Sinusitis is the infection and inflammation of the mucous membrane that lines the nose and paranasal sinuses. As explained in the general content of Nose Care, these are air cavities located in the bones of the face, known as the frontal, ethmoid, maxillary, and sphenoid sinuses. Under normal conditions, mucus can drain and air can circulate through the sinuses, but sinusitis can cause the hairs that filter inspired nasal air to fail to evacuate mucus or the exit holes to become blocked and filled with mucus. This is a fairly common infection and can be caused by bacteria, viruses, or fungi. Among other symptoms, it causes nasal obstruction and/or congestion, loss of smell or inability to detect odors, nasal discharge, and facial pain or pressure. This condition is one of the most common reasons for medical consultations and affects both children and adults. For expert and effective care, patients choose a private clinic, such as Consultant ENT.
What are its causes?
Sinusitis can be caused by a variety of factors:
The cilia, also called vibrissae, which are the hairs found in the nasal passages, are unable to extract mucus properly.
Colds or allergies can cause excessive mucus production—thicker and more viscous—or inflame the mucous membrane, narrowing or blocking the opening of the sinuses and preventing mucus drainage.
According to the Spanish Association of Pediatrics, viral infections predispose the development of bacterial sinusitis in 80% of cases, while the remaining 20% have an allergic component.
A deviated nasal septum or polyps inside the nose can block the opening of the sinuses.
Are there risk factors?
Therefore, the following risk factors increase the risk of suffering from sinusitis
Acute upper respiratory colds of viral origin.
Suffering from allergic rhinitis, especially during its most intense periods.
Diseases such as cystic fibrosis.
Anatomical obstructions such as a deviated nasal septum, adenoid hypertrophy (enlarged pharyngeal tonsils), or nasal polyps.
Irritants such as tobacco (passive smokers are also at greater risk), chlorinated water in swimming pools, air conditioning, etc.
Having a weakened immune system due to HIV or chemotherapy.
Sudden changes in atmospheric pressure (flying or diving).
What symptoms does sinusitis cause?
Among the most common symptoms of sinusitis, which often appear after a cold, are:
Fever
Cough during the day, which may worsen at night.
Puffy eyes, especially in the morning.
Nasal obstruction.
Loss of smell (hyposmia), decreased sense of smell, or inability to detect odors (anosmia).
Heavy flow of nasal mucus (rhinorrhea).
Fatigue and a general feeling of malaise.
Headache.
Pain or pressure behind the eyes , toothache , or facial sensitivity .
Nasal congestion and discharge.
Sore throat and postnasal drip.
Difficulty breathing.
What types of sinusitis are there?
This infection can be:
Acute: Symptoms last up to four weeks.
Subacute: The illness lasts from four weeks to three months.
Chronic: The inflammation lasts for more than three months. Its symptoms are similar to those of acute sinusitis, but they tend to be milder and are not usually accompanied by fever.
On the other hand, depending on its location, sinusitis can be frontal, maxillary, ethmoid, and sphenoid, or pansinusitis, if all the paranasal sinuses are affected.
What complications can sinusitis cause?
The chronic nature of sinusitis itself should be considered a complication, which may require surgical treatment.
In addition, although rare, the following complications may occur:
Skin infection around the eye (orbital cellulitis). The infection spreads to the orbit and central nervous system. This is a very serious condition.
If it spreads to the central nervous system, which is more likely if sinusitis affects the frontal or ethmoid sinuses, meningitis, encephalitis, or intracerebral abscesses may develop, requiring hospital diagnosis and treatment.
Septic cavernous sinus thrombosis. This is a very serious complication, the likelihood of which increases with infection in the ethmoid and sphenoid sinuses.
How is sinusitis diagnosed?
The diagnosis of sinusitis is clinical and is made based on the patient's medical history and physical examination. This is based on palpation of the sinus areas and anterior rhinoscopy, preferably endoscopic. There are clearly defined criteria that confirm the diagnosis of sinusitis:
The presentation of a respiratory infection lasting seven days.
The presence of two or more of the following symptoms: purulent nasal discharge, response to decongestants, facial pain or pain in sinus areas that worsens with postural changes, headache, and, finally, others such as fever, personal history of sinusitis, toothache, or anatomical alterations (nasal polyps, deviated nasal septum, etc.).
In general, imaging tests are not necessary for diagnosis; they are usually performed only to detect possible complications. The most convenient is a computed tomography (CT) scan of the breasts. Plain X-rays have low sensitivity and can therefore produce false positives and negatives.
Finally, microbiological studies may be necessary in cases of poor outcome, complications, immunosuppression, or suspected atypical germs.
How is sinusitis treated?
With pharmacological treatment. The goal of draining the sinuses is to combine antibiotics, anti-inflammatory drugs, and topical medication to open the sinuses and facilitate mucus evacuation.
To relieve pain, a nonsteroidal anti-inflammatory drug such as ibuprofen and an analgesic-antipyretic such as paracetamol can be used. Applying local heat to the affected breast can also be effective.
Similarly, a nasal spray containing ephedrine or pseudoephedrine may be prescribed to facilitate sinus drainage, followed by nasal lavage with saline solution, which helps eliminate secretions.
The use of topical nasal corticosteroids is also recommended, while antihistamines are only indicated for allergic patients. Mucolytics may help reduce mucus viscosity, and vapors may also be prescribed. Finally, in complicated cases and chronic sinusitis confirmed by a CT scan that persists despite treatment, endoscopic surgery may be used.
10 keys to preventing sinusitis
Although this condition has a good prognosis, it is essential to prevent it by avoiding the most common risk factors, such as the flu and colds:
1. Drink plenty of water throughout the day
Keeping your body hydrated is key to increasing your body's moisture content and, therefore, also that of your sinuses. To achieve this, aim to drink between 1.5 and 3 liters of water a day.
2. Don't smoke and avoid smoky environment
Tobacco contains many irritants and weakens the immune system. Also, avoid other irritants like chlorine and direct exposure to air conditioning.
3. Avoid dry air
Control the temperature and humidity in your home to increase the humidity in your nose. Humidifiers can help you achieve this.
4. Avoid extreme temperatures
Avoid sudden changes in temperature or blood pressure, especially if you have a cold or chronic sinusitis. You should also avoid leaning forward with your head down, and if possible, sleep with the head of your bed elevated.
5. Wash your hands frequently
especially after returning from a walk, before eating, or after contact with sick people, to keep infection-causing germs at bay. Do this thoroughly with soap and warm water, or with an alcohol-based hand rub, for at least fifteen seconds.
6. Get vaccinated against the flu
Especially if you belong to any risk group, as doing so significantly reduces your chances of contracting the infection.
7. When you get a cold, take action as soon as possible
Quickly relieve flu and cold symptoms to prevent mucus buildup. If necessary, take decongestants, and if your cold doesn't improve, see your doctor.
8. Treat allergies appropriately
Likewise, if you notice allergy symptoms, see your primary care physician or allergist as soon as possible. They will advise you on the steps to take and the most appropriate treatment for your case.
9. Use steam
Steaming with water vapor or eucalyptus can help facilitate drainage.
10. Follow the prescribed treatment faithfully
Follow the recommendations your sinus surgery specialist has given you for pain relief or other symptoms of this condition to prevent the disease from becoming chronic or developing complications. And never self-medicate with antibiotics.
