Paranasal sinuses are natural cavities located in the thickness of the bones of the face that surround the eyes, nose and cheeks. They have a structure in the shape of a pocket or valley and act as a sounding board, amplifying the sounds and the voice; in addition, these cavities filled with air (pneumatic spaces) increase the perception of odors and lighten the massive front, making the skull less heavy as a whole.
The paranasal sinuses are covered by a respiratory mucosa, the same one that covers the nasal cavities, and in all, four pairs are distinguished:
- frontal sinuses : pair of small air cavities located in the frontal bone, above the orbits; each frontal sinus communicates with the middle meatus of the homolateral nasal fossa by means of the nasofrontal (or rhinofrontal) duct.
- maxillary sinuses: paranasal sinuses located, one on each side, in the upper bone thickness of the homolateral jaw, just below the orbit (which determines the floor with their upper wall). Their lower wall maintains close relationships with the dental roots, in particular with the first upper molar and the last premolars. They represent the largest air spaces between the various paranasal sinuses and communicate with the middle meatus of the homolateral nasal cavity through the natural ostium (drainage orifice)
- ethmoid sinuses and sphenoid sinuses : they include all the ethmoid and sphenoid cells, intended as pneumatic cavities excavated respectively in the thickness of the ethmoid bone and the sphenoid bone.
There is a certain variability from person to person regarding the number of paranasal sinuses present, their shape and relative dimensions, especially with regard to the bones of the frontal and ethmoid sinuses.
Being connected to the nose, for example in the presence of a strong cold, the paranasal sinuses can be infected due to a nasal infection. The inflammation of the mucosa of the paranasal sinuses is called sinusitis, which generally has an infectious or allergic origin. Sinusitis can be acute (generally on an infectious basis, with accumulation of pus and catarrh) or chronic (generally on an allergic basis or in any case following successive recurrences). They can be favored by dives, by underwater swimming or by anatomical anomalies (such as deviations of the nasal septum) and appear more frequently in the coldest months (they can still strike even in periods far from winter ones).
When the free flow of air in the cavities is prevented by the accumulation of mucous and purulent secretions coming from the nose, an increase in pressure is generated inside the paranasal sinuses which irritates the membranes, making them more susceptible to infections. The closure of the paranasal sinuses can generate insomnia and compromise the ability of concentration and memory; their infection is also the cause of pain at the infected breast (at the forehead above the nose, or at the level of the cheekbones above the canines), with fever and headache.
In addition to inflammatory diseases, the paranasal sinuses may also be affected by polyps and tumoral pathologies (benign tumors and malignant tumors).
Radiography of the paranasal sinuses allows indirect visualization by X-rays. It is performed when a paranasal sinus disease is suspected, especially sinusitis, and can be replaced by CT, which offers more detailed images. Alternatively, direct visualization by fiber optic endoscope is also possible.
Remedies for sinusitis
Maintaining a correct environmental humidity and applying moist heat (hot packs, hot showers full of steam or fumigations) to inflamed and painful paranasal sinuses can relieve sinusitis. Also important is the abundant body hydration (drink plenty of water), while it can help the consumption of hot drinks with inhalation of vapors. Nasal washes are equally important, to be carried out once or twice a day with special solutions or by irrigating one nostril at a time with a solution of hot water (250 ml), salt (a teaspoon) and a pinch of bicarbonate. Finally, how not to remember the manipulation of the paranasal sinuses, which if performed following the right massage technique, can provide immediate relief from the disorder.
