Sinusitis

Sinusitis is a common inflammation of the paranasal sinuses, the cavities that produce the mucus necessary for the nasal passages to work effectively.

It can be acute or chronic, and it can be caused by viruses, bacteria, fungi, allergies, or even an autoimmune reaction. Although uncomfortable and painful, sinusitis often goes away without medical intervention. However, if symptoms last more than 7 to 10 days, or if there is a fever or a bad headache, you should see your doctor. In 2015, the Centers for Disease Control and Prevention (CDC) noted that 12.1 percent of adults surveyed in the United States (U.S.) had been diagnosed with sinusitis in the previous 12 months.

Fast facts on sinusitis

Here are some key points about sinusitis. More detail is in the main article.

• People have four pairs of sinuses, hollow spaces behind the bones of the face.
• Allergies, bacteria or a virus can cause inflammation of the sinuses, or sinusitis.
• It usually goes away without treatment, but sometimes medical attention is needed.
• Chronic sinusitis lasts more than 12 weeks.

A sinus is a hollow space in the body. There are many types of sinus, but sinusitis affects the paranasal sinuses, the spaces behind the face that lead to the nasal cavity. The paranasal sinuses have the same mucous membrane lining as the nose.They produce a slimy secretion called mucus. This keeps the nasal passages moist and traps dirt particles and germs. Sinusitis occurs when mucus builds up and the sinuses become inflamed. Doctors often refer to sinusitis as rhinosinusitus, because inflammation of the sinuses nearly always occurs with inflammation of the nose known as rhinitis.

Symptoms

Symptoms vary, depending on the length and severity of the infection. If the patient has two or more of the following symptoms and thick, green or yellow nasal discharge, they may be diagnosed with acute sinusitis.

• facial pain and pressure
• blocked nose
• nasal discharge
• reduced sense of smell
• congestion
• cough

In more advanced cases, the following symptoms may also be present:

• fever
• halitosis, or foul-smelling breath
• tiredness
• toothache
• headache

If these symptoms continue for 12 weeks or longer, the doctor may diagnose chronic sinusitis.

Causes

Sinusitis can stem from various factors, but it always results from fluid becoming trapped in the sinuses. This fuels the growth of germs.

• Viruses: In adults, 90 percent cases of sinusitis result from a virus
• Bacteria: In adults, 1 case in 10 is caused by bacteria
• Pollutants: Chemicals or irritants in the air can trigger a buildup of mucus
  • Fungi: The sinuses either react to fungi in the air, as in allergic fungal sinusitis (AFS), or they are invaded by fungi, as in chronic indolent sinusitis. This is rare in the U.S.

Most acute cases will resolve without treatment. However, sinusitis can be uncomfortable, so people often use home remedies and over-the-counter (OTC) medications to relieve symptoms.In the following cases, the person should see a doctor:

• Symptoms persist longer than 7 to 10 days.
• There is a fever higher than 101.5° Fahrenheit, or around 38.6° Celsius.
• There is a bad headache that does not resolve with over-the-counter (OTC) drugs.
• Visual disturbances occur, or there is swelling around the eyes.
• Symptoms continue after taking antibiotics prescribed by a physician.

If the sinusitis has a bacterial cause, a doctor may prescribe antibiotics. If symptoms remain after the course of medication is finished, the individual should return to the doctor.

Chronic sinusitis

Chronic sinusitis is not usually bacterial in nature, so antibiotics are unlikely to resolve symptoms. A fungal infection can be treated with antifungal drugs. Corticosteroid sprays can help in recurrent cases, but these need a prescription and medical supervision. In allergic sinusitis, treating allergies with shots or reducing and avoiding exposure to allergens like animal dander or mold can lessen the occurrence of chronic sinusitis.

Surgery

Structural issues, such as a deviated septum, may need surgery. Surgery may also be advised if there are polyps, or if the sinusitis has resisted all other treatments.

Functional endoscopic sinus surgery (FESS) is the main procedure used for treatment, but other surgeries may be required as other parts of the nose are often affected. If a deviated septum is causing recurrent infections, for example, a septoplasty will be used to straighten out this bone and cartilage.

Treatment may still be required following surgery to prevent the return of sinusitis.

Surgery should always be the last resort on sinusitis in children, and obtaining a second opinion is recommended before proceeding.

Insurers may require patients to provide in-depth evidence to ensure that the surgery is for sinusitis and not for cosmetic surgery, to improve the appearance of the nose.

Prevention

The following may help prevent sinusitis:

• Practice good hand hygiene.
• Avoid smoking and second-hand smoke.
• Keep vaccinations up to date.
• Stay away from people with colds and other respiratory infections.
• Use a humidifier to moisten the air at home, and keep it clean. A selection of humidifiers is available for purchase online.
• Maintain air conditioning units to prevent mold and dust from collecting.
• Where possible, avoid allergens.

Home remedies

Less severe or recurrent cases of sinusitis can be treated at home without the need to visit a doctor. These remedies can reduce pain and unblock the sinuses to allow proper drainage.

Home remedies for sinusitis include:

• Nasal irrigation: Also known as sinus irrigation, sinus rinse, or sinus lavage, this home procedure involves rinsing and clearing the nasal passages with salt water or a saline solution.
• Warm compress: Applying a warm compress gently to the affected areas of the face can relieve some swelling and discomfort.
• Painkillers: These can reduce symptoms of pain and fever.
• Steam inhalation: Breathing hot, moist air can provide relief from congestion. At home, steam from a bowl of hot water, possibly with some drops of essential menthol or eucalyptus oil, can help unblock the sinuses. Essential oils should not be applied directly or swallowed.
• Decongestant tablets and sprays: These may reduce swelling and allow the sinuses to drain. Patients should not use sprays for more than 3 days. Decongestant tablets and sprays are available to purchase online.
• Hydration and rest: Drinking fluids regularly and avoiding overexertion can help the symptoms to pass.

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