Sinusitis is an inflammation of the mucous membranes found within one or more of the sinuses. Sinusitis lasting anything from a few days up to a month is called acute sinusitis.
Sinusitis is an inflammation and swelling within the lining of the sinuses, caused in short-term infections such as the cold, but also by allergies, problems in the structure of the nose, and sometimes growths called nasal polyps.
Acute sinusitis is short-lasting; this kind of inflammation can clear up within a few days to a month. When sinusitis is an ongoing problem that lasts three months or more, it is termed chronic sinusitis.
Sinusitis is one of the most common problems of the respiratory system. It can affect people of any age, although children have very small or non-existent sinuses until the age of around five or six, so they tend not to get sinusitis.
What are the sinuses?
Sinuses are hollow air spaces located in the bone cavities in the head. The sinuses make mucus, a fluid that cleans bacteria and other particles out of the air you breathe. These hollow spaces, located within the skull or bones of the head surrounding the nose, include:
- The frontal sinuses over the eyes in the brow area
- The maxillary sinuses inside each cheekbone
- The ethmoid sinuses just behind the bridge of the nose and between the eyes
- The sphenoid sinuses behind the ethmoids in the upper region of the nose and behind the eyes
In normal human anatomy, each sinus has an opening into the nose for the free exchange of air and mucus. There is also a continuous mucous membrane lining that coats all the sinuses. Therefore, it isn't hard to assume that, anything that causes swelling or infection in the nose also can affect the sinuses.
What is sinusitis?
Sinusitis is an inflammation of the lining of one or more of the sinus cavities in the facial bones around your nose. Most cases of sinusitis are caused by acute infectious sinusitis, which is caused by infections like the common cold and lasts less than four weeks. If the signs and symptoms of sinusitis last more than 12 weeks, or if a person has frequent attacks of sinusitis, they may have chronic sinusitis.
The incidence of this medical condition is very high: chronic sinusitis is one of the most common chronic diseases in the United States, affecting an estimated 33 million people each year.
Signs and symptoms of sinusitis
Although sinusitis theoretically affects only the sinus lining, the symptoms of sinusitis can in fact affect the functioning of your whole body and can make your life miserable.
Some of the most common symptoms that can tell you you could have sinusitis are:
- Nasal congestion that makes it difficult for you to breathe through your nose
- A rynny nose
- A sore throat
- Pain, tenderness and swelling around the eyes, cheeks, nose or forehead (places close to sinuses)
- A headache when you wake up in the morning is a typical sign of a sinus problem
- Loss of smell
- Fever
- Pain in the eyes; the ethmoid sinuses are near the tear ducts in the corner of your eyes. Therefore, inflammation of these cavities often causes swelling of the eyelids and tissues around your eyes, and pain between your eyes.
- Reduced sense of smell or taste
- A cough
- Tooth pain
- Bad breath
- Fatigue
Possible causes of sinusitis
The most common causes of sinusitis are viral, bacterial or fungal infections of the upper respiratory tract, including the numerous viruses that cause the common cold.
The mechanism of infection is simple. When an infection such as a cold inflames and swells the mucous membranes in your nose, the swollen membranes obstruct the sinus openings and keep mucus from draining. This blockage is the critical point! As drainage becomes blocked, the blockage creates an environment in which bacteria and viruses trapped in the sinuses can grow.
Sinus infections are usually (9 out of 10 cases in adults; 5-7 out of 10 cases in children) caused by a virus and they are less commonly (1 out of 10 cases in adults; 3-5 out of 10 cases in children) caused by bacteria. Secondary bacterial infection is also possible.[1]
There are also several other, less frequently seen, causes of sinusitis and they include [1]:
- Allergies. The inflammation that occurs with allergies may easily block the sinuses through the very same mechanism
- A deviated nasal septum. In this condition, the wall between the nostrils, usually called the nasal septum, is crooked or asymmetrical, which may restrict or block the sinus passages, creating a perfect environment for infections as mucus and debris cannot drain well.
- Nasal polyps. Growths within the nostrils called polyps may restrict the nasal passages, slowing drainage and allowing infections to grow.
- Other medical conditions. Several other conditions can affect sinuses also. For example, people with cystic fibrosis or HIV and other immune deficiency diseases are more likely to develop sinusitis compared to healthy individuals.
- Chronic sinusitis - It can be difficult to determine the cause of chronic sinusitis. Some experts think it is an infectious disease, but others are not certain. It is an inflammatory disease that often occurs in people with asthma.
Risk factors for developing sinusitis
- Having asthma
- Overuse of nasal decongestants
- Chronic drug misuse (snorting substances)
- Having a foreign body in your nose
- Frequent swimming or diving
- Dental work
- Pregnancy
- Changes in altitude (flying or diving)
- Air pollution and smoking
- Gastro-esophageal reflux disease (GERD)
- Hospitalization that involves installed nasogastric tube
Complications of sinusitis
The most common complication of sinusitis is a possible aggravation of asthma attack. Severe complications from sinusitis are rare, but the fact is that they can be life-threatening. Most common complications of sinusitis are:
- Meningitis. The infection may spread to the bones of your eyes or to the membranes that protect your brain called meninges, causing severe brain damage. Meningitis can be a fatal condition.
- Vision problems. Although it happens rarely, some patients experience reduced vision or even blindness if the infection spread to their eye socket.
- Blood vessel complications. Infections that spreads to the veins around the sinuses can cause aneurysms and blood clots that interfere with the blood supply to your brain, which can lead to infarctions.
Diagnosis of sinusitis
Because a patient’s nose can get stuffy and runny in many conditions of the upper respiratory tract, such as a common cold or pollen allergies, a patient may confuse simple nasal congestion associated with a cold with sinusitis.
A cold, however, usually lasts about 7 to 14 days and disappears without treatment. Acute sinusitis often lasts longer and typically causes more symptoms than just a cold.
Physical examination, including a detailed medical history, is sometimes enough to make the appropriate diagnosis. If your symptoms are vague or persistent, your health care provider may order a CT (computed tomography) or X-ray scan to confirm that you have sinusitis.
If the doctor can't make the right diagnosis just from physical examination, several other tests may be performed. Laboratory tests to diagnose chronic sinusitis may include:
- Blood tests. These tests are done to rule out other conditions associated with sinusitis like an immune deficiency disorder or cystic fibrosis.
- Cultures. These are special blood tests which are done to detect bacterial or fungal infection.
- Biopsy. A biopsy, in which a tissue sample is taken and examined under a microscope, is done to determine the health state of the cells lining the nasal cavity.
Treatment of sinusitis
Acute sinusitis.
If a person is diagnosed with acute sinusitis, several treatment options could be beneficial. The most common may include the use of decongestants to reduce nasal congestion, antibiotics to control a bacterial infection, if present, and of course pain relievers to reduce any pain you may be experiencing.
Problem is that patients sometimes use over-the-counter or prescription decongestant nose drops and sprays for too long. Nasal sprays should be used for only a few days because they can lead to even more congestion and swelling of nasal passages. Even nasal spray addiction is possible.
If a virus causes sinusitis, then antibiotics will not help and the condition will usually resolve spontaneously in a few days, so do not ask your doctor for antibiotics!
Chronic sinusitis
Doctors often find it difficult to treat chronic sinusitis successfully, because the symptoms persist even after taking antibiotics for an extended period. Many general practitioners are treating chronic sinusitis as though it is an infection, by using antibiotics and decongestants, but not with success. Others use both antibiotics along with steroid nasal sprays.
Treatment options that could relieve some of the symptoms of chronic sinusitis are:
- Inhaling steam from a vaporizer or a hot cup of water
- Saline nasal spray can give relief.
- Gentle heat applied over the inflamed area is comforting.
Surgery for sinusitis
The most common surgery done today is called a functional endoscopic sinus surgery. In this operation, the natural openings in the sinuses are enlarged to allow for better drainage of mucus. This type of surgery is less invasive than conventional sinus surgery, and serious complications are rare. Surgery should be considered only after failure of other treatment options, including medications. [2]
Other types of surgery can correct a bent nasal cartilage, or septal deviation. This operation is called a septoplasty. Other operations can remove nasal polyps that may be the cause of sinusitis.
READ Help For Sinus Pain, Pressure, And Headaches
Tips for the prevention of sinusitis
There are several things that every person could do to reduce the risk of developing sinusitis. Some of these steps are [1]:
- Minimize the risk of upper respiratory infections, which can be done by limiting close contact with people who have colds and washing your hands frequently with soap and water.
- Quit smoking. Tobacco smoke can cause irritation and inflammation of the lining of the sinuses and nose. Inflammation can result in blocked nasal passages.
- Avoid polluted air. Contaminants in the air can irritate and inflame your lungs and nasal passages.
- Use of humidifiers
Self-care for sinusitis
- Steam your sinuses often by inhaling steam several times a day. The steam inhalation therapy will stimulate drainage from the sinuses.
- Warm compresses should be applied daily.
- Every person diagnosed with sinusitis should drink as many fluids as it can because diluting secretions and promoting drainage by consuming additional liquids is very beneficial.
- Don't drink alcohol. Drinking alcohol can worsen the swelling of the lining of the sinuses and nose.
- Have flu vaccinations
- Keep your allergy symptoms under control
- Avoid swimming in pools treated with chlorine, which irritates the lining of the nose and sinuses.