Sinusitis

Overview

Sinusitis is when the nasal cavity and spaces between the head [sinuses] are inflamed and filled with fluid. This results in facial swelling and persistent and uncomfortable headaches that require immediate attention. Even though multiple treatment options are available, there is no definite solution for sinusitis.

Due to this problem, there is a hindrance in how fluid, or mucus, drains from your nose cavities. As a result, the affected person always experiences a runny or stuffy nose. In addition, the area around your eyes might feel heavy and have swelling without having a cold or flu.

When the sinusitis persists for a long time or relapses frequently, it is considered a chronic infection. In this infection, the tissue lining the nose cavity experiences inflammation and remains moist most of the time. In the absence of inflammation, the moisture helps capture the dust, allergens, and pollutants to prevent them from irritating the cavity.

A normal sinus is filled with air and supports a comfortable breathing experience, whereas an inflamed cavity creates a blockage. The fluid in the sinus cavity supports the growth of bacteria and germs, which leads to infection immediately.

The symptoms of sinusitis make it difficult for the patient to distinguish between a common cold and sinusitis. However, some precautionary measures help deal with the signs and relieve them.

Types of sinusitis:

Ideally, two types of sinusitis infections include:

Acute sinusitis: It is a condition that affects the sinus cavities and shows symptoms that last for less than four weeks. Acute sinusitis originates as a common cold and usually subsides within ten days. However, if it leads to bacterial infection, it might affect the cavities longer.

Chronic sinusitis: Chronic sinusitis is also known as chronic rhinosinusitis. This is because it infects the nasal cavity, and the symptoms last up to 12 weeks even after consistent medical intervention. Most people suffering from the chronic condition are the ones that have allergic rhinitis or asthma.

Symptoms:

The symptoms of sinusitis can vary, but they often include:

Pain, tenderness, swelling, and pressure around the eyes, cheeks, nose, or forehead.
A blocked or runny nose with thick mucus, which can be green or yellow.
Decreased sense of smell and difficulty breathing through the nose.
Postnasal drip, where mucus runs down the back of the throat.
In some cases, a fever and fatigue may also be present.
If you’re experiencing these symptoms that don’t improve or are severe, it’s important to consult a healthcare professional for proper diagnosis and treatment. Sinusitis can be caused by infections, allergies, or other factors, and the treatment may vary depending on the cause.

Causes:

Sinusitis, the inflammation of the tissue lining the sinuses, can be caused by a variety of factors:

• Viral infections, such as the common cold, are the most frequent cause.
• Bacterial infections may follow a viral infection or occur on their own.
• Fungal infections can cause sinusitis, especially in individuals with weakened immune systems.
• Nasal polyps or growths in the sinuses can block sinus drainage and lead to chronic sinusitis.
• Allergies can trigger sinusitis by causing inflammation and blocking sinus drainage.
• Structural issues, such as a deviated septum, can obstruct the sinuses and lead to infection.
• Environmental irritants, like pollutants or chemicals, can also contribute to sinusitis.

To treat sinusitis effectively, it’s important to identify the underlying cause. If you’re experiencing persistent or severe symptoms, consulting a healthcare professional is advisable for proper diagnosis and management.

Risk factors:

Risk factors for sinusitis include a variety of conditions and environmental factors that can increase the likelihood of inflammation and infection of the sinuses:

Allergies that affect the sinuses, such as hay fever.
Viruses, bacteria, or fungi can cause upper respiratory tract infections.
Structural issues within the nose, like a deviated septum, nasal polyps, or tumours.
Immune system disorders that weaken the body’s defence mechanisms.
Cystic fibrosis leads to thick mucus buildup in the lungs and sinus linings.
Exposure to mould or other environmental irritants.
Tobacco smoking can impair the normal function of the sinuses.
Dental infections can spread to the sinuses.
Airplane travel exposes individuals to a high concentration of germs.
Understanding these risk factors can help take preventive measures and manage sinusitis effectively. If you have concerns about sinusitis or its risk factors, it’s best to consult with a healthcare professional.

Possible Complications:

Even though sinusitis is a common problem, and 80% of people suffer from such blockage at some point in their lives, it might get complicated if left untreated. While chronic sinusitis might not show severe symptoms, bacterial sinusitis may aggravate life-threatening complications.

Due to persistent inflammation, the cavity walls might become weak, affecting the blood vessels in the area. As a result, this might create complications in the lymph drainage pathway involving the eyes and the central nervous system.

Below are some other complications that you must pay attention to before ignoring the severe symptoms of sinusitis:

• Infection of other parts

Since sinus fluid drains continuously, the infection may spread to other parts like ears and eyes. As a result, the surrounding tissue might see severe sinusitis complications if left untreated. Additionally, the infection might spread to the brain and bones.

• Thrombosis

Frequent inflammation of the sinus cavity can lead to blood clots. Thus, chronic infection can impose a risk of thrombosis and related severe complications.

• Seizure

In such severe cases, when the infection spreads to the brain, it can cause seizures, dizziness, and inability to think correctly. Furthermore, the infection might affect sensory organs and make the patient sensitive to light and sound.

• Eye infection

When the infection spreads to the eyes or orbital cavity, it will likely affect the eye socket's eye movement, vision, and morphology. This might cause redness, swelling, and pain in the eye socket.

Most cases of sinusitis are due to virus infection; hence, they should subside within 7-14 days. However, if you notice any symptoms that remain for over a week, it is a sign to see your doctor immediately.

Prevention:

Preventing sinusitis involves several practical steps to reduce the risk of inflammation and infection in the sinuses:

Stay Hydrated: Drink plenty of fluids to help thin mucus and maintain healthy mucous membranes.
Rest: Ensure adequate rest to allow your body to fight off infections.
Nasal Irrigation: Clear nasal passages using a neti pot or saline nasal sprays.
Humidity: Use a humidifier to moisten the air, especially in winter or dry climates.
Avoid Smoke and Pollutants: Stay away from cigarette smoke and polluted environments.
Manage Allergies: Keep allergies under control with appropriate medications and by avoiding allergens.
Healthy Diet and Exercise: Maintain a balanced diet and regular exercise to support the immune system.
Hand Hygiene: Wash your hands frequently to prevent the spread of infections.
Vaccinations: Get recommended vaccines, such as the flu vaccine, to reduce the risk of sinusitis-related infections.
These measures can help you maintain sinus health and prevent the occurrence of sinusitis.

When to consult a doctor?

Sinusitis is a common condition that subsides on its own if the affected person takes the necessary precautions. However, there comes a time when it is imperative to see a doctor and seek expert medical guidance.

Below are some signs to see a doctor for sinusitis:

• Self-care is ineffective:

Generally, mild infections subside with self-care and proper treatment methods at home. However, some measures, like steam inhalation and essential oil therapy, may not work when the condition is severe. Thus, it is an indication that you must see a doctor.

• Infection lasts for more than a week:

Any nasal or respiratory infection that lasts beyond a week is considered dangerous. Additionally, the sinusitis has a history of relapsing, which worsens the condition. Thus, if the disease or symptoms last for more than a week, it indicates the moderate severity of the situation.

• Fever

Even though the inflammation leads to fever, the symptoms remain in control. Thus, if the fever lasts over three days, it is a sign of severe infection and requires proper medical intervention.

• Aggravation in pain

Sinusitis is a condition that is associated with persistent pain. However, if the pain gets unbearable and spreads to the head and neck region, it might be a sign to see a doctor immediately.

• Increase in nasal discharge

While sinusitis causes mild congestion and a runny nose, an aggravation in infection causes uncontrollable fluid discharge. Hence, it is essential to consult a doctor to control the fluid build-up.

Diagnosis

Based on symptoms of sinus infection, a medical expert might suggest different diagnostic techniques. Below are some common ways to diagnose sinusitis:

• Physical examination

During the physical examination, a physician assesses the patient’s face for visible symptoms, such as tenderness in the nose, swelling around the eyes, and other visible signs.

• Allergy test

Many people prone to sinusitis also have a history of severe allergies, which might trigger sinus cavities repeatedly. Thus, an allergy test might help identify if any allergy in the patient’s body triggers sinusitis.

• Imaging test

This is one of the most effective ways to examine sinusitis and understand its severity. Imaging tests like CT or MRI scans give proper details about the nasal cavity and sinuses. They might highlight severe inflammation or physical blockage.

Additionally, imaging tests can detect the presence of polyps, tumours, or fungal infections that an endoscope cannot capture.

• Endoscopy

It is a procedure in which the doctor inserts a thin tube with a flexible optic fibre into the nose cavity. This test allows the doctor to identify deviated septum, polyps, or tumours if they are present in the passage.

• Culture test

A culture test involves taking a sample of nasal discharge and allowing it to grow. This test helps assess the type of microorganism causing chronic sinusitis. Some cases involve antibiotic-resistant organisms and lead to a chronic condition. Hence, examining the samples and seeking suitable treatment is essential.

Treatment

A treatment protocol for sinusitis involves multiple medicines and procedures depending on the severity of the problem. Below are the possible treatment methods a doctor might suggest. Sinusitis can be treated with various medications. Here are some examples:

• Antibiotics: If sinusitis is caused by a bacterial infection, antibiotics like Amoxicillin or Amoxicillin and Clavulanate Potassium may be prescribed.
• Nasal Corticosteroids: Sprays such as fluticasone and mometasone help reduce inflammation.
• Decongestants: These can relieve congestion and are available over the counter or by prescription (Phenylephrine).
• Antihistamines: Useful if sinusitis is related to allergies (Citrizine).
• Pain Relievers: Medications like acetaminophen can alleviate pain associated with sinusitis.
  It’s important to consult with a healthcare provider for a proper diagnosis and treatment plan tailored to your specific condition.
• Surgery

In severe cases of chronic sinusitis, doctors prefer a surgical procedure, endoscopic sinus surgery. However, this is the last option when common drugs do not improve the condition.

After identifying the blockage, the doctor might use different instruments to remove the tissue causing a nasal blockage. Furthermore, many procedures involve enlargement of the sinus cavity to allow proper fluid drainage.

Additional information

Anatomy of the sinus cavity

A sinus cavity is divided into four pairs, and they are

• Maxillary sinus: These sinuses are present on either side of the nose, one each in the maxillary bones, also called the cheekbones. An infection in these sinuses causes swelling in the cheekbones.
• Ethmoidal sinus: These sinuses are present on either side of the nose and between the eyes. Infection in these sinuses causes sore throat, bad breath, thick secretions and cough.
• Frontal sinus: The frontal sinuses are present just above the nose and extend above the eyebrows. An infection in these sinuses leads to severe headaches.
• Sphenoid sinus: These sinuses are located behind the nose and between the eyes. An infection in these sinuses produces typical symptoms like earache, neck pain, pain behind the eyes and pain in the temples.