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Sinusitis

By Apollo 24|7, Published on- 21 November 2022 & Updated on -

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  • Symptoms: Headache, pain in cheekbones, runny nose, nasal congestion without cold, body fatigue, fluid accumulation in ear cavities, facial swelling, difficulty in sleeping, throat irritation 
  • Causes: Fluid buildup in air-filled cavities of the face leads to a virus infecting the area. Bacterial strains cause many sinus infections. 
  • Risk factors: Deviated nasal septum, history of fungal infection, infection in ear, teeth or throat, people with weak immune system
  • Severity: Mild to moderate (depending on how well the condition in treated) 
  • Which doctor to consult: Otolaryngologist, general physician, paediatrician

 

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.

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, the mild infection subsides with self-care and proper treatment methods at home. But 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 more than 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 there is mild congestion and the presence of a runny nose in sinusitis, an aggravation in infection causes the uncontrollable fluid discharge. Hence, it is essential to control the fluid build-up by consulting a doctor.

Diagnosis

Based on the symptoms of the 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 looks for visible symptoms by assessing the patient’s face. The physician will look for 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 allergy, which might trigger sinus cavities repeatedly. Thus, an allergy test might help identify if any allergy in the patient’s body is triggering the sinusitis.

  • Imaging test

This is one of the most effective ways to look at sinusitis and understand the severity of the problem. Imaging tests like CT or MRI scans give proper details about the nasal cavity and sinuses. It might highlight severe inflammation in the area or physical blockage.

Additionally, imaging tests can detect the presence of polyps, tumours, or fungal infections which can’t be captured with an endoscope.

  • Endoscopy

It is a procedure where 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 includes taking the sample of nasal discharge, 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 going for a 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.

  • Corticosteroids

Nasal corticosteroids are very commonly used in the treatment of sinusitis. These are available in sprays and help heal inflammation, nasal congestion, and frequent sneezing. This includes medicines like fluticasone, mometasone, budesonide, triamcinolone, and other similar medications. Moreover, the steroids are mixed with saline mist or a similar solution.

  • Saline irrigation

These are common nasal sprays useful for minor sinusitis symptoms and work on the condition immediately. It gives quick relief from inflammation and congestion.

  • Anti-allergens

If an allergen is triggering sinusitis symptoms, then antihistamines or other anti-allergens are an excellent choice.
Aspirin desensitisation

Some people may develop sinusitis symptoms as a reaction to aspirin. Hence, this treatment involves the administration of smaller doses of aspirin at regular intervals to desensitise and improve tolerance to the medicine.

  • Antifungal medication

This medication is suitable if the causative organism for sinusitis is a fungal strain.

  • Medication for nasal polyps

Nasal polyps and chronic sinusitis are often interconnected. Hence, the former medications are suitable for treating chronic sinusitis symptoms. The medicines to reduce nasal polyps may also decrease the congestion in the nose.

  • Antibiotics

It is essential to go for an antibiotic treatment to prevent the infection from getting severe. In most cases, sinusitis involves a causative organism and could lead to pneumonia if left untreated.

  • 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.

Risks and complications if left untreated

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 and affect the blood vessels in the area. As a result, it 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, it imposes a risk of thrombosis and related severe complications due to chronic infection.

  • 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 is likely to affect the eye movement, vision, and morphology of the eye socket. This might cause redness, swelling, and pain in the eye socket.

Most cases of sinusitis are due to virus infection, hence, it should subside within 7-14 days. However, if you notice any symptom that remains for more than a week, it is a sign to see your doctor immediately.

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 extends 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.

Types of sinusitis

Ideally, there are two types of sinusitis infections that include:

  • Acute sinusitis: It is a condition that affects the sinus cavities and shows symptoms that lasts 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 for a longer period.
  • 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.
     

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Frequently Asked Questions

Some unusual causes of sinusitis include the following:  Infection in the nearby cavities may trigger an infection in the sinus cavities Hormonal changes during puberty or pregnancy Addiction to tobacco smoking Immunodeficiency that might trigger the symptoms immediately Emotional disturbances like stress, thermal changes, or change in humidity of the environment  

Yes. The home remedies for sinusitis include using over-the-counter sprays, humidifiers, acupressure therapy, and steam inhalation. Apart from this, many people use essential oils, improve their sleeping habits, avoid certain food items, and use compression techniques to overcome the symptoms. However, all these home remedies are only suitable for improving the symptoms and providing temporary relief. A sinusitis infection does not subside until the underlying cause is resolved.

Some common ways to prevent sinusitis include adopting home remedies to alleviate the symptoms. Additionally, if the patient is aware of the allergies, taking proper medications and preventing sinusitis symptoms from getting triggered becomes essential. Generally, saltwater irrigation and nasal sprays help prevent severe symptoms of sinusitis.