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SINUSITIS

  • Sinusitis refers to the inflammation, infection, or swelling of the cavities located around the nasal passages known as sinuses. Typically, these sinuses are small air-filled spaces positioned behind your cheekbones and forehead. However, when they become infected, they can become obstructed and fill with fluid, providing an environment where harmful microorganisms can thrive.
  • There are various factors that can lead to sinus blockage, including the common cold, allergic rhinitis, nasal polyps, or even a deviated septum.

    • What are Sinuses?


  • Our head contains four sets of sinuses, which are interconnected hollow spaces situated within the skull around the nose. These cavities or spaces have small openings known as ostia that connect to the nasal passages. Since both the sinuses and the nose are lined with the same delicate mucosal tissue, any infection affecting one can also impact the other. When this mucosal lining becomes infected, it leads to a condition known as sinusitis, or alternatively referred to as rhino-sinusitis (with "rhino" denoting the nose in medical terminology).

    • The four pairs of sinuses are as follows: –

  • Frontal sinus (in forehead)
  • Maxillary sinus (behind cheeks)
  • Ethmoid sinus (behind eyes)
  • Sphenoid sinus (deep behind the ethmoids)

    • Types of Sinusitis

  • Acute sinus infection – If the infection is present or less than 30 days, this is also called as acute sinusitis due to infection, or acute bacterial rhinosinusitis.
  • Sub-acute sinus – An infection present for over 1 month but less than 3 months.
  • Chronic sinus infection- An infection that has been present for more than 3 months.
  • Chronic sinusitis is further categorized into chronic with or without nasal polyps, or allergic fungal sinusitis.

    • The accepted functions of sinuses include, relative weight reduction of the front part of the skull (sinuses are hollow and filled with air), air-conditioning, and humidification of air that’s breathed in, giving added resonance to voice and lending mechanical rigidity.

    Causes of Sinusitis

  • Sinus infections can result from anything disrupting.

    • 1.Airflow into the sinuses

    2.Mucous drainage out of the sinuses

  • Common colds, allergies, or similar conditions can result in inflammation of the lining of the sinuses and the nearby nasal passages, leading to the obstruction of the ostia, which are the small openings connecting the sinuses to the nasal cavity.
  • Sinus blockages can also occur due to the presence of tumors, growths, or structural abnormalities located in close proximity to the sinus openings.
  • Conditions such as cystic fibrosis, the use of drying medications like antihistamines or anti-allergic drugs, or exposure to dry and low-humidity air can hinder mucous drainage by causing thickening of secretions.
  • When cilia, which are tiny hair-like structures responsible for directing the flow of mucous out of the sinuses, become damaged by irritants like smoke, their ability to move mucous in the correct direction weakens, leading to its accumulation within the sinuses.
  • Stagnant mucous in the sinuses creates a conducive environment for the proliferation of bacteria, viruses, and sometimes even fungi, particularly in individuals with conditions like AIDS or compromised immune systems. In some cases, these microorganisms can initiate or exacerbate sinus blockages.

    • Precautions & Treatments

  • An ear, nose, and throat (ENT) specialist will examine the nasal cavity for indications of inflammation, redness, accumulated pus, and impaired drainage along the mucosal lining of the nasal passages. For a comprehensive assessment, the doctor may suggest an endoscopic examination of the nose and CT scans of the nasal and paranasal sinuses.
  • An ENT physician generally prescribes medical treatment for acute sinusitis. However, chronic or recurrent sinusitis need proper investigation to find out their cause. The treatment prescribed may involve an endoscopic procedure called FESS or functional endoscopic sinus surgery.
  • Self-administered treatments are strongly discouraged. It is important to refrain from excessive use of topical nasal decongestant drops like Otrivin and Nasivion, as this can result in a difficult-to-treat condition known as rhinitis medicamentosa.
  • Failure to treat sinusitis can result in significant discomfort and pain. In cases where patients have other concurrent health issues, such as asthma, the overall health of the individual may worsen due to sinusitis. In rare instances, neglecting treatment for sinusitis may potentially escalate into severe conditions such as bone infections, meningitis, or brain abscesses.

    • Symptoms

    Most patients with sinus infection will show some of the following symptoms: –

    1.Stuffy nose

    2.Obstructed nose

    3.Cough

    4.Headache

    5.Recurring throat pain

    6.Feeling of pain or pressure in face

    7.Pain in ear and / or teeth

    8.Weakened sense of smell

    9.Trickling sensation / irritation in the throat

    10.Recurring urge to clear the throat