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Sinusitis – Causes, Symptoms and Treatment
Sinusitis is an inflammation of the sinuses that can be acute or chronic. It causes facial pain, nasal congestion, and a feeling of pressure in the head.
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Sinusitis is an inflammation of the sinuses that can be acute or chronic. It causes facial pain, nasal congestion, and a feeling of pressure in the head.
What is Sinusitis?
Sinusitis is an inflammation of the mucous membranes lining the paranasal sinuses -- air-filled cavities located in the bones around the nose and forehead. These sinuses connect to the nasal cavity and help regulate airflow and mucus drainage. Sinusitis can be acute (short-term) or chronic (lasting more than 12 weeks) and is one of the most common health conditions worldwide.
Causes
The most frequent causes of sinusitis include:
- Viral infections: The majority of acute sinusitis cases follow a common cold, which inflames the nasal lining and blocks sinus drainage.
- Bacterial infections: A secondary bacterial infection can develop after a viral episode, leading to more severe symptoms.
- Allergies: Allergic rhinitis (hay fever) chronically irritates the nasal passages and increases the risk of developing chronic sinusitis.
- Structural issues: A deviated nasal septum or nasal polyps can obstruct normal sinus drainage.
- Fungal infections: Rare, but more likely in individuals with weakened immune systems.
Symptoms
Common symptoms of sinusitis include:
- Facial pressure or pain, especially below the eyes, across the forehead, or at the bridge of the nose
- Blocked or runny nose with thick, discolored (yellow or green) mucus
- Reduced or absent sense of smell
- Headaches
- Fatigue and a general feeling of being unwell
- Fever, particularly with bacterial infections
- Pain that worsens when bending forward or lowering the head
Diagnosis
Sinusitis is typically diagnosed through:
- Clinical evaluation: A doctor reviews the symptoms and presses on facial areas to check for tenderness.
- Nasal endoscopy: A thin, flexible camera is inserted into the nasal passages to examine the sinus openings and mucous membranes.
- Imaging (CT scan): Used in chronic or complicated cases to assess the extent of inflammation and any structural abnormalities.
- Nasal swab: May be taken to identify bacterial pathogens in suspected bacterial sinusitis.
Treatment
Acute Sinusitis
Most cases of acute sinusitis resolve on their own without antibiotics. Recommended measures include:
- Decongestant nasal sprays or drops (for short-term use only)
- Saline nasal irrigation to clear mucus and soothe the lining
- Pain relievers such as ibuprofen or paracetamol
- Steam inhalation to ease congestion
- Adequate rest and fluid intake
Bacterial Sinusitis
When a bacterial infection is confirmed or strongly suspected, antibiotics such as amoxicillin are prescribed. Treatment typically lasts between 5 and 10 days.
Chronic Sinusitis
Management of chronic sinusitis may include:
- Corticosteroid nasal sprays to reduce inflammation
- Allergy treatment when an allergic cause is identified
- Functional endoscopic sinus surgery (FESS) when conservative treatments fail to provide relief
When to See a Doctor
Seek immediate medical attention if you experience:
- Severe headache or stiff neck
- Visual changes or swelling around the eyes
- High fever above 39 degrees Celsius
- Symptoms that persist for more than 10 days or worsen after initial improvement
References
- Fokkens WJ et al. - European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1-464.
- Rosenfeld RM et al. - Clinical Practice Guideline: Adult Sinusitis. Otolaryngology - Head and Neck Surgery. 2015;152(2 Suppl):S1-S39.
- World Health Organization (WHO) - Acute Respiratory Infections including Sinusitis. WHO Global Health Observatory, 2023.
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