SINUSITIS

Sinusitis is an inflammation, or swelling, of the tissue lining the sinuses. Normally, sinuses are filled with air, but when sinuses become blocked and filled with fluid, germs (bacteria, viruses, and fungi) can grow and cause an infection.

Conditions that can cause sinus blockage include the common cold, allergic rhinitis (swelling of the lining of the nose), nasal polyps (small growths in the lining of the nose), or a deviated septum (a shift in the nasal cavity).

There are different types of sinusitis, including:
• Acute sinusitis: A sudden onset of cold-like symptoms such as runny, stuffy nose and facial pain that does not go away after 10 to 14 days. Acute sinusitis typically lasts 4 weeks or less.
• Subacute sinusitis: An inflammation lasting 4 to 8 weeks.
• Chronic sinusitis: A condition characterized by sinus inflammation symptoms lasting 8 weeks or longer.
• Recurrent sinusitis: Several attacks within a year.

Who Gets Sinusitis?
About 37 million Americans suffer from at least one episode of sinusitis each year. People who have the following conditions have a higher risk of sinusitis:
• Nasal mucous membrane swelling as from a common cold
• Blockage of drainage ducts
• Structural differences that narrow the drainage ducts
• Nasal polyps
• Conditions that result in an increased risk of infection such as immune deficiencies or taking medications that suppress the immune system.

In children, common environmental factors that contribute to sinusitis include allergies, illness from other children at day care or school, pacifiers, bottle drinking while lying on one’s back, and smoke in the environment.

In adults, the contributing factors are most frequently infections and smoking.

What Are the Signs and Symptoms of Acute Sinusitis?
Some of the primary symptoms of acute sinusitis include:
• Facial pain/pressure
• Nasal stuffiness
• Nasal discharge
• Loss of smell
• Cough/congestion

Additional symptoms may include:
• Fever
• Bad breath
• Fatigue
• Dental pain

Acute sinusitis may be diagnosed when a person has two or more symptoms and/or the presence of thick, green, or yellow nasal discharge.

What Are the Signs and Symptoms of Chronic Sinusitis?
People with chronic sinusitis may have the following symptoms for 8 weeks or more:
• Facial congestion/fullness
• A nasal obstruction/blockage
• Pus in the nasal cavity
• Fever
• Nasal discharge/discolored postnasal drainage

Additional symptoms of chronic sinusitis may include:
• Headaches
• Bad breath
• Fatigue
• Dental pain

How Is Sinusitis Diagnosed?
To diagnose sinusitis, your doctor will review your symptoms and give you a physical examination.

The exam may include the doctor feeling and pressing your sinuses for tenderness. He or she may also tap your teeth to see if you have an inflamed paranasal sinus.

Other diagnostic tests to assess the potential causes for sinusitis may include a mucus culture, nasal endoscopy (see below), X-rays, allergy testing, CT scan of the sinuses, or blood work.

Is Sinus Surgery Necessary?
Mucus is developed by the body to moisten the sinus walls. In the sinus walls, the mucus is moved across tissue linings toward the opening of each sinus by millions of cilia (a hair-like extension of a cell). Irritation and swelling from an allergy can narrow the opening of the sinus and block mucus movement. If antibiotics and other medicines are not effective in opening the sinus, surgery may be necessary. Also, if there is a structural abnormality of the sinus such as nasal polyps, which can obstruct sinus drainage, surgery may be needed.

Surgery is performed under general anesthesia using an endoscope. Most people can return to normal activities within five to seven days following surgery. Full recovery usually takes about four to six weeks.

A procedure called a “turbinectomy” may also be performed to shrink the swollen tissues of the nose.

What Happens If Sinusitis Is Not Treated?
Delaying treatment for sinusitis may result in suffering from unnecessary pain and discomfort. In extremely rare circumstances, untreated sinusitis can lead to meningitis or brain abscess and infection of the bone.

Do you suffer ear, nose and throat problems.

Dr. Troost is a ENT specialist in medical and surgical management of ear, nose and throat problems. He also focuses on problems with snoring and sleep apnea