On Sinuses

In our head and neck section, we learned about sinuses. As you know, those are the things that get clogged when you're sick, but I'd never figured out what they were until now. It turns out that they're mucosa lined cavities which are carved out of skull bones during development for the sole purpose of getting congested during illness. Just kidding. Their purpose is debatable, but the most reasonable one I heard was that they function to make the skull lighter.

One sinus is particularly interesting because it lies between the nasal cavity and the brain, specifically the pituitary gland. Some brain surgery is now done through this sinus. It's called the sphenoidal sinus. What happens is that they stick these really long laproscopic tools up the patient's nose, punch through the floor of the sinus at the top of the nasal cavity, then punch through the roof, and voila! they're in the brain right where the pituitary gland sits. This technique is nice because is minimally invasive, and patients recover much better.

One of the tools they stick up the patient's nose is a camera, so we had the opportunity to watch clips from one of these surgeries. The clip I really want to tell you about is the one where they repair the holes they poked in the beginning. They gather up little bits of bone and mucous and such and pack the hole they've made. To hold it all in place, they'll also use some biologically resorbable material. One of the things they pack up the hole with is fat. Yes, the patient's own fat. They harvest it from elsewhere on the patient and start sticking it up their nose. We watched little pincers holding a string of fat go all the way up the nostril, drop off the fat, pack it down, go all the way back down the nostril, pick up more fat, and then repeat. It was rather surreal, because you start with something familiar and normal, and then it rapidly turns into something that you never expected to see happen to a nose. There's a nose, an ordinary nose, but then all of a sudden, you see these pincers holding a yellow gob of fat. And not only that, those pincers are actually traveling up the nose, and for some reason, you're going with them. All of a sudden, you're not looking at someone's nose anymore, which is a perfectly normal thing to do, but you're actually hanging out inside their nose with some fat from their belly, which is not a very normal thing to do.

So, before I go, one last note on sinuses. You know when you get sick there's one particular pair of sinuses that feels particularly congested and horrible? It's the pair right under your cheek bones right? Those sinuses are called the maxillary sinus. The problem with those sinuses is that the hole they drain through is relatively high up. Imagine something like a teapot, where is spout is high, so it actually needs to be tipped over in order to drain. Now, there are cells in the sinus that sweep mucous up towards the opening, and this is all well and good when you're not sick, but when you're sick and there's tons of mucous, they're overwhelmed, and you end up with a congested sinus. So, based on where the hole is for drainage, one thing you might try when this happens is tipping your head over. That might help. Let me know how it goes.^^