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Sinusitis ( Sinus Infection )

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    What Is Sinusitis?

    Sinusitis is an inflammation or swelling of the tissue lining the sinuses. Healthy sinuses are filled with air. But when they become blocked and filled with fluid, germs can grow and cause an infection.

    Conditions that can cause sinus blockage include:
    • The common cold
    • Allergic rhinitis, which is swelling of the lining of the nose
    • Small growths in the lining of the nose called nasal polyps
    • A deviated septum, which is a shift in the nasal cavity

    Causes of sinusitis

    Sinuses are air-filled hollow cavities in the skull. These are present in four pairs – two behind the forehead, two on either side of the bridge of the nose, two behind the eyes and the two largest ones behind the cheekbones.

    The sinuses are lined by mucous membranes that produce mucus to lubricate the insides. The sinuses help in warming and moistening the inhaled air. The air from the nose passes through small channels into the sinuses and circulates back into the nasal cavity from which they reach the lungs.

    Normally the mucus is drained into the nasal cavity and the sinuses are free of mucus or any form of microorganisms like viruses and bacteria.


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    Viral infection as a cause of sinusitis

    The common cause of such inflammation is an infection or more commonly upper respiratory tract infection.

    The most common cause of sinusitis is the cold virus or influenza (flu). The virus affects the nasal and the sinus mucous membranes and leads to increased mucus formation and inflammation that blocks the nose and the sinuses.

    Bacterial and other infections as a cause of sinusitis

    Infection may also be bacterial or may be fungal. An infected tooth may also cause the sinuses to become infected although this is rare.

    Allergic reactions that lead to sinusitis

    Allergic reactions lead to stimulation of excess mucus production that blocks the channels draining the mucus into the nose and may lead to inflammation of the nose and the sinuses.

    Allergic rhinitis, seasonal allergic rhinitis, hay fever, and asthma are common conditions that may lead to sinusitis.

    Pollutants that lead to sinusitis

    Pollutants in the air, smoke, chemicals, household detergents, disinfectants may all be inhaled and these may lead to irritation of the sinuses and may cause inflammation and sinusitis. Smokers are at a higher risk of sinusitis.

    Types of Sinusitis

    1. Acute Sinusitis
    2. Chronic Sinusitis

    Acute Sinusitis

    Acute sinusitis is a sinus infection which usually goes away on its own without treatment. There are various treatments that may help to ease symptoms. Antibiotic medicines are only sometimes needed. Complications are uncommon but include persistent (chronic) sinusitis and the infection spreading to nearby structures.

    • Acute sinusitis usually starts with cold-like symptoms such as a runny, stuffy nose and facial pain. It may start suddenly and last 2-4 weeks.
    • Subacute sinus inflammation usually lasts 4 to 12 weeks.
    • Chronic inflammation symptoms last 12 weeks or longer.
    • Recurrent sinusitis happens several times a year.

    Symptoms of Acute Sinusitis

    The main signs include:
    • Facial pain or pressure
    • Stuffed-up nose
    • Runny nose
    • Loss of smell
    • A cough or congestion
    You may also have:
    • Fever
    • Bad breath
    • Fatigue
    • Dental pain

    Chronic Sinusitis

    Chronic sinusitis means that a sinusitis becomes persistent and lasts for longer than 12 weeks. Chronic sinusitis is uncommon.

    Chronic sinusitis is a persisting inflammatory condition of one or more sinuses. It is less common than acute sinusitis but appears to be getting more common in all age groups. Various treatments may be tried. Surgery to improve the drainage of the sinus is an option if other treatments fail, and usually works well.

    Symptoms of Chronic Sinusitis

    You may have these symptoms for 12 weeks or more:
    • A feeling of congestion or fullness in your face
    • Nasal obstruction or nasal blockage
    • Pus in the nasal cavity
    • Fever
    • A runny nose or discolored postnasal drainage

    You may also have headaches, bad breath, and tooth pain. You may feel tired a lot.

    Treatment for Sinusitis

    If you have a simple sinus infection, your doctor may recommend you use a decongestant and saline nasal washes. You shouldn’t use an over-the-counter decongestant more than 3 days, though, because it can make you more congested.

    If your doctor gives you antibiotics, you’ll probably take them for 10 to 14 days. The symptoms usually disappear with treatment.

    Warm, moist air may help if you have chronic sinusitis. You can use a vaporizer, or you can inhale steam from a pan of warm water. Make sure the water isn’t too hot.

    There are some other things you can do yourself to help with chronic sinusitis:
    • Warm compresses can ease pain in the nose and sinuses.
    • Saline nose drops are safe to use at home.
    • Over-the-counter decongestant drops or sprays can help. Don’t take them longer than recommended.

    In some cases, your doctor may prescribe steroids along with antibiotics.

    Can I Prevent Sinusitis?

    There is no sure-fire way to prevent sinusitis. But there are some things that might help.

    • Don’t smoke, and try not to be too near people who are smoking.
    • Wash your hands often, especially during cold and flu season, and try not to touch your face.
    • Try to stay away from things you know you’re allergic to.

    Do I Need Sinus Surgery?

    You might if antibiotics and other medicines don’t open the sinus.

    Also, if the structure of your sinuses may not be quite right. For example, nasal polyps may block them and keep them from draining as they should. If that’s the case, your doctor may talk to you about some type of procedure.

    Sinusitis Diagnosis

    Your doctor will feel for tenderness in your nose and face and look inside your nose.

    Other methods for diagnosing chronic sinusitis include:

    • Nasal endoscopy A thin, flexible tube (endoscope) with a fiber-optic light inserted through your nose allows your doctor to see the inside of your sinuses. This also is known as rhinoscopy.
    • Imaging studies Images taken using a CT scan or MRI can show details of your sinuses and nasal area. These might pinpoint a deep inflammation or physical obstruction that’s difficult to detect using an endoscope.
    • Nasal and sinus cultures. Cultures are generally unnecessary for diagnosing chronic sinusitis. However, when the condition fails to respond to treatment or is worsening, tissue cultures might help determine the cause, such as bacteria or fungi.
    • An allergy test. If your doctor suspects that the condition might be triggered by allergies, he or she might recommend an allergy skin test. A skin test is safe and quick and can help pinpoint the allergen that’s responsible for your nasal flare-ups.

    Doctors usually use an endoscope to do these operations. Most people can get back to their normal activities within 5 to 7 days. Full recovery can take about 4 to 6 weeks.

    What Happens if Sinusitis Isn’t Treated?

    You’ll have pain and discomfort until it starts to clear up. In rare cases, untreated sinusitis can lead to meningitis, a brain abscess, or an infection of the bone. Talk to your doctor about your concerns.

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