Sinusitis: Causes, Symptoms, Treatment and Prevention

What are Sinuses

The human skull is like a shell made of thin bones containing cavities. Some of these cavities are occupied by structures like the brain, eyes, ears, nose, while others are air-filled spaces that communicate with the nose through tiny windows. These air-filled spaces cause an echo effect which gives volume to the human voice, similar to speaking into an earthenware pot.

What is Sinusitis

It is a condition in which the soft lining of the sinuses gets swollen and the tiny windows to the nose get blocked which leads to production and accumulation of fluid in the sinuses. Further, this fluid gets infected by bacteria and viruses.

What causes sinusitis 

Some common causes of sinusitis are- common cold, allergies, nasal polyps (soft grapelike swelling of the lining of the sinuses), or a crooked nose bone blocking the nose.

Also read: Natural and Effective Remedies for Sinus you Can Rely upon

Symptoms of a sinus infection

Sudden start-up of cold-like symptoms with a stuffy nose and pain in some area of the face that lasts more than 10 days are the first visible symptoms of sinus infection.

• Acute sinusitis lasts 10 to 14 days with two or more symptoms and yellow-green or opaque nasal discharge 
• Sub-acute sinusitis lasts 4 to 8 weeks
• Chronic sinusitis lasts for 8 weeks or longer with symptoms like swelling on the nose, pus in the nose and fever 
• Recurrent sinusitis is when several attacks occur within a year or symptoms lasting more than 12 months

Usual symptoms include 

• Facial pain/pressure, dull constant aching pain, worse when bending over or lying down, often starting on one side of the head and progressing to both sides of the head
• Nasal stuffiness
• Nasal discharge, seen both in acute and chronic sinusitis, may be yellow or green in colour and may contain blood or pus
• Loss of smell
• Cough/congestion
• Fever
• Bad breath
• Fatigue
• Dental pain
• Infection of the eye sockets with loss of vision accompanied by fever and severe illness.
• Another serious complication is infection of the bones (osteomyelitis) of the forehead and face

Conditions that predispose to sinusitis

• Recurrent colds or allergies with a stuffy nose
• Changes in the size of windows opening from the sinuses to the nose, maybe from birth or because of infections
• Polyps in the nose
• Decreased immunity either from birth or acquired from the use of medications like steroids and anticancer medications
• Smoking 
• Asthma 
• Cystic fibrosis which is a hereditary disorder producing very thick mucus in the nose and lungs
• In children commonly allergies, infections acquired from other children at daycare or school, pacifiers, drinking from bottles while lying on the back, and smoke or dust in the environment
• Most cases are viral infections, but bacterial infections are suspected if the symptoms last more than 10 days

Diagnosis 

The diagnosis is usually done by history of the illness combined with an examination by a doctor confirmed by CT scans or X-ray’s mucus cultures and if required an endoscopy is done in which tiny camera and lights are used to look into the nose.

Also read: Curing Sinus with the Help of Ayurveda

Treatment

Medical treatment by antibiotics, antiallergics, painkillers, nasal drops and sprays and if required steroids and immunoglobulins to boost immunity. The selection of medications and dosages of each will vary depending on the doctor’s assessment of the case. Self-medication with over the counter prescriptions can often worsen acute sinusitis or make it chronic.

Self-help   

• Avoiding anything known to cause you allergies including foods, deo sprays, air fresheners and other strong- smelling compounds that irritate the nose
• Steam inhalation 
• Avoid smoking and drinking as much as possible
• Drink warm soups and fluids to help thin out the mucus
• Walk for 15 minutes a day or practice deep breathing exercises in the morning or evening to increase airflow through the nose and sinuses
• Avoid sitting under a fan with wet hair or in front of an air conditioner

When is surgery indicated 

If medical treatments fail repeatedly and a blockage of the windows into the sinuses or a crooked nose bone or polyps are found on examination, endoscopic sinus surgery and septoplasty or a new technique called balloon sinuplasty are indicated. Patients can resume work in two to five days after surgery.

What happens if sinusitis is not treated

It may resolve or become chronic or may progress to complications like an infection of the brain and skull bones or the sockets of the eyes leading to visual disturbances, which makes treatment longer, more expensive and extensive surgical corrections.

Inputs by Dr Dillon Dsouza , Consultant ENT and Head and Neck surgeon, attached to Jaslok hospital, Breach Candy hospital and Desas hospital.

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