Posted by on Oct 24, 2018 in Uncategorized

Sinusitis (Rhinosinusitis)

The term sinus means a cavity within a bone or other tissue, especially one in the bones of the face or skull connecting with the nasal cavities. Sinusitis affects the paranasal sinuses i.e. the air-filled spaces that surround the nasal cavity.

The paranasal sinuses are lined with a mucous membrane that functions to produce and circulate mucus into your nose. This serves to filter dust and particles as well as moisten the air we breathe. When these cavities become inflamed or swollen, you have sinusitis.

Sinusitis is most commonly caused by a viral or bacterial infection or by an allergy and it’s a very common medical condition. It can occur in any of the paranasal sinuses: maxillary, ethmoidal, frontal, or sphenoidal. Sinusitis nearly always occurs in conjunction with inflammation of the nasal passages (rhinitis), and for this reason doctors refer to the disorder as rhinosinusitus. It may be acute (short-lived) or chronic (long-standing).

Acute and chronic sinusitis cause similar symptoms, including

  • Yellow or green pus discharged from the nose
  • Pressure and pain in the face
  • Congestion and blockage in the nose
  • Tenderness (pain when touched) and swelling over the affected sinus
  • Reduced ability to smell (hyposmia)
  • Bad breath (halitosis)
  • A productive cough (especially at night)

Below, are links to two excellent short videos which describe sinusitis, its signs and symptoms, and the mainstream medical approaches to treatment are outlined. The first video runs for just under 5 minutes and the second runs for just under 6 minutes.


How breathing retraining can help

A blocked nose is one of the most common signs of a dysfunctional breathing pattern. It is widely accepted that people suffering from nasal congestion tend to be habitual ‘mouth-breathers’. However, contrary to popular thinking, habitual mouth breathing may in fact be the reason for the nasal congestion in the first place. Inflammation of the nasal passages, constriction of the smooth muscle lining the nasal passages and even outgrowths from the nasal mucosa, such as nasal polyps may in fact be a response to the dysfunctional breathing pattern. In other words, inflammation and constriction of the upper airway is happening in response to the underlying problem: over-breathing.

The Buteyko breathing method relieves nasal congestion by helping to restore a more normal breathing rate and volume. Inflammation and mucus production reduce as breathing volumes normalise. In addition to this restoring higher CO2 levels in the nasal passages helps soothe nasal membrane tissue and dilates the smooth muscle lining the nasal sinuses.

One of the conclusions of a study titled ‘Nasal congestion and hyperventilation syndrome’ published in the American Journal of Rhinology in Nov-Dec 2005 was the following:

“HVS (hyperventilation syndrome) should be included in the differential diagnosis of patients presenting with nasal congestion, particularly after failed nasal surgery. One possible explanation is increased nasal resistance secondary to low arterial pCO2 levels.”

pCO2 (partial pressure of carbon dioxide) reflects the amount of carbon dioxide gas dissolved in the blood.

Reference: Am J Rhinol, 2005 Nov-Dec; 9(6):607-11.

Over-breathing (hyperventilation) lowers the carbon dioxide level within the blood and the respiratory system including the paranasal sinus passages. A low carbon dioxide environment stimulates mast cells to release greater amounts of histamine, an inflammatory agent, in response to contact with allergens. In short, the body over-reacts and the nasal and sinus regions become swollen and inflamed. Secondary infections are common in the warm moist environment. Breathing re-training with the Buteyko method can normalise breathing and reduce the symptoms of sinusitis.

In January 2013, the results of a study carried out at Limerick University Hospital clearly demonstrated the effectiveness of the Buteyko breathing method in reducing the symptoms of rhinosinusitus/sinusitis. I wrote a short summary piece on this study, in the form of a ‘Letter to the editor’ which was published in Irish Pharmacist (July 2014, p. 16).This piece is reproduced below.


Dear Editor,

Readers may be interested to know about an interesting small study which was carried out by researchers from the Department of Otolaryngology at Limerick University Hospital. The study investigated the effectiveness of the Buteyko breathing method on the nasal symptoms of patients with asthma. There were 26 participants in the study and all of them had a diagnosis of asthma and chronic rhinosinusitus (inflammation of the mucous membranes of the nose and one or more sinuses). The age of participants ranged from 23 to 60 years with a mean of 38 years.

Participants underwent weekly sessions of Buteyko breathing training for three weeks and they were followed up for three months after training. The participants completed questionnaires to rate their nasal symptoms before training commenced and three months after training. There were significant improvements in the participants’ nasal symptoms, in that what the researchers referred to as the ‘sinonasal obstruction symptom evaluation scores showed a 71 per cent reduction after three months. There was also a significant improvement in the quality of life of participants.

Irishman Patrick McKeown, an internationally acclaimed Buteyko expert, provided the Buteyko training to the study participants.

You may access a summary of the study and its results (from the journal Clinical Otolaryngology, 15 January 2013) via the following link:


Dr Alan Ruth