Sinusitis: Symptoms, Causes and When Surgery Is Required

Sinusitis is a very common medical problem that can happen to people of any age. Sinusitis causes difficulty in day-to-day activities like breathing, sleeping, and even concentrating. Most cases improve with simple home care, but some can become chronic and might lead to serious complications. In this article, we will understand the different types, with their causes and available treatment options.

Table Of Contents

• What is Sinusitis (Sinus Infection)?
• What Are Sinuses?
• Types of Sinusitis
• Signs and Symptoms of Sinusitis
• What Are The Causes of Sinusitis?
• Risk Factors for Sinusitis
• Is Sinusitis Contagious?
• How is Sinusitis Diagnosed?
• Management And Treatment of Sinusitis
• What Are The Best Medications for Sinusitis?
• Can Sinusitis be Prevented?
• When to Consult a Doctor for Sinusitis?
• Conclusion
• Frequently Asked Questions

What is Sinusitis (Sinus Infection)?

Sinusitis is also known as rhinosinusitis. It is an inflammation, swelling, or congestion of the tissue lining inside the skull called sinuses, which are generally filled with air. Bacterial infections and allergies can block them and fill them with fluid. Over time, the mucus increases, disrupting normal drainage. This can cause pressure or pain in the face and nasal congestion or a stuffy nose.

What Are Sinuses?

Sinuses are a pair of four air-filled cavities around the nose, eyes, and forehead. These are connected through narrow passages. Sinuses are responsible for making the skull lighter and also produce mucus, which drains out through the nasal passages. This keeps the nose clean and free of bacteria, allergens and other germs. The sinuses must stay in good shape; otherwise, they can become problematic with bacteria or infection.

Types of Sinusitis

There are four major types of sinusitis:

• Acute sinusitis: This is the most common type of sinusitis, which is usually caused by a virus or bacteria. It happens when the sinuses get infected for less than four weeks. It generally begins as a common cold, and its symptoms fade away within seven to ten days. In some rare cases, people develop a bacterial infection.
• Subacute sinusitis: This sinusitis lasts between four and twelve weeks, and is caused by bacteria, virus or fungus.
• Chronic sinusitis: It is also known as chronic rhinosinusitis; this gets identified when symptoms remain the same for more than twelve weeks regardless of medical treatment. Bacteria, infection, fungus, a deviated nasal septum, nasal polyps, or, in some rare cases, an immune system deficiency can cause it. People who have asthma are more likely to get chronic sinusitis.
• Recurrent acute sinusitis: This happens when a person has four or more acute sinusitis episodes in one year, lasting less than two weeks every time.

Other types of sinusitis:

• Pansinusitis: This type of sinusitis causes inflammation in all four pairs of the sinuses.
• Odontogenic sinusitis: This condition is caused by an infection in teeth and gums.
• Allergic fungal sinusitis: This condition is caused by an allergic reaction to a fungus.
• Sphenoid sinusitis: This condition affects the sinuses located deep behind the nose, known as the sphenoid sinuses.

Signs and Symptoms of Sinusitis

Some common signs and symptoms of sinusitis can include:

• Cloudy discoloured nasal or postnasal drip (mucus drips down the throat).
• Thick yellow or green discharge from the nose.
• Facial pressure, especially around the nose, eyes and forehead.
• Bad breath or a bad taste in the mouth.
• Blocked or stuffy nose.
• Toothache.
• Reduced sense of smell.
• Fever.
• Cough.
• Headache.
• Tiredness.
• Sore throat.

What Are The Causes of Sinusitis?

Sinusitis is mostly caused by a cold or flu virus spreading to the sinuses from upper airways. In some cases, it can also be caused by an infected tooth, bacteria, or fungal infections.

Long-lasting sinusitis causes can be associated with:

• Mechanical obstruction: Deviated septum, or any swellings within the nose like nasal polyps.
• Focal infection: Common cold, nasal infections, adenotonsillitis, dental extraction, Streptococcus pneumoniae bacteria, Haemophilus influenzae bacteria, Moraxella catarrhalis bacteria, dust or pollution exposure.
• Allergies: Allergic conditions like asthma and hay fever.
• Immunodeficiency: A weak immune system.
• Autonomic imbalance: Emotional disturbances, stress, thermal changes, change in humidity.
• Hormones: Hormonal fluctuations due to pregnancy, puberty, or hypothyroidism.

Risk Factors for Sinusitis?

The risk of having chronic sinusitis increases due to the reasons mentioned below:

• A deviated septum
• Nasal polyps
• Asthma
• Aspirin sensitivity
• Dental infection
• Immune system disorders like HIV/AIDS or cystic fibrosis
• Hay fever or another allergic condition
• Smoking

Is Sinusitis Contagious?

Sinusitis by itself is not contagious, but the virus or bacteria causing sinusitis can be contagious. It’s advised to stay hygienic by washing hands regularly, staying away from others while being sick, and covering the mouth and nose with the elbow while coughing or sneezing.

How is Sinusitis Diagnosed?

Doctors diagnose sinusitis based on the symptoms and medical history. Doctors can check the ears, nose and throat for swelling, drainage, or blockage. They might use a small lighted instrument called an endoscope to have a look inside the nose. After examination, if required, doctors can also recommend patients to a specialist, like an otolaryngologist, also known as an ENT.

Doctors might recommend one or more of the following tests to diagnose sinusitis:

• Nasal Endoscopy: A flexible and thin tube with light and a camera is inserted into the nose to examine sinuses in detail.
• Nasal Swab: Mucus is collected from the nose with the help of a soft cotton swab. The sample is then tested for viruses and bacteria that might be causing the infection.
• CT Scan: If required, doctors may recommend a CT scan, which provides detailed images of the sinuses and helps detect blockages, inflammation, or other structural problems leading to sinusitis.
• Allergy Testing: For people suffering from chronic sinusitis, certain allergy tests could be helpful to identify the reasons.
• Biopsy: In some rare cases, doctors can collect a small tissue sample from the nose for testing.

Management And Treatment of Sinusitis

Treatment options for sinusitis depend on the symptoms and how long they last.

People can treat sinusitis at home with:

• Decongestants
• Over-the-counter cold and allergy medications.
• Nasal saline rinses.
• Drinking plenty of fluids.

If the symptoms of sinusitis do not improve after ten days, the doctor can prescribe:

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• Oral or topical decongestants.
• Prescription intranasal steroid sprays.

Doctors can also treat chronic sinusitis by focusing on underlying conditions, where the treatment options can include:

• Intranasal steroid sprays
• Topical antihistamine sprays or oral pills
• Leukotriene antagonists
• In some cases, if required, surgery to treat structural problems, polyps or fungal infections.

Can Sinusitis be Prevented?

Depending on the reasons, there are a few ways to reduce the risk of having sinusitis, such as:

• Rinse your nose with salt water as instructed by the doctor.
• Taking allergy preventive steps, which include medications, allergy shots and avoiding dust, pollen or smoke.
• Using steroid nasal sprays as per the doctor’s recommendation.
• Maintaining good hygiene.
• And by avoiding smoking.

When to Consult a Doctor for Sinusitis?

Mostly sinusitis gets treated on its own. But a doctor’s intervention is required in cases where people are experiencing symptoms of a serious infection like:

• Having continuous high fever (over 103 degrees Fahrenheit/40 degrees Celsius).
• Having confusion or other mental changes.
• In case their vision changes, especially if they have pain or swelling around their eyes.
• In case of having seizures.
• When they are having a stiff neck.

Conclusion

Sinusitis can be uncomfortable and frustrating, especially when they interfere with sleep, work, or daily activities. With proper diagnosis and treatment, patients can possibly recover quickly. Hence, it is advised to pay close attention to symptoms and immediately contact medical help. This can reduce discomfort and prevent complications of any sort.

Frequently Asked Questions

Q1. When does sinusitis require surgery?

Ans. Sinus surgery is generally advised when the condition seems severe or if there’s a structural blockage which does not improve even after medication.

Q2. Is sinus surgery low risk?

Ans. Sinus surgery rarely has complications, but post-surgery, patients may sometimes experience minimal bleeding.

Q3. What is the best age for sinus surgery?

Ans. It is best for children over the age of 6, and can also be done at any age if the complication seems to be a bit too much.

Q4. At what age does sinusitis start?

Ans. Sinusitis in the forehead and behind the eyes usually don’t start developing until after 7 years.

Q5. How to prevent sinusitis infection naturally?

Ans. Saline nasal rinses, steam inhalation, and staying hydrated are some ways to prevent sinus infection naturally.