The beauty of the human body

This amazing image is from the September issue of National Geographic. Its is actually a 3 dimensional CT scan color enhanced image of the sinuses of the human skull, through the frontal bone imaging the intricate sinuses in the human skull.

Evolutionarily it is presumed that sinuses (which are simply hollow spaces that develop in the skull bones) evolved to lighten the weight of the skull, particularly in upright walking mammals that don't have large posterior neck ligaments opposing the pull of gravity and supporting the weight of the skull, like horses or cows for instance. Humans are not born with sinus cavities but they are fully developed by about 6-9 years of age.

I often ordered CT scans of the sinus area if I suspected chronic sinus disease in a patient, which is not uncommon in the Ohio Valley with the high rates of allergy and the pollution from coal burning power plants that line the banks of the Ohio river. I ordered just a 4-6 cut quick sinus CT to decrease costs. X-rays of the sinuses are not accurate enough to be used to diagnose sinusitis.

Interestingly, acute bacterial sinusitis is believed to be grossly OVER diagnosed and treated inappropriately with antibiotics, but chronic sinusitis is believed to be UNDER diagnosed and treated with courses of antibiotics that are often too short to eliminate infection in the sinus cavities, which have relatively poor antibiotic penetration due to much less blood flow compared to other areas of the body.

Symptoms of chronic sinusitis can be some what subtle. Chronic fatigue, pain, pressure or fullness in the facial area or frank headaches, chronic postnasal drainage resulting in chronic cough, nausea or loss of appetite. Rarely fever. They are more common in those that have allergies, and after acute sinus infections that are most likely caused by viruses. When the sinuses are clogged with mucus and other materials or don't empty properly due to inflammation of the lining they are more likely to become infected by bacteria.

Treatment consists of long course antibiotics in CT scan confirmed chronic sinusitis, 21-30 days is not unusual to fully treat this condition. Short term topical decongestants are helpful. Also nasal inhaled topical steroids to calm the inflammation of the nasal area which harbors the openings to the sinuses and to treat underlying allergies if that condition exists. Lavaging or washiing out the sinuses daily with a special type of salt water you can make yourself can be done and is VERY effective way to treat recurrent sinus infections, allergies. Google "sinus lavage" for details. Most people just won't poor fluid upo thier nose no matter how great and low cost and effective it is. That's too bad.