Ethmoid Sinus Infection – Overview, Symptoms and Treatment

You might know that the sinuses are the air-filled cavities in the head. There are four sets of them which are:

  • Ethmoid sinuses
  • Maxillary sinuses
  • Frontal sinuses
  • Sphenoid sinuses

What Is Ethmoid Sinusitis?

The ethmoid sinuses or ethmoid air cells of the ethmoid bone are one of the four paired par nasal sinuses. It’s actually a collection of approximately nine air cells situated between the upper limit of the nasal fossa and the orbit.

They are a variable in both size and number of small cavities in the lateral mass of each of the ethmoid bones and cannot be palpated during an extra oral examination.

Ethmoid Sinus 3D illustration

The ethmoid sinuses are located close to the bridge of the nose. The main purpose of these sinuses is to assist filter, humidify and clean the air. They also help to avoid your head become heavy. The mucus which goes through sinuses drains into a nose.

They are lined with the same kind of skin found elsewhere within therespiratory tract. This skin has tiny little hairs projecting from it, called cilia. The cilia beat constantly, to help move themucus produced in the sinuses into the respiratory tract.

Ethmoid sinusitis is a common infection. However, in contrast to maxillary sinusitis, the microbiology of ethmoid sinusitis is not well established; and only a few reports have documented the organisms isolated. The role of anaerobes in this infection has also not been well studied, although the recovery of anaerobes was recorded in a few cases.

An ethmoid sinusitis disease is also called an Ethmoiditis, is a medical problem that occurs when the mucus backs up in your sinuses and they become infected. It usually occurs due to swelling of the nasal passage.

Causes of Ethmoid Sinus

The main causes of ethmoid sinus are an upper respiratory infection, allergy or common cold. Other causes also include a deviated septum, which is the tissue that separates the nostrils, is displaced to one side or the other.

Nasal polyps are noncancerous growths in the lining of your nasal cavity and can be a cause of sinusitis as well.

Symptoms of Ethmoid Sinusitis

Since ethmoid sinuses are close to nose near the tear ducts in the eyes, more eye-related symptoms are common in its case than others. There can be pain between eyes and you may experience tenderness when you touch the bridge of the nose.

Sometimes, there is a swell around eyes. However, some other ethmoid sinus symptoms provided below.

  • Thick nasal secretions
  • Facial swelling
  • ​A runny nose lasting longer than 10 days
  • ​Sinus headaches
  • ​Post-nasal drip
  • ​Bad breath
  • ​Sore throat
  • ​General fatigue
  • ​Decreased sense of smell and taste
  • Fever

Can Ethmoid Sinus Disease Cause Headaches?

 Yes, it can! Ethmoiditis headache typically occurs in the area of the sinuses in the area of the cheeks (maxillary sinus), bridge of the nose (ethmoid sinus), or above the eyes (frontal sinus). Less often it may refer pain to the top or back of the head).

Sinus headache may occur on one side or both sides of the head and the neck is typically not involved. The symptoms are frequently worsened by bending over or coughing (as with migraine), and examination of the facial area may reveal local tenderness, redness, swelling, and possibly the presence of clear or discolored nasal discharge.

A sinus headache is a dull deep seated continuous pain with certain identifying characteristics and not a sharp, needle-like or throbbing pain.

Ethmoid and frontal sinus headaches are nearly always located in the medial brow area or the medial side of the orbit and just above the eye.

The two maxillary sinuses located in the cheeks below the eye and above the teeth will usually, when infected, involve the ethmoid sinuses on that side, thereby referring pain to the brow and orbit as well as to the cheek, the back of the head and sometimes to an ear or tooth.

Ethmoid Sinusitis Diagnosis

A person can only determine if the infection has reached the sphenoid when he feels the pain on top of your head or at the back of the neck. This part of the sinus cannot be infected easily. The basic explanation for this is its location. It would be hard for bacteria or viruses to reach it because the location is not that easy to penetrate. It is not easy to diagnose sphenoid sinusitis.

It can be diagnosed based on the symptoms mentioned above and after an examination of the nasal passage. The doctor can use an otoscope, a special light to check up your nose and ears for a sinus infection. Other than this, your doctor can take temperature, examine throat as well as listen to your lungs sounds to confirm.

In a case of thick nasal secretions, you might have to give a sample to be checked for a bacterial infection by a lab. There can be a need for a blood test to confirm the evidence of any infection. The doctor needs to get a sample of blood or sweat to know if there are traces of bacteria and fungus in the sinus.

Sometimes, the doctor may require some of the imaging tests to check the causes of your sinus problem. They can be x-rays and CT-scan. The x-rays may help in identifying any blockage whereas CT scan can be more detailed showing any blockage, growths, infection and masses.

Preventing Ethmoid Sinusitis

Ethmoid sinus mucosal thickening can be a problem for some but you can prevent it by keeping the nasal passages clear. Here are a few ways that might help you prevent it. They include:

  • Stay hydrated
  • Inhale steam so that you can cleanse the nasal passages
  • ​Nasal irrigation
  • ​Use of a humidifier
  • ​Use of the saline drops helps to keep nasal passages moist
  • ​Sleep with the head elevated. Use sinus mask.
  • ​Avoid blowing the nose, if required do it gently
  • ​Avoid overuse of decongestants
  • Avoid antihistamines

Sinus can be a problem and it seems to be a prominent issue these days with a lot of people. A few preventing steps and proper care can help you avoid problems. Take care of yourself, if you feel any symptoms, go see your doctor confirm if you have any problem with your sinuses and get the best treatment.

Practice Yoga everyday for at least 30 minutes. Early morning (empty stomach) is the best time to practice it. There are mainly 2 Pranayama which are done to cure Sinusitis permanently— Kapal Bharti and Anulom Vilom.

Treating Ethmoid Sinusitis

There are several ways to treat your Ethmoid sinus, you can treat it at home or you can follow a prescribed medication plan by a doctor. Following are the different ways in which you can treat Ethmoid Sinus:

Over-the-Counter Treatments

You can take ibuprofen (Advil), acetaminophen, or aspirin to control the discomfort caused by Ethmoid Sinusitis.

You can use nasal sprays for a temporary relaxation. Fluticasone (Flonase) nasal spray is known to relieve the sinus irritation temporarily.

Natural/Home Remedies

Steam Inhalation: Boil water in a bowl/container the put it at the surface, Put a towel on your head and lean forward to inhale the steam releasing from the boiled water while covering your face.

Precaution: Make sure the vapors are not too hot; otherwise it might leave mark of steam burns.

Additional Tip: You can add 2-3 drops of Tea Tree oil, Tulsi to make the inhalation more effective.

Make a habit of elevating you head while sleeping; it will help draining your nasal passage. You can use 2 pillows to make the required angle.

Drink plenty of water and juices, it will help in thinning your mucus and eventually drain it.

Keeping your nasal passage moist also helps in relieving your Ethmoid sinus, you can use saline nasal spray several times a day to do it.

Eating 2-3 cloves of raw garlic early morning (empty stomach) can help you getting rid of your respiratory infections and hence your sinus too as sinus is also caused by minor respiratory infections.

Drink herbal tea made with fennel, peppermint and sage it will help in draining sinus passages.

Diet for controlling Ethmoid Sinusitis

Minimize the salt usage in your food, as excess consumption of sodium may trigger the swelling of sinus passage.

Add honey instead of sugar in your meals and beverages.

Try to avoid milk, white flour, rice, chocolates, carbonated soft drinks, and fast food.

Eat vitamin A rich food as it helps in thinning the mucus and battling with sinus infection.

Precautions:

Most of the people suffering from Ethmoid Sinusitis also suffer from respiratory allergies like sneezing, coughing, allergic to pollens et cetera. You should control such allergies by following a medication plan or adapting home remedies.

Try to protect yourself from respiratory infections; it is quite common and viral.

Stay away from pollution and avoid smoking cigarettes as it helps in triggering the irritation in the sinus passage.

Avoid alcohol, as alcohol makes the sinus passage swell and hence blocks the nasal passage.

Prescription Treatments

Usually a doctor prescribes antibiotics such as azithromycin (Zithromax), erythromycin or amoxicillin which helps in getting rid of infection causing bacteria.

Ethmoid Sinus Surgery

Sinus can be treated through oral medication as well as surgery. The following are some surgeries can be helpful for the treatment.

Ethmoidectomy is that type of surgery which helps to clear the nasal cavity between your eyes and the bridge of the nose.

Maxillary antrostomy is a form of surgery which helps the sinus below your cheekbones drain properly.

Powered septoplasty with turbinoplasty is that surgery which helps treat a deviated septum or large-sized turbinated in the nose.

Procedure of Ethmoidectomy

The most suitable surgery for chronic ethmoid sinusitis is Ethmoidectomy as it helps clear the cavity for proper drainage of mucous.

It is done with the help of two important instruments a magnifying endoscope, which is a thin tube with a small camera and a light at the end, and a microdebrider, a tiny curved rotating tip which helps the surgeon put instrument wherever he needs to.

The surgeon removes the infected tissue and bone of the cavity which has hampered drainage with the help of the two instruments which help him to remove the infected tissue without damaging the healthy tissue.

Benefits and Risks

It is a very effective form of surgery as after the operation you are less likely to have sinuses and the symptoms like headache, nasal congestion and facial pressure are also rare. Secondly, it is minimally invasive and a patient is usually discharged on the same day.

The ethmoid sinus surgery recovery is rapid and there are lesser risks as compared to other forms of surgery.

Every surgery carries certain risks because of anaesthesia and other related processes. However, considering the Ethmoid sinus surgery complications one has fear of bleeding which might start after the surgery and might lead to leakage of cerebrospinal fluid or other critical intracranial injuries which can cause damage to the brain that cannot be treated.

Apart from this, as ethmoid sinuses are close to the eyes so there is a chance of damaging the optic nerve or the muscles that control the eye that might impair or distort a patient’s vision. In some rare cases there is a chance of the patient losing his sense of smell.

However, if you consult a proficient surgeon you do not need to worry about the risks and just concentrate on benefits.

Ethmoid Sinus Cancer

Ethmoid sinus cancer is very rare and since there are wide varieties of factors that can trigger Ethmoid sinus cancer, it is hard to pinpoint the cause (source). One of the biggest challenges with Ethmoid sinus cancer is the fact that by the time they become detectable, they have already reached the advanced stage.

That means the only option left by the time they are detected is to take drastic measures to ensure effective treatment.

Ethmoid sinus cancer may spread rapidly to the adjacent areas, especially because of the fact that the early disease is frequently asymptomatic. Unfortunately, this also means that the Cancer involving the ethmoid sinus alone is a rare entity.

In majority of cases, by the time Ethmoid sinus cancer is detected, it has already reached advanced stage. Cure rates are generally poor at this stage. The cancer growth is confined within the bony structure of the sinuses and remains asymptomatic until they erode and invade adjacent structures. 20 to 40 percent of patients die of direct extension of cancer into the vital areas of the skull.

Early diagnosis and treatment is crucial in effective treatment of the disease. X-ray or CT scan is recommended to confirm the presence or absence of brain metastasis and tumor extent. However there is still need to determine the nature of the tumor biopsy.

Pretreatment evaluation and staging is a crucial step for multidisciplinary planning of treatment. In few cases, salvage surgery or salvage radiation therapy is also considered appropriate. Since most of the treatments fail within the first two years, patient is required to make frequent follow-ups during this period.

About 33 percent of the patients develop second primary cancers in the aerodigestive tract, and so a lifetime of follow-up is essential.

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