Everything you want to know about sinusitis or sinus infection or rhinosinusitis

Tired of dealing with sinusitis? Here's what you need to know.

Sinuses refer to air-filled spaces in the human skull. In sinusitis, the soft lining of the sinuses gets swollen and the passage to the nose gets blocked leading to the fluid being produced and collecting in the sinuses. This fluid gets infected by bacteria and viruses. Dr Dillon D'souza, Consultant ENT and Head and Neck surgeon, Jaslok hospital, Breach Candy hospital and Desa's hospital, explains more about this condition.

What causes sinusitis

Some of the common causes include common colds, allergies, nasal polyps, or a crooked nose bone blocking the nose.

Symptoms of sinusitis

Sudden cold-like symptoms with a runny stuffy nose, pain in some area of the face that lasts more than 10 days.

1. Acute sinusitis lasts 10 to 14 days with two or more symptoms and yellow-green nasal discharge,

2. Subacute lasts 4 to 8 weeks.

3. Chronic sinusitis lasts 8 weeks or longer with symptoms of face swelling nose block pus in the nose, fever and

4. Recurrent sinusitis is when several attacks occur within a year or symptoms lasting more than 12 months.

Usual symptoms include

Facial pain/pressure, dull constant aching pain, worse when bending over or lying down, often starting on one side of the head and progressing to both sides of the head

Nasal stuffiness

Nasal discharge may be yellow or green in colour and may contain blood or pus

Loss of smell

Cough/congestion

Fever

Bad breath

Fatigue

Dental pain

Infection of the eye sockets with loss of vision accompanied by fever and severe illness

Infection of the bones (osteomyelitis) of the forehead and face

Conditions that predispose to sinusitis

Recurrent colds or allergies with a stuffy nose,

changes in the size of windows opening from the sinuses to the nose, maybe from birth or because of infections,

polyps in the nose,

decreased immunity either from birth or acquired from the use of medications like steroids and anticancer medications

smoking,

asthma,

cystic fibrosis a hereditary disorder producing very thick mucus in nose and lungs.

In children, allergies, infections acquired from other children at daycare or school, pacifiers, drinking from bottles while lying on the back, and smoke or dust in the environment.

Most cases are viral infections, but bacterial infections are suspected if the symptoms last more than 10 days.

Diagnosis of sinusitis

History of the illness combined with an examination by a doctor confirmed by CT scans or X-ray's mucus cultures and if required an endoscopy procedure using a tiny camera and lights, to look into the nose is performed.

Treatment of sinusitis

Medical treatment by antibiotics, antiallergics, painkillers, nasal drops and sprays and if required steroids and immunoglobulins to boost immunity. The selection of medications and dosages of each will vary depending on the doctor's assessment of the case. Self-medication with over the counter prescriptions can often worsen acute sinusitis or make it chronic.

Tips to deal with sinusitis

Avoid foods, deo sprays, air fresheners and other strong- smelling compounds that irritate the nose.

Steam inhalation which can even be done by running a hot shower after a bath and sitting in the steam for some time for those who find it difficult to do inhalations.

Avoid smoking and drinking or reduce as much as possible

Drink warm soups and fluids to help thin out the mucus

Walk 15 minutes a day or deep breathing exercises morning and evening to increase airflow through the nose and sinuses.

Avoid sitting under a fan with wet hair or in front of an air conditioner.

When is surgery for sinusitis indicated

If medical treatments fail repeatedly and a blockage of the windows into the sinuses or a crooked nose bone or polyps are found on examination endoscopic sinus surgery and septoplasty or a new technique called balloon sinuplasty are indicated. You can resume work in two to five days after surgery.

What happens if sinusitis is not treated

It may resolve or become chronic or may progress to complications like the infection of the brain and skull bones or the sockets of the eyes leading to visual disturbances, which makes treatment longer, more expensive and surgical correction more extensive.