Sinusitis


There are four pairs of sinuses in our head. Sinuses are hollow, air-filled and interconnected spaces located around the nose in the skull. All these spaces or cavities open into the nose through tiny openings called ostia. As both sinuses and nose are lined with the same soft tissue called mucosa, any infection that affects one affects the other. When this mucosa gets infected, the resulting condition is called sinusitis. It is also called rhino-sinusitis (‘rhino’ is a medical term for the nose).

The four pairs of sinuses are as follows: –

  • Frontal sinus (in forehead)
  • Maxillary sinus (behind cheeks)
  • Ethmoid sinus (behind eyes)
  • Sphenoid sinus (deep behind the ethmoids)

The accepted functions of sinuses include, relative weight reduction of the front part of the skull (sinuses are hollow and filled with air), air-conditioning, and humidification of air that’s breathed in, giving added resonance to voice and lending mechanical rigidity.

Types of Sinusitis


  • Acute sinus infection – If the infection is present or less than 30 days, this is also called as acute sinusitis due to infection, or acute bacterial rhinosinusitis.
  • Sub-acute sinus – An infection present for over 1 month but less than 3 months.
  • Chronic sinus infection- An infection that has been present for more than 3 months.
  • Chronic sinusitis is further categorized into chronic with or without nasal polyps, or allergic fungal sinusitis.

Causes of Sinusitis

  • Sinus infections can result from anything disrupting:
        • Airflow into the sinuses
        • Mucous drainage out of the sinuses
  • Common colds, allergies or similar conditions causes the lining of the sinuses and also the adjacent nasal passage to become swollen, thus blocking the ostia (the tiny openings of sinuses that open up into nasal cavity)
  • Sinuses can also get blocked by tumours, growths or structural abnormalities lying close to the sinus openings.
  • Diseases like cystic fibrosis, or due to drying medications like antihistamines or anti-allergic drugs, or simply because of breathing in air which lacks humidity or is dry, can cause mucous drainage to get hindered because of thickening of secretions.
  • When cilia (tiny hair-like structures that direct flow of mucous out of the sinuses), gets damaged by irritants such as smoke, its ability to movie mucous in the right direction weakens and it gets accumulated in sinuses.
  • When mucous goes stagnant in sinuses, it becomes rich, thriving and fertile ground for the growth of bacteria and viruses and sometimes for fungus as well (e.g. in AIDS patients or in immunocompromised individuals). In some case, these microbes can cause or worsen sinus blockage.

Symptoms


Most patients with sinus infection will show some of the following symptoms: –

  • Stuffy nose
  • Obstructed nose
  • Cough
  • Headache
  • Recurring throat pain
  • Feeling of pain or pressure in face
  • Pain in ear and / or teeth
  • Weakened sense of smell
  • Trickling sensation / irritation in the throat
  • Recurring urge to clear the throat

Precautions & Treatments


  • An ENT physician will check the nasal cavity to seek signs of swelling or redness, gathered pus and hindered drainage along the mucosal lining of the nasal passages. To get a complete status, the doctor can recommend endoscopic examination of nose along with CT scans of nose and paranasal sinuses.
  • An ENT physician generally prescribes medical treatment for acute sinusitis. However, chronic or recurrent sinusitis need proper investigation to find out their cause. The treatment prescribed may involve an endoscopic procedure called FESS or functional endoscopic sinus surgery.
  • Self-medication is not at all recommended. Avoid using topical nasal decongestant drops such as Otrivin and Nasivion that could lead to a tough to treat condition known as rhinitis medicamentosa on overuse.
  • If sinusitis is not treated it can lead to lot of discomfort and pain. If there are other health problems like asthma, along with sinusitis, then the patient’s health might deteriorate. In rare cases, not getting sinusitis treated might lead to serious conditions like bone infection, meningitis, or brain abscess.

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