Dr. Tariq Jagnarine
Family Medicine/Endocrinology
The sinuses are small air pockets located between the eyes and behind the forehead, nose, and cheekbones. When the sinuses and nasal passages become inflamed, the condition is known as sinusitis. The terms “sinusitis” and “sinus infection” are sometimes used interchangeably.
A sinus infection is a very common condition. Inflammation can occur because of conditions such as structural issues in the nose, or a sinus infection. According to the American College of Allergy, Asthma & Immunology, sinus infections affect 31 million people in the United States each year.
SINUSITIS RISK FACTORS
Sinusitis often occurs when something, such as mucus, blocks the openings of the sinuses. Anyone can develop sinusitis, or a sinus infection. However, certain health conditions and risk factors can increase the chances.
Possible contributors to sinusitis include:
• Structural issues affecting the nose, such as:
o Deviated septum, which occurs when the wall of tissue that runs between the left and right nostrils is uneven
o Nasal bone spur, or growth
o Nasal polyps, which are usually noncancerous
• Weakened immune system
• History of allergies
• Colds and other upper respiratory tract infections, which can be caused by viruses, bacteria, or fungi
• Cystic fibrosis, which causes thick mucus to build up in the lungs and other mucous membrane linings
• Mould exposure
• Tobacco smoking
• Dental infection
• Aeroplane travel, which can expose you to a high concentration of germs
Sometimes a cold, allergens or bacteria can cause too much mucus to form. This mucus build-up can become thick and encourage bacteria and other germs to build up in the sinus cavity, eventually leading to a sinus infection.
SINUSITIS TYPES
There are different types of sinusitis, and they all have similar symptoms. The severity and duration of the symptoms would vary.
• Acute sinusitis
Acute sinusitis has the shortest duration. It may last up to 4 weeks. A viral infection brought on by the common cold can cause symptoms that typically last up to 10 days. Viral infections eventually lead to most cases of acute sinusitis, but seasonal allergies are another possible source.
• Subacute sinusitis
Subacute sinusitis symptoms can last up to 12 weeks. This condition commonly occurs with seasonal allergies or bacterial infections.
• Recurrent acute sinusitis
In recurrent acute sinusitis, you have at least four episodes of acute sinusitis over the course of 1 year. Each episode of acute sinusitis must last at least 7 days.
• Chronic sinusitis
Symptoms of chronic sinusitis last for more than 12 weeks. Chronic sinusitis symptoms are often less severe than acute sinusitis symptoms, and fever is rare. Bacterial infection may be to blame in these cases. Additionally, chronic sinusitis commonly occurs alongside persistent allergies or structural nasal issues.
SINUSITIS SYMPTOMS
The symptoms of sinusitis are similar to those of a common cold. They may include:
• Decreased sense of smell
• Fever
• Stuffy or runny nose
• Headache from sinus pressure
• Fatigue
• Cough
It may be difficult for caregivers to detect sinusitis in a child. Signs include:
• Cold symptoms that do not improve within 10 to 14 days
• Allergy symptoms that do not respond to medication
• Lingering cough
• Fever above 102.2°F (39°C), which is considered a high fever
• Thick green or yellow mucus coming from the nose
SINUSITIS DIAGNOSIS
A doctor would ask about the symptoms, and perform a physical exam before making a diagnosis. The doctor may check for pressure and tenderness by pressing a finger against the head and cheeks, and may also examine the inside of the nose to look for signs of inflammation. In most cases, the doctor can diagnose sinusitis based on the symptoms and the results of a physical exam.
In the case of chronic sinusitis, the doctor may recommend imaging tests to examine the sinuses and nasal passages. These tests can reveal mucus blockages and any abnormal structures, such as polyps.
• Allergy tests. An allergy test identifies environmental factors that may cause an allergic reaction.
• Blood tests. A blood test can check for conditions that weaken the immune system, such as HIV.
SINUSITIS TREATMENT
Most sinusitis cases are caused by viral infections, and may not require treatment. Over-the-counter (OTC) medications and home remedies may help ease the symptoms, though.
Nasal congestion
Nasal congestion is one of the most common symptoms of sinusitis. Try these tips to help reduce nasal congestion:
• To help relieve the feeling of pain from sinus pressure, apply a warm, damp cloth to the face and forehead several times a day.
• Perform a nasal saline rinse to help clear the thick and sticky mucus from the nose.
• Drink water and juice to stay hydrated and help thin the mucus; use an OTC medication, such as guaifenesin, that thins mucus.
• Use a humidifier in the bedroom to add moisture to the air. Turn on the shower and sit in the bathroom with the door closed to surround yourself with steam.
• Consider using an OTC nasal corticosteroid spray. There are decongestants available over the counter.
Pain medications
In rare cases, sinusitis can trigger a sinus headache or pressure in the forehead and cheeks. OTC medications such as Tylenol and ibuprofen can help.
Antibiotics
If the symptoms do not improve within a few weeks, it is likely a bacterial infection. Antibiotic therapy is needed if persons have symptoms that do not improve, including:
• Runny nose
• Congestion
• Cough
• Continued facial pain or headaches
• Eye swelling
• Fever
Surgery
If the chronic sinusitis does not improve with time and medication, persons may undergo surgery to:
• Clear the sinuses
• Repair a deviated septum
• Remove polyps
SINUSITIS PREVENTION
Because sinusitis can develop after a cold, the flu, or an allergic reaction, following a health-promoting lifestyle and reducing exposure to germs and allergens can help prevent this inflammation. To reduce the risk, people can:
• Get a flu shot every year.
• Eat nutritious foods, such as fruits and vegetables.
• Wash the hands regularly.
• Limit exposure to smoke, chemicals, pollen, and other allergens or irritants.
• Take antihistamine medication to treat allergies and colds.
• Avoid exposure to people with active respiratory infections, such as a cold or the flu.
SINUSITIS COMPLICATIONS
If left untreated, sinusitis may cause rare complications, such as:
• an abscess, which is a walled-off collection of pus in the sinus cavity
• meningitis, a life-threatening infection that can cause brain and spinal cord damage
• orbital cellulitis, an infection of the tissue surrounding the eyes
Sinusitis is treatable, and most people recover without seeing a doctor or taking antibiotics. However, you should tell a doctor if you are having repeated or chronic sinus issues. It may be an underlying medical condition, such as nasal polyps.
