Insight Into Sinus Trouble

QUESTION: Although my wife believes that sinus trouble is very much like a
common cold, I have always thought that this was a most serious disease, and
that it can easily cause death. Can you offer us some insight?
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ANSWER: There is a bit of truth in both positions in this friendly family
health discussion. While every common cold does not become a sinus infection,
sinusitis is a complication of upper respiratory tract infections in about 1%
of the cases. When the normal defenses of the sinus break down, bacterial and
viral infections can penetrate into these normally sterile spaces and create
quite a problem. The tissue lining the sinus spaces becomes inflamed,
producing a thick secretion which may block the normal flow of secretions from
the sinus and create painful pressure in the sinus. As the bacteria continue
to grow, this pressure increases and with it, pain and tenderness, fever and
purulent (pus) discharge. Since the sinuses lie so close to the brain and
other very sensitive nerve structures, any spread through the thin bony walls
of a sinus can produce infections of the brain's coverings (the meninges) and
to the brain itself. Fortunately this is a rare occurrence, and generally is
not seen in otherwise healthy individuals. Rapid diagnosis has been advanced
by using the CT scanner, which can accurately reveal the presence of infection
as well as any damage to the sinus walls. Intensive use of antibiotics and
surgical drainage can usually control these life endangering complications.