Sinusitis

Sinusitis – General Information

Normally, there are two major types of Sinusitis, acute and chronic. The sinuses are cavities filled with air that are located around the nasal passages. When these passages suffer an inflammation, a type of fluid accumulates and affects the normal drainage of the mucus in the sinuses. This is known as the acute form of the condition. The disease can cause difficulties with breathing through the nose, or when the patient leans forward he may experience facial pain. In most cases, in addition to pain, the patient may also experience symptoms such as headache, fever and nagging cough. Usually, this form of Sinusitis is caused by a virus, but there are also cases in which the condition is provoked by certain bacteria or allergies.

Treatment for this disease is applied differently depending on the cause, and may include antibiotics for bacterial conditions or oral corticosteroids for acute inflammation. The chronic form of Sinusitis starts with an inflammation of the mucous membranes located in the patient’s sinuses. This inflammation leads to an accumulation of fluid preventing normal mucus drainage. If not treated properly, it may cause severe infections of the upper respiratory system that may include the nose, pharynx, sinuses and throat. There are also other causes for this affection, such as a certain type of allergy, deviated nasal septum or the presence of mold or fungi inside the sinuses.

Sinusitis – Symptoms

In most cases, Sinusitis appears when the mucus membranes of the patient’s respiratory system, including the nose, sinuses or throat, become inflamed. This inflammation can obstruct the sinus openings leading to difficulties in draining the mucus. This creates a proper environment for infection development. The cause of the disease is usually viral, but there are cases in which the condition may be triggered by bacteria or fungi. The difference between these forms consists in the prolonged period (longer than two weeks) of manifestation and evolution of the bacterial form. There are also other causes, considered non infectious, that may lead to Sinusitis. These include allergies, which may lead to a blocking of the sinuses; deviated nasal septum, which can restrict or block the sinus openings; nasal polyps, which can also block the sinuses; certain diseases such as cystic fibrosis, gastroesophageal reflux, HIV and other immunodeficiency disorders.

In most cases, smoking can worsen the patient’s condition because the sinus openings become exposed to polluted air, leading to a more severe inflammation. The most common signs and symptoms caused by Sinusitis also include facial pain, fever, pain and swelling of the tissue that surrounds the nose, eyes, cheeks and forehead, erythema, which is characterized by redness of the skin in the sinus area, nasal congestion, reduced sense of smell, difficulty breathing, dental pain, cough, halitosis, fatigue, sore throat and nausea. The signs and symptoms caused by the chronic form are similar to the ones caused by the acute form, only they last longer.

Sinusitis – Treatment

The diagnosis of Sinusitis must be made in the first stages of the affection in order to prevent any complications and is placed after gathering the patient’s medical history and applying certain imaging studies and laboratory examinations. In most cases, the first step in diagnosing the disease is reporting the signs and symptoms the patient is experiencing. The doctor may also ask the patient about any recent cold or allergies that he had suffered from, and especially if he is smoking or has been exposed to cigarette smoke. During the examination, the doctor may also check for any tenderness of the patient’s nose or throat, and insert a light source into the nasal passages to observe any possible inflammation or secretion. It is very important that the physical exams are made first because they can help ruling out other conditions that can cause Sinusitis to develop, such as nasal polyps or deviated nasal septum. Some doctors can perform a full computerized tomography of the patient’s sinuses to search for inflammation, but this procedure requires a longer period of time. In most cases, treatment for Sinusitis is applied differently depending on the form of the disease the patient is suffering from. For the acute form of the disease, the most effective treatment option is the use of over the counter medicines. These types of drugs can provide symptom relief, treating headaches, pressure, fatigue and pain. It is very important to consult with the health care provider before starting any type of therapy.

There are cases in which doctors can recommend analgesics such as Aspirin or Paracetamol to relieve the pain, but it is very important for the doctor to check first if the patient does not also suffer from AERD (Aspirin exacerbated respiratory disease), because in such cases Aspirin administration can cause severe complications such as anaphylaxis. If a patient diagnosed with the acute form of Sinusitis does not respond to therapy in the first 48 hours after applying the treatment, doctors should administrate a full treatment with antibiotics, preferably Amoxicillin. If the patient is allergic to these medicines, doctors can prescribe Fluoroquinolones and Doxycycline. For the chronic form of Sinusitis the first treatment option is nasal irrigation and flushing, which may provide relief from facial pain, headache, halitosis, cough, anterior rhinorrhea and nasal congestion. In some cases, doctors may employ the use of bulb syringes, squirt bottles and neti pots. These may be used in order to remove bacteria and secretions and to help restoring the normal functioning of the sinuses. There are cases in which the doctor may apply nasal irrigation to control the condition, along with medication therapy. It is very important to treat the condition in the first stages of evolution to prevent any severe complications and to increase the patient’s chances for full recovery. If the disease is not treated properly, or even not treated at all, the patient can develop serious complications that can cause permanent damage of the sinus tissues, leading to permanent breathing dysfunctions and improper nasal drainage. Also, the doctor’s advices must be followed strictly. For further information regarding the most effective therapy options against this medical condition, contact your physician.