Sinusitis
Though it may be little comfort to know, as many as 37 million people each year are affected by sinusitis or sinus infection each year. Healthcare providers report nearly 32 million cases of chronic sinusitis a year to the Centers for Disease Control and Prevention.
Defining Sinusitis
Sinusitis means that one of more of the four pairs of sinuses known as the paransal sinuses are infected or inflamed. The paranasal sinuses are:
- Frontal sinuses, located over the eyes in the brow area.
- Maxillary sinuses, located inside each cheekbone.
- Ethmoid sinuses, located just behind the bridge of the nose and between the eyes
- Sphenoid sinuses, which are behind the ethmoids in the upper region of the nose and behind the eyes.
Each of the sinuses has an opening into the nose for exchange of air and mucus and each is joined with the nasal passages by a continuous mucous membrane lining. When there is swelling in the nose due to an infection, an allergic reaction, or other type of immune reaction, your sinuses are affected. When a sinus gets blocked because of the swelling, pus and other liquid materials build in the sinus and cause pressure on the sinus wall. This can cause intense pain known as a sinus attack. If air is prevented from entering the sinus because of a swollen membrane at the opening, a vaccuum is created, which also causes pain.
Sinus infections are divided into four categories:
- Acute cases that last 4 weeks or less. Most often, these types of infections start with a common cold caused by a virus. The cold and sinus inflammation caused by the virus usually goes away in two weeks, but bacteria sent to your sinuses when you blow your nose or sniff can become trapped when the sinuses stop draining properly because of inflammation. The bacteria multiply and it leads to a bacterial infection. This becomes acute sinusitis. Allergy suffers may be similarly affected when their nasal membranes become swollen and the sinus passages become blocked.
- Subacute cases, that last 4-12 weeks.
- Chronic cases, that last more than 12 weeks and can actually continue for months or even years. In chronic sinusitis, the membranes of the paranasal sinuses and the nose have thickened because they are constantly inflamed. The term chronic rhinosinusitis may also be used to describe this condition. Chronic sinusitis often occurs in people with asthma, the majoriy of whom have allergies. It is possible that constant exposure to inhaled allergens present year round, such as dust mites, pets, mold, and cockroaches can cause chronic inflammation of the nose and the sinuses. Other groups of people who may be prone to developing chronic sinusitis include those with significant anatomical variations inside the nose, such as a deviated septum, that leads to blockage of the sinus passages.
- Recurrent cases, which means you have experienced several attacks in a year's time.
Symptoms
The most common symptom of sinusitis is pain. Depending on where the infection is located:
- pain in the forehead, over the frontal sinuses, when you are touched
- pain in the upper jaw and teeth, or your cheeks may be tender if the infection is in the maxillary sinuses.
- swelling of the eyelids and tissue around your eyes and pain between your eyes if the infection is in the ethmoid. You may also have a stuffy nose, loss of smell and tenderness when the sides of your nose are touched.
- earaches, neck pain and achiness at the top of your head if the sphenoid sinuses are infected.
- pain and tenderness in more than one area described above.
Other symptoms include thick nasal secretions that may be yellow, green, or tinged with blood. Acute and chronic sinusitis are also strongly associated with nasal symptoms, such as a stuffy nose and general feeling of fullness over the entire face.
Less common symptoms include:
- tiredness
- decreased sense of smell
- cough
- sore throat
- bad breath
- fever
Diagnosis
Sinus infections are often confused with the common cold. A cold will last 4-14 days and usually goes away without treatment. However, sinus infection often lasts longer and causes more symptoms than a cold.
Diagnosis may include:
- physical exam
- history of symptoms
- CT scan
- lab tests
Treatment
After you have been diagnosed with sinusitis and a probable cause has been determined, your doctor may recommend antibiotics to clear up the infection, pain relievers to reduce the pain you are experiencing, and a decongestant to reduce the congestion.
If you have chronic sinusitis, your doctor may prescribe nasal steroid sprays and long courses of oral antibiotics alone or in combination. You may be instructed to use a saline wash or sprays in the nose to help remove thick secretions that are blocking the sinuses.
If medication does not help, surgery to enlarge the natural opening of the sinus, remove any polyps, and correct any anatomical deformities may be required. In children, surgery may be performed to remove the adenoids, tissue in the back of the throat that obstructs the nasal-sinus passages.
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