Sinuses are the empty spaces, that are located behind cheek bones, nose and forehead just above eyes close to the nose bridge.

Sinuses function primarily by providing warmth, mucus to the nasal cavity, to protect nose from dirt, microorganisms and pollutants from the outside air. They also help with the voice of individuals, as they lighten the skull.

Sinusitis is an inflammation of the inner lining of sinuses, that may block their opening into nose, leading to the trapped mucus inside sinuses, in turn promoting growth of viruses, bacteria inside the sinus cavities.

It is caused most commonly by viruses but may also be caused by bacteria and allergy to pollutants, irritants, etc.

It most frequently affects young, middle aged adults and children.

RISK FACTORS:

  1. Respiratory tract infection such as cold, flu, etc.
  2. Allergy to pollutants, irritants, etc., bronchial asthma, hay fever.
  3. Nasal polyps, nasal masses.
  4. Structural problems of sinuses such as deviated nasal septum.
  5. Lowered immunity due to recurrent infections, HIV, chemotherapy, etc.
  6. Chronic smoking.

For children

  1. Frequent use of pacifier.
  2. Feeding from a bottle in a lying down position.

SYMPTOMS:

Most common symptoms are

  1. Stuffy/blocked nose causing decreased sense of smell, difficulty in breathing, mouth breathing.
  2. Headache and pain, pressure with swelling over cheeks and forehead (puffiness of face with tenderness).
  3. Mucus, thick, yellow-green discolored nasal discharge with post nasal drip.
  4. Sore throat.
  5. Cough.
  6. Fever.
  7. Bad breath.
  8. Fatigue, generalized weakness and body ache.

Acute sinusitis caused by virus may generally subside in about 7-10 days.

If the symptoms last for more than 7-10 days or recurs, it could be due to allergy, a bacterial infection, low immunity.

Chronic sinusitis is when the symptoms last for more than 3 months, with episodes of about 4 in a year.

DIAGNOSIS:

Acute sinusitis can be diagnosed based on symptoms, physical examination by the doctor usually.

However, a swab may be collected from inside of nose and culture, allergy test may be done to confirm/rule out bacterial infection, allergy respectively. These are only done when the symptoms are chronic and don’t subside with self-care and over the counter medications.

Nasal endoscopy, CT/MRI scan that may help to diagnose polyps, masses in sinuses, deviated nasal septum, etc.

TREATMENT:

Relief from symptoms by self-care, measures at home, over the counter medications are the primary mode of approach in the treatment of sinusitis as it is most commonly caused by virus.

  • Avoiding factors, allergens, etc. that may aggravate symptoms.
  • Plenty of rest and hydration by drinking water of at least 2-3 liters or more every day, intake of fluids, juices.
  • Placing a humidifier in the room to keep the air and surrounding environment moist, to avoid dry air around.
  • Using a vaporizer.
  • Steam inhalation, drinking warm fluids such as soups help in loosening the thick mucus discharge and hence, in its drainage.
  • Warm, salt water gargles help in soothing the throat.
  • Warm compresses, hot packs over cheeks, forehead may help in giving relief from headache, pressure over sinuses, swelling.
  • Over the counter medications such as acetaminophen, ibuprofen, decongestant tablets and nasal sprays.
  • Over the counter antihistamine medications, sprays for allergy.
  • Prescribed antibiotic medications for bacterial sinusitis.
  • Prescribed oral, nasal steroid medications help with recurrent, chronic sinusitis.
  • When none of the treatment options work, FESS (Functional Endoscopic Sinus Surgery) may be done to remove the block between nose and sinuses, removal of polyp in sinuses.

References:

https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/sinus-infection.html

https://www.cdc.gov/antibiotic-use/community/for-patients/symptom-relief.html

https://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/symptoms-causes/syc-20351661

https://www.nhs.uk/conditions/sinusitis-sinus-infection/

http://www.aaaai.org/conditions-and-treatments/allergies/sinusitis

http://www.who.int/respiratory/other/Rhinitis_sinusitis/en/

– Dr. Divya Teja Pasupuleti

 

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