Watering eyes, a stuffed or runny nose, a tender swollen face, and a heaviness in your head that graduates into an intense, dull ache…we've all woken up with these flu-like symptoms characteristic of sinus trouble. But if you're having repeated attacks, deeper investigation is called for.

It's a common condition and we've heard it spoken about often. But what does a doctor mean exactly when he tells you that you suffer from sinus trouble?

"The sinuses are small, hollow, air-filled cavities that are found in the cheekbones, forehead and surrounding the nose. These cavities are rather like small chambers," says Dr Vinnakota Sriprakash, ENT specialist and head and neck microsurgeon at the Microcare ENT hospital in Hyderabad. "When we speak, the presence of these chambers adds depth and resonance to our voice. It also lightens the weight of the head." But there is much that can affect the sinuses, causing them to become inflamed. "From childhood, our bones are constantly growing. When there is an excessive growth of the bone in the nasal septum this can lead to a obstruction in the area of your sinuses, predisposing patients to infection."

Sometimes this obstruction or structural defect becomes a permanent part of our anatomies, making sinusitis a recurrent condition. So as adults, we may succumb to frequent attacks. But what many people don't realize is that sinusitis can also occur as a result of allergies, not only infections.

Battling Allergic Sinusitis: Flu-like symptoms that crop up immediately and without warning, snowballing into a full-blown attack are often caused by allergic sinusitis. And there are many triggers. It could be a food or beverage that you've consumed, dust, pollen, animal dander (hair), smoke or fumes that you've been exposed to--all this can inflame the sinuses, causing severe nasal block, debilitating headaches and a loss of productivity. Antihistamines, prescribed in such cases, work to relieve the symptoms such as sneezing and watering eyes. However, some of these may make you drowsy, and doctors advise not to drive or operate machinery while you are in such medications. If your doctor suspects that your frequent sinus attacks are caused by allergies, he will recommend a blood test called RAST (RadioAllergoSorbent Test). A Skin Prick test, which exposes the surface of your skin to various allergens can also help isolate and identify the common triggers.

Surgical Intervention--when does it help?: Today, relief from sinitus is possible with surgical intervention, but before you go under the knife, you should consider how much you can really benefit from the treatment. "In order to do this, it is important to assess the root cause of your sinus trouble. If your sinus trouble is caused by a severe structural defects in the nasal cavity which trigger chronic and persistent respiratory infections, surgery is the only effective option. But most people have only a mild obstruction that can be kept in check with proper OTC (over-the-counter) medication. Surgical intervention isn't really required in these cases. However, if your sinus is caused by allergic triggers or a combination of allergic and structural defects, it cannot be corrected only by surgery," says Dr Sriprakash. In any case, surgery isn't recommended before the age of 17 years, as bones are still in their growth phase.

Adenoid Alert: "All too often, the seeds of sinusitis are sown in childhood," says Dr Vidit Tripathi, an ENT surgeon based in New Delhi, specializing in endoscopic sinus surgery. "If adenoids (a lumpy tissue situated at the end of the nasal cavity, seen in children under five) experience swelling and are not treated, it leads to the incorrect development of the palate and nose, a condition that can cause sinus trouble later in life. In fact, most children who wear braces in their teen years have not been properly treated for adenoids."

Sinus solutions: A sinus cold, especially a chronic one can be a nuisance. But as we're lost in the harried activities of our daily lives, it's easy to ignore the pain and suffer silently rather than opt for treatment. For chronic sufferers, a change in lifestyle is in order. People who spend a great deal of time in in an air conditioned environment should set up a humidifier at home or at work to ensure that the air is moist. Dry air can irritate nasal passages. A saline or a medicated nasal spray and over-the-counter decongestants can also help you find relief. However, Many of these, if abused too frequently can cause the blood supply to the lining of the nose to decrease drastically, causing tenderness, ulcers and bleeding too; So its always important to consult your doctor first. "Early treatment of sinusitis will prevent other severe secondary infections," says Dr Tripathi.

"Medical intervention is a must, because if left untreated, it can lead to ear infections that affect your hearing, and in extreme cases, may even spread to the brain, resulting in a loss of vision and other severe complications. Regular and appropriate medication is the key. As much as possible, avoid dust. Steam inhalation, yoga and breathing exercises are worth exploring." (The author can be contacted at kamala.metroplus@gmail.com)