Do Structural Abnormalities Cause Sinusitis?

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Do structural abnormalities cause sinusitis?

We have seen in detail the various causes of Sinusitis – microbial, allergies, polyps, etc. Structural abnormalities are a common cause of chronic sinusitis and we have compiled a detailed articles here to explain in detail how structural abnormalities such as deviated septum can cause sinusitis.

Structural abnormalities of the nasal septum, paranasal sinuses, and the lining are a common cause of chronic sinusitis. Tight anatomical relations between nose and sinuses, narrow canals that connect them, a very responsive lining and thin bony structures make a delicate balance. Even the smallest structural abnormalities in the region can disturb the balance and cause chronic sinusitis – a condition that negatively affects the quality of life and manifests as a high socioeconomic burden.

How structural abnormalities cause sinusitis?

To maintain them clean and healthy, cells in the sinus lining continuously produce mucus to “wash off” dust particles and microorganisms. Cells with cilia (that can also be found in the lining), push the mucus towards the nasal cavity. Cilia are fine thread-like structures that continuously move in a whip-like motion (that’s how they push the mucus). Whenever something disturbs the continuous flow of the mucus, the risk of sinusitis increases and then, it is just a matter of time when the disease will occur.

The structural abnormalities we are going to talk about in this article make the mucus flow difficult, slowing it down or bringing it to a complete halt. Depending on the severity, the patient might experience just slightly longer episodes of sinusitis, or suffer chronic sinusitis with excruciating pain.
In patients with such problems, common cold, flu or exposure to any other virus or bacteria is all it takes to fan the flames of sinusitis.

Possible structural abnormalities that can cause Sinusitis

Nasal Septal Deviation

Nasal septal deviation is the most common structural abnormality of the face. Research suggests that only less than 30% of people do not have it. Of the remaining 70%, not everybody suffers equally – while it’s just a minor inconvenience for many, a small percentage of unlucky ones have symptoms that interfere with the quality of their life.

The problem was recognized a few millennia ago in ancient Egypt. They treated it the best they could – with a hammer. Forceful and poorly controlled fracture sometimes turned out good and sometimes didn’t. Luckily, today ENT surgeons have much more subtle tools in their hands. And anesthesia. The surgery is safe, reliable, complications are rare, and results are incredible – from complete nasal obstruction to normal breathing in less than 30 minutes!

What is nasal septal deviation?

The septum is a thin bony structure in the nose that separates the nasal cavity into left and right nasal passages. Ideally, the septum lies precisely at the middle line of the face (an imaginary line that splits the face into two halves). However, perfect symmetry is extremely rare not only in humans but among the living creatures in general. So, the septum is almost always a bit off the middle line, and that’s what nasal septal deviation is – a misalignment. Most often, the misalignment is barely visible, while in some people it can be quite apparent cosmetic defect.

What are the symptoms?

Typically, the airflow through nostrils is uneven. In severe cases, breathing through one nostril can be impossible (the one on the side of deviation). Nasal obstruction causes problems like snoring, impaired sense of smell, bleeding from the nose, facial pain and dangerous, even life-threatening conditions such as sleep apnea.

The list of problems a patient may experience doesn’t end here. The deviation is often combined with other structural abnormalities (for example, hypertrophied turbinates, concha bullosa, etc.) which have their own symptoms and set of problems the patients have to face.

How does nasal septal deviation cause Sinusitis?

Just like we mentioned above, one of the nasal passages becomes narrower than the other one due to the deviation. This causes uneven airflow through the nose – the air runs at high speed through the narrower nasal passage. As a result, the lining on the side of the deviation dries out quickly, becomes sensitive, inflamed and swollen.

The absence of mucus creates a perfect environment for infection – dryness disables the defense mechanisms of the lining. The swelling narrows down the connecting canals’ openings (the canals between sinuses and nasal cavity). The latter brings sinus drainage almost to a halt and the mucus that piles up inside the sinus cavities is quickly colonized by microorganisms from the nose. Finally, all of the above-mentioned trigger off a Sinusitis episode.

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Medically reviewed by SinusDoctor,
Dr G V K Chaitanya Rao

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