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Wednesday, 27 November 2013

Sinusitis - Headache/Sinus headache - The Causes.

Sinusitis is defined as a condition of inflammation of the paranasal sinuses of which can develop headache as a result of exposure to a cold or flu virus, or an allergic reaction to pollen, mold, dust or smoke, etc..Sinusitis affects 37 million people each year.
causes
1. Structure abnormalities
structure abnormalities of the growths of benign tumors in the sinuses or nasal polyps in the nasal cavity or sinuses, can restrict and obstruct the movement of mucus from the sinuses of which can lead to a headache. In a case, a 59 year old man had ectopic teeth in both sinus maxillaris which obstructed the left ostium, causing dumbness of the left cheek and severe headache.(6)

2. Allergens
Allergens are one of the major causes of sinus headache and can be divided divided into seasonal and perennial. Seasonal rhinitis is a disease particularly of teenagers and young adults and appears to be less common in primary and pre school age children(7)
 
3. Second hand smoke
In the study of  recruited 30 adult volunteers (17 males, 13 females; average age = 41 y, range = 19-79 y) from a university laboratory complex and from the general community, and  In univariate analyses, geometric mean carbon dioxide thresholds differed significantly with respect to smoking status (36% carbon dioxide in smokers versus 25% in nonsmokers; p < .005), but not with respect to age, gender, or self-reported history of allergic rhinitis(8)

4. Maxillary sinuses
Maxillary sinuses which is the largest of the paranasal sinuses, and drains into the nose, are susceptible to infection as a result of fungal infection, cyst, inverted papilloma, hemorrhagic necrotic polypsosteomas of that can lead to obstruction of mucus. In severe case, surgery may be necessary(9)

5. Odontogenic origin
Odontogenic etiology is said to account for 10% to 12% of cases of maxillary sinusitis. Some researchers suggested that an odontogenic source should be considered in individuals with symptoms of maxillary sinusitis and a history of dental or jaw pain; dental infection; oral, periodontal, or endodontic surgery; and in those people resistant to conventional sinusitis therapy. An odontogenic infection is a polymicrobial aerobic-anaerobic infection, with anaerobes outnumbering the aerobes(10)

6.  Fungii
In the study of allergic mucin from 17 definitive and 10 probable AFS patients histologically examined for fungal elements. Sera from 18 definitive AFS patients, 10 probable AFS patients, 6 chronic sinusitis patients, and 5 A. fumigatus-allergic patients were tested for specific IgE to A. fumigatus and five rAsps, conducted by Medical College of Georgia, showed that most definitive AFS patients have A. fumigatus-specific IgE and many have specific IgE to rAsps. Many also demonstrate Aspergillus spp. or Fusarium spp. in situ. Findings suggests that A. fumigatus is an important causative agent in AFS in the southeast United States(11)

7. Bacteria and Virus
Rhinosinusitis (RS) is an inflammatory condition of the contiguous nasal and paranasal sinuses that is accompanied by a viral or bacterial infection. And Controlling the inflammation will attenuate many of the symptoms of RS, including nasal blockage discharge, facial discomfort, headache, and hyposmia, and promote the clearance of the infectious agent(12)

8. Immune deficiency
Some researchers suggested that sinus headache may be also be result of immune deficiency, Dr. Kern RC, in the study conducted by Northwestern University Feinberg School of Medicine, said that
There are evidence from laboratory and others indicated that chronic rhinosinusitis (CRS) is associated with a failure of the mechanical and immunologic barriers across the nasal mucosa(13)

9. Asthma
Asthma is said to be associated with Sinus headache. In the study of Rhinosinusitis and asthma, Dr.Marseglia GL, and the team said that chronic rhinosinusitis and asthma are not simply localized disease processes, but part of a systemic inflammatory disease affecting the respiratory tract. There is a correlation between severity of asthma and the clinical and imaging features of rhinosinusitis. It is very important to understand that in patients with chronic sinus disease, both upper and lower airways need to be evaluated and treated and that in patients with moderate or severe asthma, the sinus area should always be investigated, regardless of the presence or not of nasal symptoms(14)

10. Vas deferens obstruction
Vas deferens obstruction cause Young's syndrome (YS)od which is a triad of bronchiectasis, chronic rhinosinusitis and infertility as a result of  gene mutation.(a) 

11. Etc. 
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Sources
(a) (http://erj.ersjournals.com/content/35/3/698.full)
(6) http://www.ncbi.nlm.nih.gov/pubmed/8365919
(7) http://www.ncbi.nlm.nih.gov/pubmed/19410204
(8) http://www.ncbi.nlm.nih.gov/pubmed/9546755
(9) http://www.ncbi.nlm.nih.gov/pubmed/22321419
(10) http://www.ncbi.nlm.nih.gov/pubmed/19348725
(11) http://www.ncbi.nlm.nih.gov/pubmed/12197579
(12) http://www.ncbi.nlm.nih.gov/pubmed/18504478
(13) http://www.ncbi.nlm.nih.gov/pubmed/18786300
(14) http://www.ncbi.nlm.nih.gov/pubmed/20152076