Sinusitis is an inflammatory condition of air spaces within our face bone called paranasal sinuses. This condition is very common in the winter season and children get more affected. Functional aspects of these spaces are still subject of study for medical science, but available evidence suggests to provide warmness and moisture to the inhaled air, provide resonance in voice production and protection of brain and vital structure form direct environmental contact. Infection is carried out by common environmental bacterias and viruses like strp. Pneumoniae, H. infulenzae, sterp. Pyogens etc. short term or long term exposure to the particular environment, the immune system of particular individual and some of the genetic makeup also plays role in frequency and severity of infections.

What are sinuses:

Paranasal sinuses are pneumatized spaces within skull bone. Different names are given to them according to the bone they located eg: maxillary sinus, frontal sinus, ethmoidal sinuses, sphenoidal sinuses. Being the largest one and first sinus to be in contact with the environment (present lateral to nasal cavity), maxillary sinusitis is very common. Frontal and anterior groups of ethmoidal lies above to a maxillary, sphenoidal and posterior group of ethmoidal located posteriorly. Similar to the nasal cavity, these are also lined with normal mucosa capable of secreting mucus. All the sinus drain their secretions into the nasal cavity through ostia. Ostia is the same path through which infection get spread all around. Unlike normal ventilation, sinuses ventilate paradoxically i.e. they inhale during the time of expiration and exhale during inhaling. The reason behind it is being positive and negative pressure on them on respective phases.

Clinical manifestation:

On the basis of onset of illness, sinusitis may be acute or chronic.

Acute sinusitis Chronic sinusitis
Onset is abrupt (2-3 days) Gradual onset
Sudden exposure to microorganisms, chemicals and other infection cause it Disturbance in normal mechanism of mucus clearance predispose it.
Symptoms more intense Mild grade and repeated symptoms
Resolves with proper antibiotics. Long-term preventive measures, surgery might be needed.

 

Signs and symptoms of Sinusitis

  • Nasal blockage
  • Thick nasal discharge
  • Pain and fever (due to inflammation)
  • Change in tone of voice ( resonance get affected)
  • Loss of taste and smell sense ( nerves passing through the area also involved)
  • Associated symptoms like a headache, muscle pain, weakness may present.

For chronic infections to occur, Nasal anatomical defects like a deviated septum, hypertrophied turbinates, polyps predispose to infections. People with suppressed immune functions like children ger recurrently affected and some defect in genes (like cystic fibrosis) sometimes leads to improper mucociliary functions to clear out nasal secretions. During winter season common environmental agents gain more pathogenic power, which might be costly in an immunocompromised individual.

Ayurvedic approach

According to Ayurveda, sinusitis is the disease of Kapha, caused by aggravated Vata. The disease is called pratishyaya (for acute) and dusta pratishyaya (for chronic sinusitis). Vata being most powerful of tridoshas (three body humor vata, pitta and kapha) when get vitiated, cause kapha as well as pitta to disbalance from their normal physiological location and function, resulting in passage of Kapha from nasal passage with some pitta symptoms.  In samskrita language its written as

Regarding the etiology of pratishyaya, all the causes that aggravate vata dosha are included such as cold exposure, excessive physical and mental activities, swimming, night awakening, pollen exposure, indigestion etc.

Treatments:

  • Avoidance of causative factors is the first line of treatment in Ayurveda.
  • Not taking food that increases vata and Kapha like cold foods and drinks, fruits, heavy meal, curd, and alcohol.
  • Fasting is considered to be most effective of all
  • Few habits to be avoided are cold exposure, taking shower, sexual activities, anxious activities and heavy physical exertions. medicated smoking with certain herbs as guided by Ayurveda helps to melt out Kapha easily and release blockage.
  • Yoga: certain yogic breathing practices and asanas are very helpful especially to cause heating effects on body, to increase the blood flow within head and to remove infected secretion from sinus with strengthening immunity. Commonly practices are bhastrika, kapalabhati, anuloma viloma, bhramari, sarbangasana, ardha halasana etc.
  • A particular therapy in Ayurveda is employed for the treatment of chronic sinusitis called NASYA. It is the process of nasal administration of different medicine especially in oil form. Since nasal cavity is considered to be the door of the brain, this herbal medicine also affects the brain in a certain way. Nasya therapy is one of panchakarma therapy ( Five body cleansing procedures). According to recent researches, this procedure shown very positive result in controlling chronic sinusitis and few other diseases of nasal cavity and head. They include allergic rhinitis, migraine headache, neuralgia, nasal polyposis, insomnia etc. In patients with recurrent sinusitis attack, Nasya therapy in combination with few classical ayurvedic preparations like laxmivilas ras, tribhuwan kriti ras, mrutunjaya ras, chyawanprash, chitraka haritaki, trayodashanga guggulu etc. from oral rout showing very good effectiveness in controlling symptoms and progression of disease.

 

Any interested individual can go through following links of clinical trials.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235399/

https://www.researchgate.net/publication/253954459_PHARMACODYNAMICS_OF_NASYA_KARMA

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221066/

https://www.researchgate.net/publication/291338201_EFFECT_OF_MADHOOKASARADI_NASYA_IN_THE_MANAGEMENT_OF_POSITIVE_SYMPTOMS_OF_SCHIZOPHRENIA

THANK YOU

Dr suman paudel,

BAMS, IOM, TU.

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