All you want to know about sinusitis

Dr Dillon D’Souza, a Consultant ENT & Head and Neck surgeon, Jaslok hospital , Breach Candy hospital, and Desa's hospital, shares information about sinus and how to diagnose it and what to do


What are sinuses?

The human skull is like a shell, made of thin bones containing cavities. Some of these cavities are occupied by the brain, eyes, ears, nose, while the others are air-filled spaces that communicate with the nose through tiny windows. These spaces make the headlight and cause an echo effect which gives volume to the human voice, similar to speaking into an earthenware pot.

What is sinusitis?

It is a process by which the soft lining of the sinuses gets swollen and blocks the tiny windows leading to fluid generation and collection in the sinuses. This fluid gets infected by bacteria and viruses.

What causes sinusitis?

Common colds, allergies, nasal polyps (soft grapelike swelling), or a crooked nose bone blocking the nose.

Symptoms of sinusitis

Sudden symptoms of cold, like a runny nose, pain in some facial area is noticed, that can last for more than ten days.

Acute sinusitis lasts 10 to 14 days with two or more symptoms and yellow-green or opaque nasal discharge, while subacute lasts 4 to 8 weeks.

Chronic sinusitis lasts for eight weeks or longer with symptoms of face swelling, nose block, pus in the nose, fever, and recurrent sinusitis is when several attacks occur within a year or symptoms lasting more than 12 months.

Usual symptoms of sinusitis may include

  • Facial pain/pressure, dull constant aching pain, worse when bending over or lying down, often starting on one side of the head and progressing to both sides of the head
  • Nasal stuffiness
  • Nasal discharge, seen both in acute and chronic sinusitis, may be yellow or green in colour and may contain blood or pus
  • Loss of smell
  • Cough/ congestion
  • Fever
  • Bad breath
  • Fatigue
  • Dental pain
  • Infection of the eye sockets with loss of vision accompanied by fever and severe illness.

Another serious complication is the infection of the bones (osteomyelitis) of the forehead, and face

Conditions that predispose to sinusitis

  • Recurrent colds or allergies with the stuffy nose.
  • Change in the size of windows opening from the sinuses to the nose, maybe from birth or because of infections.
  • Polyps in the nose.
  • Decreased immunity either from birth or acquired from the use of medications like steroids and anticancer medications.
  • Cystic fibrosis a hereditary disorder producing very thick mucus in nose and lungs.

In children, common allergies, infections acquired from other children at daycare or school, pacifiers, drinking from bottles while lying on the back, and smoke or dust in the environment.

Most cases are viral infections, however, bacterial infections are suspected if the symptoms last more than ten days.

Diagnosis of sinusitis

Made by the history of the illness combined with an examination by a doctor confirmed by CT scans or X-ray’s mucus cultures, and if required, an endoscopy procedure using a tiny camera and lights, to look into the nose.

Treatment of sinusitis

It can be treated medically through antibiotics, antiallergics, painkillers, nasal drops and sprays, and if required, steroids and immunoglobulins to boost immunity.

The selection of medications and dosages will vary depending on the doctor’s assessment of the case. Self-medication with over the counter prescriptions can worsen acute sinusitis or make it chronic.

Self-help for sinusitis

Avoid anything that can trigger your allergies, including foods, deodorant sprays, air fresheners, and other strong- smelling compounds that can irritate nose.

Steam inhalation, which can even be done by running a hot shower after a bath, and sitting in the steam for some time, for those who find it difficult to do inhalations.

  • Avoid smoking, and drinking or reduce as much as possible
  • Drink warm soups, and fluids to help thin out the mucus
  • Walk 15 minutes a day or deep breathing exercises morning and evening to increase airflow through the nose and sinuses.
  • Avoid sitting under a fan with wet hair or in front of an air conditioner.

When is surgery indicated

If the treatments fail, and the blockage is because of a crooked nose bone or polyps, the doctors can prescribe an endoscopic surgery, and septoplasty, or a new technique — balloon sinuplasty. The patients can resume their work within two to five days post-surgery.

What happens if sinusitis is not treated?

It may resolve or become chronic or may progress to complications like an infection of the brain and skull bones or the sockets of the eyes leading to visual disturbances, which makes treatment longer, more expensive, and surgical correction more extensive.

Also Read :- 7 common sinusitis myths you shouldn’t believe in