Sinusitis - Causes, Symptoms and Treatment

What Is Sinusitis?

Sinusitis is a very common condition that is caused by bacteria, fungi, viruses, or any other allergies. Sinusitis is defined as inflammation of the mucosal lining of the sinus passages. It can be acute or chronic. Frequent attacks of sinusitis for over three months, also known as chronic sinusitis, result in the thickening of the mucosal membranes and excess production of nasal and sinus secretions. These secretions are usually thick and sticky and frequently predispose the sinuses to bacterial infection.

How Is Sinusitis Caused?

A sinus is a hollow and air-filled space in the body. The lining of the sinuses produces a slimy secretion called the mucus. This mucus helps to keep the nasal passages moist, and it also traps germs and other particles. Sinusitis is caused when the mucus builds up and irritates the sinuses resulting in the inflammation of the sinus.

What Are the Different Types of Sinusitis?

There are four different types of sinusitis. They are:

• Acute sinusitis.

• Subacute sinusitis.

• Chronic sinusitis.

• Recurrent sinusitis.

Acute Sinusitis:

Sinusitis which lasts for a shorter duration is called acute sinusitis. It is commonly caused by a viral infection brought on by a common cold. The symptoms last for about one to two weeks. In case it is caused by a bacterial infection, then it can last for up to four weeks. Acute sinusitis is caused by seasonal allergies.

Subacute Sinusitis:

Subacute sinusitis is caused by a bacterial infection or seasonal allergies. The symptoms of subacute sinusitis last up to three months.

Chronic Sinusitis:

The symptoms of chronic sinusitis last for more than three months. Chronic sinusitis is commonly caused by bacterial infections. It can also occur due to nasal structural problems or persistent allergies. Chronic sinusitis is a very rare condition.

Recurrent Sinusitis:

The condition is called recurrent sinusitis, when the symptoms of sinusitis occur several times a year.

What Are The Common Causes And Risk Factors of Sinusitis?

• A cold or flu.

• Frequent exposure to allergens, such as dust, mites, mold, pollen, etc.

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• Frequent rhinitis.

• Exposure to extremes of air temperature.

• Exposure to cigarette smoke.

• Certain structural deformities in the upper respiratory tract, such as a deviated nasal septum, nasal polyps, hypertrophy of inferior turbinates (chronic sinusitis can itself cause hypertrophy of inferior turbinates), allergies. Nasal polyps and deviated nasal septum are by far the commonest causes of chronic rhinosinusitis.

What Are the Symptoms of Sinusitis?

The symptoms of sinusitis are:

• Sinus pressure and pain.

• Runny nose.

• Facial pain.

• Blocked nose.

• Sinus and nasal congestion.

• Itching and sneezing.

• Post-nasal drip.

• A frequent headache.

• Difficulty in breathing.

• A sore throat.

• Tooth pain.

• Ear pain.

• Halitosis (bad breathe).

• Irritability.

• A chronic cough.

• Sleep disturbances.

What Are the Complications of Sinusitis?

• Meningitis.

• Periorbital cellulitis or abscess.

• Cavernous sinus infection.

• Brain abscess.

• Osteomyelitis.

Hence, it is important to ensure proper and adequate treatment of sinusitis, both acute and chronic.

How Is Sinusitis Diagnosed?

Commonly, a doctor can identify sinusitis by the history of symptoms and clinical examination. To confirm the diagnosis, doctors may recommend a few other diagnostic tests like:

• Imaging tests.

• Examination of the sinuses.

• Allergy test.

• Culture test.

Imaging Tests:

Imaging tests like an X-ray of paranasal sinuses can clearly point out the presence and, in most cases, the underlying cause of sinusitis. Sometimes CT (computed tomography) and MRI (magnetic resonance imaging) may be recommended as CT, and MRI shows the details of the sinuses and the nasal area.

Examination of the Sinuses:

To view the sinuses, a thin and flexible tube with fiber-optic light is inserted through the nose. This examination helps to determine the deviated nasal septum.

Allergy Test:

An allergy test is performed to check if any allergies are triggering the symptoms of sinusitis.

Culture Test:

Culture tests are generally not recommended in case of diagnosing sinusitis. It is rarely recommended to determine the causative factors like bacteria or fungi, or viruses. This culture test is done by collecting the samples from the nose.

What Are the Home Remedies for Sinusitis?

The following measures are quite effective in treating the above-mentioned symptoms:

1. Menthol steam inhalation three times a day.

2. Nasal saline washes with a neti pot.

3. Use a humidifier at home.

4. Avoiding allergens such as dust, mites, mold, pollens, etc., by wearing masks or avoiding contact with mold spores or animal dander can significantly decrease the attacks of rhinosinusitis.

5. Drink warm water with honey, and lime to clear the mucus stuck in the throat from post-nasal drip.

How Is Sinusitis Treated?

Medications prescribed to manage sinusitis are the following:

• Antihistamines for allergies.

• Nasal decongestants (not longer than three days if used thrice daily, as they can cause rebound congestion).

• Nasal steroid sprays like Budesonide, Fluticasone, Triamcinolone, Beclomethasone, and Mometasone to control the inflammatory process.

• Antibiotics are required if there is fever and/or purulent nasal discharge.

• Mast cell stabilizers may be used to control symptoms of allergies.

In severe cases, where the condition does not respond to the above treatment options then surgical procedures may also be considered.

• Functional endoscopic sinus surgery.

• Polypectomy.

• Turbinectomy.

• Chemical sinus cautery.

How to Prevent Sinusitis?

Ways to prevent sinusitis are:

1) Try to avoid contact with people who have a cold or those people who are sick with other infections.

2) Wash your hands thoroughly after sneezing or coughing and before meals.

3) If you have allergies try to manage the symptoms and keep them in control.

4) Avoid smoking because tobacco smoke can irritate the lungs and the nasal passages.

5) You can use a humidifier if your home is very dry. By using a humidifier, moisture is added to the air, preventing sinusitis. Humidifiers also help to keep the home clean and make them free of molds.

Conclusion:

Sinusitis is a treatable condition. Most people recover without any medical intervention. But seeing a doctor is necessary if there are recurrent episodes of sinusitis or when the condition is not responding to the provided treatment.