Sinusitis

What is Sinusitis?

Sinusitis is a respiratory tract infection of the facial sinuses (openings or cavities in the bones around the nose where air, mucus and fluid pass through the nose) and occurs when there is an undrained collection of fluid in the nasal cavities allowing growth of bacteria to occur. The fluid creates pressure and inflammation within the sinuses and may cause discomfort in the nose, ears and teeth.

What are the risk factors of Sinusitis?

The sinuses are air-filled cavities formed in four left and right pairs. When these cavities are infected, a thickening of the mucous secretion can impair the sinuses, in a condition called empyema (Sinusitis).

Different symptoms may appear depending on the degree and location of the infection. The most common symptoms are headache, pus nasal discharge, nasal stuffiness, a poor sense of smell, bad odor, and attention deficit disorder.

You're at increased risk of getting acute sinusitis if you have:

• Hay fever or another allergic condition that affects your sinuses
• A nasal passage abnormality, such as a deviated nasal septum, nasal polyps or tumors
• A medical condition such as cystic fibrosis, gastroesophageal reflux disease (GERD), or an immune system disorder such as immunoglobulin or antibody deficiency
• Regular exposure to pollutants such as cigarette smoke

You're at increased risk of getting chronic or recurrent sinusitis if you have:

• A nasal passage abnormality, such as a deviated nasal septum, or nasal polyps
• Aspirin sensitivity that causes respiratory symptoms
• A medical condition such as cystic fibrosis or gastroesophageal reflux (GERD)
• An immune system disorder such as HIV/AIDS or cystic fibrosis
• Hay fever or another allergic condition that affects your sinuses
• Asthma — about one in 5 people with chronic sinusitis have asthma
• Regular exposure to pollutants such as cigarette smoke

• What causes Sinusitis?

  Sinusitis may be caused in two ways, based on the infectious source and environmental factors such as nutrition, cold, heat, humidity, and dryness. Viruses, bacteria, and fungi usually cause sinusitis. Viruses infect in the upper nasal passage and bacterial infections are caused by streptococcus and hemophilus influenza.

  Acute bacterial sinusitis typically develops as a complication of a viral respiratory infection (i.e. cold or flu), nasal allergies or some other condition, which causes inflammation of the sinuses and is usually diagnosed 10-14 days after the onset of symptoms. The inflammation produced by these conditions prevents the normal drainage of fluids out of the sinuses, often resulting in infection.

  Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are the three bacteria that cause 70% of all cases of acute bacterial sinus infections in adults and children.

• What are the symptoms associated with Sinusitis?

  A diagnosis of bacterial sinusitis may be made in patients who have an upper respiratory tract infection that persists after ten days or worsens after 5-7 days and is accompanied by the following symptoms: extreme facial pain, persistent nasal drainage (yellow, yellow/green, thick), headache, stuffy nose, difficulty smelling and tasting, nasal-sounding voice, cough, tooth pain, fever and chills and facial swelling around the eyes.

• How is Sinusitis diagnosed?

  A nasal X-ray and rhinoscopy are the two main tools for diagnosis.

  They are used to directly look at the sinus openings and check for obstruction either by swelling or growth. Rhinoscopy is a procedure for directly looking in the back of the nasal passages with a small flexible fiber optic tube.

  It may sometimes be necessary to perform a needle aspiration of the sinus to confirm what bacteria are actually present causing the sinus infection.Acute sinusitis will have symptoms of nasal drainage, cough, fever, weakness, headache, facial pain and toothache; it is usually treated with mediations rather than with an operation. Antibiotic therapy is the most common treatment for bacterial sinusitis; medications for fever, pain or vasohypertonic medicine can be prescribed.

  Chronic sinusitis is usually defined as a case of acute sinusitis that lasts longer than three months. The most common symptoms of sinusitis are headache, a feeling of nasal stuffiness, nasal drainage, dysosmia, and distraction, but the systemic symptoms of fever or weakness do not usually occur. The treatment of chronic forms of sinusitis requires antibiotic drugs for 5-14 days. It may also require a sinus drainage, a surgical operation to open the blocked sinus or remove the infected mucous membrane under general anesthesia. In this case, the mucous membrane is irreversibly changed.

• How is Sinusitis treated?

  When a patient experiences the symptoms described above, a physician visit is in order so that the physician can diagnose whether or not it is a bacterial sinus infection. Antibiotics are effective in killing the bacteria that causes sinus infections. For bacterial sinus infections, decongestants and/or expectorants* are often given in addition to antibiotics to treat the symptoms of the infection; however, these agents alone will not kill the bacteria causing the infection. New antibiotics are available that have high efficacy against sinus infections.

  * A decongestant is a type of drug which is used to relieve nasal congestion.
    An expectorant is a medication that helps bring up mucus and other material from the lungs, bronchi, and trachea