hoarseness, tickling and rawness of the throat and constant need to clear the throat. Usually, a virus causes acute laryngitis, but it also can be the result of a bacterial infection. Laryngitis can occur in the course of another illness such as an ordinary cold, bronchitis, flu, or pneumonia. Excessive drinking of alcohol or heavy smoking or reflux of stomach acid into the esophagus most often causes chronic laryngitis. If the cause of disorder is bacterial, the physician may prescribe a course of antibiotics. The best treatment of viral laryngitis is to rest the voice as much as is practical and drink warm, soothing liquids.

COUGH

A cough is a normal protective reflex, designed to defend the respiratory system against irritants. However, a forceful cough can be painful and bothersome. Some of these coughs need the physician’s attention. Others respond to simple self-care and the right medicine.

What causes a cough? Here are some typical irritations that cause coughing:

Infections, such as cold and flu;

Environmental irritants, such as cigarette smoke, smog, dust, home aerosol sprays, and cold and dry air;

Asthma, which inflames and constricts the air passages;

Gastroesophageal reflux – the backup of stomach acid into the esophagus when a person lies down;

Medications, such as inhaled corticosteroids or certain medications prescribed for high blood pressure and heart disease;

Coughing itself. Sometimes there is no medical explanation for a cough. Some people cough to release nervous tension, gain attention, or express anger. Whatever the reason, one cough can irritate the person’s throat and lead to another, setting up a vicious cycle.

A cough begins when an irritant reaches one of the cough receptors in the nose, throat, or chest. The receptor sends a message to the cough center in the brain, signaling the body to cough. After a person inhales, the epiglottis and vocal cords close tightly, trapping air within the lungs. The abdominal and chest muscles contract forcefully, pushing against the diaphragm. Finally, the vocal cords and epiglottis open suddenly, allowing trapped air to explode outward.

GRIPPE

Grippe is an acute infectious epidemic disease caused by a virus and marked by depression, distressing fever, acute catarrhal inflammation of the nose, larynx, and bronchi, neuralgic and muscular pains, gastrointestinal disorders, weakness and nervous disturbances. All ages are liable to this disease. It is in severe cases that vomiting is frequent in babies and young children as well.

Like the common cold, grippe is primarily spread between people indoors, especially at schools, nursing houses, and other places where large numbers of people gather. Outbreaks usually occur in the winter and early spring.

There are three types of grippe viruses. All of them are spread from person to person by inhalation of infected droplets from the air. Type A usually is responsible for the large grippe epidemics. This type is constantly changing, with new strains appearing regularly. This results in a new epidemic every few years. Types B and C are not as widespread: type B causes smaller, more localized outbreaks, and type C is less common and usually causes only a mild illness. These types are fairly stable viruses.

It is the typical form of grippe that onset is sudden, beginning with chills, muscular pains and aches in the back and limbs, and bronchitis. Nervous symptoms, e.g., headache and in severe cases convulsions in babies are usually present.

There are mild cases of the disease. The duration of the disease in a mild case is usually three to four days and the temperature is not very high.

It is in severe cases that patient’s temperature is very high. Distressing fever and other symptoms, e.g., acute catarrhal inflammation of the bronchi, muscular pains persist for several days. Sometimes pneumonia develops and even death may occur in two or three days. Therefore it is in very young children or when there are pulmonary complications that grippe is especially serious.

In order to minimize the severity of the attack in grippe and to protect the patient from secondary infection, the patient must go to bed at the beginning of an attack and not to be up again without the approval of his/her physician.

The effects of grippe may persist for a long period of time, therefore a convalescent becomes sensitive to heat, cold, draughts, and so on, he/she easily gets colds, coughs and other respiratory diseases