What is sinusitis?
Sinusitis is one of the most commonly diagnosed diseases in the United States, affecting approximately 16 per cent of the adult population annually. The sinuses are an associated system of air-filled cavities located in the skull.
Inflammation of the sinuses is caused by viruses, bacteria, fungi, or as a result of allergies. The inflammation prevents the sinuses from draining normally, leading to a buildup of mucus and secondary infection.
The main symptoms of a sinus infection are the nasal obstacle, discoloured nasal discharge, and facial discomfort or pressure that has been present for 7 days or more.
Types of sinusitis
- Acute sinusitis: Acute sinusitis has the shortest duration. A viral infection caused by the common cold can cause symptoms that usually last 1 to 2 weeks. In the case of a bacterial infection, acute sinusitis can last up to 4 weeks. Seasonal allergies can also cause acute sinusitis.
- Subacute sinusitis: Subacute sinusitis symptoms can previous up to 3 months. This condition commonly happens with bacterial infections or seasonal allergies.
- Chronic sinusitis: Symptoms of a chronic sinusitis last longer than 3 months. They are often less serious. Bacterial infection can be the culprit in these cases. Additionally, chronic sinusitis commonly occurs in conjunction with persistent allergies or structural nasal problems.
Signs and symptoms of sinus infection or sinusitis
There are many signs and indications of sinusitis and sinus infections. The following is a summary of the predominant ones (18 in total) that can occur. Most patients have several signs and indications at the same time. Others may have some symptoms that are irregular; most do not have all symptoms at once. Signs and symptoms of a sinus infection or sinusitis contain the following:
- Headache due to pressure in partially or totally blocked sinuses. Pain may increase when the person bends over.
- Facial tenderness and/or swelling when the facial areas over the sinus areas are touched.
- Pressure or pain due to mucus pressing on the sinus tissue or inflammation of the sinuses.
- Fever due to inflammation of the tissues of the nasal sinuses and infection.
- Cloudy and discoloured nasal drainage is often seen in bacterial sinus infections.
- Congestion is a feeling of nasal congestion and occurs with both infectious and non-infectious sinusitis.
- Postnasal drip is the overproduction of mucus from sinusitis that flows into the throat and irritates the throat tissue.
- Sore throat is inflammation of the throat tissue from postnasal drip.
- Coughing is a response to postnasal drip and the body’s attempt to flush irritants from the throat tissue.
- Tooth pain caused by pressure on immediate nerves and tissues
- Earache caused by pressure on surrounding nerves and tissues.
- Eye pain caused by pressure on nearby nerves and tissues.
- Fatigue due to fever, immune response, and/or cough
- Bad breath is usually due to bacterial infections
- Itching / Sneezing: In non-infectious sinusitis, other allergy symptoms related to itchy eyes and sneezing may be communal, but may include some of the symptoms listed above for infectious sinusitis.
- Nasal drainage is usually clear or whitish in colour in people with non-infectious sinusitis.
- Ulceration can occur with rare fulminant fungal infections with well-defined borders and a black necrotic centre in the nasal area. Some fungal infections produce dark, black-appearing exudates. This requires an immediate medical evaluation.
- Multiple chronic symptoms (one to three months) are usually a sign of chronic or subacute sinusitis.
Causes of sinusitis
The sinuses are air-filled spaces in the skull. They are found behind the forehead, nasal bones, cheeks, and eyes. Fit sinuses do not contain bacteria or other microorganisms. Most of the time, mucus can drain and air can flow through the sinuses.
When the sinus starts to become blocked or too much mucus builds up, bacteria and other germs can grow more effortlessly.
It can occur from one of these conditions:
- Small hairs (cilia) in the sinuses are unable to remove mucus properly. This can be due to some medical conditions.
- Colds and allergies can cause too much mucus to be produced or block the opening of the sinuses.
- A deviated septum, nasal bone spur, or nasal polyps can block the opening of the sinuses.
Diagnosis of sinusitis
To diagnose a sinus infection, your physician will ask about your symptoms and achieve a physical exam. They can check pressure and sensitivity by pressing a finger against your head and cheeks. They can also examine the inside of the nose for signs of inflammation.
- In most cases, your physician can diagnose a sinus infection based on your symptoms and the consequences of a physical exam.
- Though, in the case of a chronic infection, your physician may recommend imaging tests to examine your nasal passages and sinuses. These tests can reveal mucus blockages and any abnormal structures, such as polyps.
- A CT scan provides a three-dimensional image of your sinuses. An MRI uses influential magnets to create images of internal structures.
- Your doctor may also use a fibre optic endoscope, which is a lighted tube that goes through your nose. It is used to directly visualize the inside of the nasal passages and sinuses. A sample can be obtained during nasal endoscopy for culture testing to detect the presence of an infection.
- An allergy test identifies irritants that can cause an allergic reaction. A blood test can detect diseases that weaken the immune system, such as HIV.
It is treated in several ways, each depending on the severity of the sinus case.
A simple sinus infection is treated with:
- Over-the-counter cold and allergy medications.
- Nasal irrigation with saline solution.
- Drink fluids (sinusitis is a viral infection and fluids will help).
If your sinus symptoms do not improve after 10 days, your doctor may prescribe:
- Antibiotics (for seven existences in adults and 10 days in children).
- Oral or topical decongestants.
- Prescription intranasal steroid sprays. (Don’t use over-the-counter sprays or drops for more than three to five days – they can actually increase congestion.)
Long-term (chronic) sinusitis can be treated by focusing on the underlying condition (usually allergies). This is usually treated with:
- Intranasal steroid sprays.
- Topical antihistamine sprays or oral pills.
- Leukotriene antagonists to decrease swelling and allergy symptoms.
- Flushing the nose with saline solutions that may also contain other types of medications.
When it is not controlled with one of the above treatments, a CT scan is used to better see your sinuses. Depending on the results, surgery may be necessary to correct structural problems in your sinuses. This is more likely to happen if you have polyps and/or a yeast infection.
Complications of sinusitis
Serious complications of chronic sinusitis are rare, but can include:
- Eyesight problems. If your sinus infection spreads to the eye socket, it can cause reduced vision or possibly blindness that may be permanent.
- Infections. Rarely, people with chronic sinusitis may develop inflammation of the membranes and fluid that surrounds the brain and spinal cord (meningitis), a bone infection, or a serious skin infection.
Prevention of sinusitis
You may not be talented to totally avoid this infection, but there are ways to prevent it in some cases:
- Do not smoke
- Avoid dry environments
- Use a humidifier when needed
- Drink much liquid
- Seek treatment for chronic allergies that can trigger inflammation of the sinuses
Risk factors for sinusitis
Several factors can increase your danger of getting a sinus infection:
- A previous cold
- Seasonal allergies
- Smoking and exposure to secondhand smoke
- Structural problems within the sinuses (such as developments on the lining of the nose or sinuses, recognized as nasal polyps)
- A weak immune system or taking medications that weaken the immune system