Sinusitis

Definition

Sinusitis is a medical condition characterized by inflammation of the paranasal sinuses due to infection by bacteria, virus or fungi, allergies or autoimmune diseases. Sinusitis can be of two types depending upon the onset, it may be acute when it occurs suddenly and symptoms are relieved before 12 weeks or chronic when the condition persists for more that 12 weeks. Most common symptoms include discharge of thick discharge from nose or back of the throat, nasal blockage, headache, pain around ear, eyes and cheeks.

Sinusitis may lead to flaring up of asthma, ear infection and spread of the infection to the meninges leading to meningitis. In most of the cases of acute sinusitis no treatment is required, however, drugs are prescribed to relieve the symptoms. In very rare cases sinusitis may require more invasive procedures like a washout.

Symptoms

The symptoms of acute and chronic sinusitis do not differ much. Common symptoms include :

  • Drainage of thick yellowish discharge from the nose or back of the throat.
  • Blockage of nasal passages leading to difficult breathing.
  • Painful swelling around the eyes, cheeks, nose or forehead.
  • Impaired taste and smelling.
  • Cough which become worse especially during night.
  • Ear pain and sometimes there may be discharge from the ear.
  • Pain in the upper jaw or teeth.
  • Pain during swallowing (sore throat).
  • Irritability and tiredness.
  • Nausea and vomiting.
  • Fever

Sinusitis may lead to number of complications like flaring up of asthma, spreading of infection to the meninges that cover the brain leading to inflammation of it (meningitis), spreading of infection to the eye causing visual difficulty even blindness, on rare occasion infection may lead to dilatation (aneurysm) or clotting of blood in the vessels adjacent to the sinus, thereby interfering with blood supply to the brain which may be fatal.

Causes

Sinuses are air-filled spaces around the skull which helps to reduce the weight of the skull, warm and humidify the inspired air. With sinusitis the lining mucosa of the sinus become swollen, leading to obstruction in the drainage of secretion of the sinuses thereby causing the symptoms of sinusitis.

  • Acute sinusitis usually occurs following infection by a virus and bacteria. It tends to follow after a common cold. Sometimes a fungus may cause sinusitis¬† especially in people with weak immunity and it more progress to a chronic condition.
  • Chronic sinusitis occurs due to persistence of the symptoms of acute sinusitis because of some underlying problem like nasal polyps or tumors, allergy, deviation of the septum that divides the nasal cavity into two chambers or trauma blocking the drainage pathway of the sinuses.

Treatment

Usually acute sinusitis does not require any specific treatment as a virus is the main cause, however, drugs are prescribed to relieve the symptoms of both acute and chronic sinusitis.

  • Saline nasal sprays are used to washout the nasal passage.
  • Decongestants reduce mucus build up.
  • Steroid nasal sprays reduce inflammation of the passages.
  • NSAIDs are used as pain relievers although caution is warranted in patients having aspirin sensitivity and children recovering from chickenpox.
  • Antibiotics usually are not vary much helpful apart from the cases when bacteria are responsible.
  • In case of fungal sinusitis antifungals are prescribed.
  • Surgery may be required if there is any underlying condition like nasal polyp responsible for sinusitis.

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