Sinus

Sinus

Sinusitis is characterized by inflammation of the sinuses due to viral, bacterial, or fungal infections.

Causes, Incidence, and Risk Factors

Sinuses, situated behind the forehead, nasal bones, cheeks, and eyes, are air-filled spaces lined with mucus membranes. Normally devoid of bacteria or germs, healthy sinuses facilitate mucus drainage and air circulation. However, blockage of sinus openings or excessive mucus accumulation can foster bacterial and germ growth.

Several conditions can precipitate sinusitis:

• Impaired function of cilia (small hairs) in the sinuses due to certain medical conditions
• Cold or allergy-induced mucus overproduction or sinus openings obstruction
• Structural issues like deviated nasal septum, nasal bone spur, or nasal polyps blocking sinus openings

Sinusitis can manifest in different forms:

• Acute sinusitis: Symptoms last up to 4 weeks
• Sub-acute sinusitis: Symptoms persist for 4 - 12 weeks
• Chronic sinusitis: Symptoms endure for 3 months or longer

Acute sinusitis commonly stems from bacterial infection following an upper respiratory tract infection. Chronic sinusitis entails prolonged sinus swelling and inflammation, potentially bacterial or fungal in origin.

Various factors can heighten the risk of sinusitis:

• Allergic rhinitis or hay fever
• Cystic fibrosis
• Daycare attendance
• Conditions impairing cilia function, like Kartagener syndrome and immotile cilia syndrome
• Altitude changes (e.g., flying or scuba diving)
• Enlarged adenoids
• Smoking
• Rare instances of tooth infections
• Weakened immune system due to HIV or chemotherapy

Symptoms

In adults, typical symptoms of acute sinusitis usually follow an unresolved or worsening cold after 5 - 7 days and include:

• Sudden fever onset, often peaking on the second day
• Red throat, occasionally with white patches
• Sore throat
• Headache, facial tenderness, or toothache
• Nasal congestion and discharge
• Malaise
• Loss of smell or bad breath
• Cough, typically worsening at night
• Chills
• Postnasal drip and sore throat

Chronic sinusitis symptoms mirror those of acute sinusitis but are usually milder and persist beyond 12 weeks. Symptoms in children may include worsening respiratory illness, high fever with darkened nasal discharge for at least 3 days, or persistent nasal discharge with or without cough for over 10 days.

Signs and Tests

Diagnostic assessments for sinusitis may involve:

• Nasal examination for polyps
• Transillumination of sinuses to detect inflammation
• Sinus tapping to identify infection
• Specialized tests such as nasal endoscopy or rhinoscopy
• Imaging studies like CT or MRI scans, particularly for chronic or recurrent sinusitis

Treatment

Self-care measures can alleviate sinus congestion:

• Applying warm, moist compresses to the face
• Hydrating adequately to thin mucus
• Inhaling steam
• Nasal saline spray use
• Humidifier usage
• Neti pot usage for sinus flushing

Over-the-counter nasal decongestant sprays should be used cautiously to prevent worsening congestion. Additionally, symptom relief strategies like avoiding temperature extremes or using pain relievers may help.

Medications and treatments may be necessary, including antibiotics for bacterial sinusitis or antifungal agents for fungal sinusitis. Surgical intervention might be warranted for chronic or recurrent cases unresponsive to medical therapy.

Expectations (Prognosis)

Most sinus infections respond well to self-care and medical treatment. Recurrent cases may necessitate evaluation for underlying issues such as nasal polyps or allergies.