Sinusitis, also known as a sinus infection, is an inflammation or swelling of the tissue lining the sinuses. Sinuses are hollow spaces behind your cheekbones, forehead, and between your eyes that produce mucus to keep the inside of your nose moist and free of dust and germs. When the sinuses become inflamed, they can get blocked and filled with fluid, leading to pressure, pain, and other symptoms.
Causes:
Sinusitis often develops when the sinus openings become blocked, trapping mucus and allowing germs to grow. The main causes include:
- Infections:
- Viral infections: The most common cause of acute sinusitis, often following a common cold or flu.
- Bacterial infections: Can develop if a viral infection lingers and leads to a secondary bacterial infection.
- Fungal infections: Less common but can occur, especially in people with weakened immune systems.
- Allergies: Allergic rhinitis (hay fever) can cause inflammation and swelling of the nasal passages and sinuses, leading to blockage.
- Nasal polyps: Small, noncancerous growths in the nasal passages or sinuses that can block drainage.
- Deviated septum: A displacement of the wall that divides the nostrils, which can narrow one or both nasal passages and obstruct sinus drainage.
- Other conditions:
- Asthma
- Cystic fibrosis
- Immune system disorders
- Dental infections (rarely, can spread to sinuses)
- Exposure to irritants like cigarette smoke or air pollution.
Symptoms:
Symptoms of sinusitis can vary depending on whether it’s acute (lasting less than 4 weeks), subacute (4-12 weeks), or chronic (lasting 12 weeks or longer). Common symptoms include:
- Nasal congestion or stuffiness: Difficulty breathing through the nose.
- Thick, discolored nasal discharge: Often yellow, green, or cloudy.
- Pain, pressure, or tenderness in the face: Especially around the eyes, forehead, cheeks, or nose. This pain may worsen when bending forward.
- Postnasal drip: Mucus dripping down the back of the throat, causing a cough or throat clearing.
- Reduced sense of smell (hyposmia) or taste.
- Headache: Often described as a pressure headache.
- Sore throat.
- Cough: May be worse at night.
- Fatigue.
- Fever: More common with acute bacterial sinusitis.
- Bad breath (halitosis).
- Ear pressure or fullness.
Diagnosis:
Diagnosing sinusitis typically involves a medical history, physical examination, and sometimes specific tests:
- Medical history and physical exam: The doctor will ask about your symptoms, their duration, and any relevant medical conditions. They will examine your nose and face, looking for redness, swelling, or tenderness.
- Nasal endoscopy: A thin, flexible, lighted tube (endoscope) may be inserted into the nose to visualize the nasal passages and sinus openings for inflammation, polyps, or pus.
- Imaging tests:
- CT scan of the sinuses: Provides detailed images of the sinuses and can identify blockages, inflammation, or structural abnormalities. This is often used for chronic or recurrent sinusitis.
- X-rays: Less commonly used for sinusitis diagnosis but may be considered.
- Cultures: Nasal or sinus cultures may be taken to identify the specific bacteria or fungi causing the infection, especially if the infection is severe, persistent, or not responding to treatment.
- Allergy testing: If allergies are suspected as an underlying cause.
Treatment:
Treatment for sinusitis depends on the cause and severity.
- For Acute Viral Sinusitis:
- Symptom relief: Rest, fluids, saline nasal sprays or rinses, over-the-counter pain relievers (e.g., ibuprofen, acetaminophen), and decongestants. Antibiotics are not effective for viral infections.
- For Acute Bacterial Sinusitis:
- Antibiotics: Prescribed if symptoms are severe, worsening, or persist beyond 7-10 days.
- Nasal corticosteroids: Reduce inflammation and help clear blockages.
- Saline nasal rinses: Help clear mucus.
- For Chronic Sinusitis:
- Nasal corticosteroids: Often a long-term treatment to reduce inflammation.
- Saline nasal rinses: Daily use to clear mucus and irritants.
- Antibiotics: May be used for longer durations (e.g., 3-4 weeks) or in low doses for their anti-inflammatory effects.
- Oral corticosteroids: Short courses may be used for severe inflammation.
- Antifungal medications: If a fungal infection is identified.
- Biologic drugs: For severe chronic sinusitis with nasal polyps that doesn’t respond to other treatments.
- Surgery (Endoscopic Sinus Surgery): Considered when medical treatments are ineffective, especially if there are structural blockages like polyps or a deviated septum. Surgery aims to open and enlarge the sinus drainage pathways.
- For Allergic Sinusitis:
- Allergy management: Allergen avoidance, antihistamines, nasal corticosteroids, and potentially allergen immunotherapy.
Managing sinusitis often involves a combination of medical treatments and lifestyle adjustments to reduce inflammation and promote proper sinus drainage. Consulting a healthcare professional is important for accurate diagnosis and an effective treatment plan.
