Acute Sinusitis

Waking every morning with headache, swelling around the eyes, cough, and the feeling of stuffiness, and congestion may not be so comfortable or a good sign to start a day. Many think that they might be suffering from cold. But if all the cold relieving medications that the person has taken are of no use and the headache doesn’t seem to reduce, the person finally drags himself to a doctor who after listening to the symptoms and conducting few physical and diagnostic examinations, concludes that the person is suffering from sinusitis. Sinusitis is not a severe condition, it can be treated effectively.

About Sinusitis

Sinuses are the empty spaces or air chambers that are present in the bones behind the eye-brows, cheeks, behind the nose near the bridge of the eye, and jaws. The main function of sinus is to secrete fluid called mucus, which cleans up the bacteria and other dust particles present in the air that we breathe in. Later this mucus is drained out from the sinus into the nose by small hair like structures called cilia and finally the mucus is drained out the body through the nose.

A healthy sinus is clean and do not contain any bacteria, unlike the nasal passage. But in case of infection or allergic reaction, the sinuses may be infected and may result in swelling of the membrane lining the sinuses, a condition called as sinusitis. When the air is trapped in the blocked sinus along with pus and other secretions, it results in increased pressure on the sinus walls that result in severe pain in the sinus region. Similarly, the swollen membrane of the sinus may block the passage of sinus into the nose (paranasal sinus) creating a vacuum which in turn results in intense pain.

There are 4 types of sinusitis.

  • Acute sinusitis, lasts up to 4 weeks.
  • A sub-acute sinusitis may last up to 4-12 weeks.
  • A chronic sinusitis has a longer course and may last for more than 12 weeks to few months or even years.
  • Recurrent sinusitis is a condition where several attacks of acute sinusitis is experienced within a year’s time.

Sinusitis may be either bacterial or viral infection. When the nasal congestion along with common cold or other allergy does not allow proper drainage of the sinus content into the nasal passage, the trapped fluid encourages bacterial or viral growth resulting in bacterial or viral sinusitis.

There are many causes of sinusitis, anything that can result in inflammation of the sinus membrane and can keep the keep the cilia from moving can result in sinusitis. Few causes of sinusitis are

  • Change in temperature and air pressure
  • Allergies
  • Pollutants
  • Using too much of decongested nasal spray as it increases the swelling of sinuses once it is stopped
  • Smoking
  • Swimming & diving
  • Growth of polyps (small non-cancerous growth) in the sinus region
  • Bacterial or viral infection
  • Cold, as the cold virus attacks the sinus and results in swelling & blockage
  • Untreated acute sinusitis
  • Structural abnormalities
  • Allergy to fungi
  • Enlarged adenoids (mass of tissue that destroys the pathogens entering into nasopharynx region)
  • Weak immune system

Sinusitis may exhibit as headache in the morning immediately after waking up or while bending down. It may or may not be accompanied by fever. There may be pain, swelling, and tenderness in the forehead, nose, cheeks, and in between the eyes. Yellow, green, or blood tinged nasal secretion may be present.

The person suffering from sinusitis may have reduced sense of smell and taste, and may complain of nasal congestion or stuffy nose. There could be drainage at the back of the throat called the postnasal drip, and mucus discharge from nose.

Some people may also have cough that worsens at nights. Sinusitis may cause swelling of the eyelids and tissue around the eye. Other symptoms include teeth ache and bad breath.

Sinusitis is diagnosed by a detailed physical examination of the patient’s face and nose, and by noting all the symptoms told by the patient. If symptoms do not lead to a conclusive diagnosis then the physician might order for a computer tomography scan to check the presence of sinusitis.

Blood tests are done to rule out sinusitis associated conditions like immune deficiency disorder (HIV). Testing the sample of mucus is done to look for bacteria or fungal infection. In addition, biopsy of the tissue lining the nose or the sinus is taken to check the condition of the tissue lining these regions.

An endoscopy is performed to view the sinus region, a thin flexible tube like device with light called endoscope is inserted into the nasal cavity through nose under local anesthesia and the inner sinus region is viewed.

If acute sinusitis is detected then the patient might not require any antibiotics as the infection goes on its own. Even if antibiotics are taken they give only slight relief and just reduce the time the person is sick. Antibiotics are prescribed in sinus infection, if the person has headache and pain in the face, swelling around the eyes along with a body temperature higher than 102.2°F, and if nasal discharge and cough persists for more than 2-3 weeks.

Along with antibiotics, the physician might also prescribe a pain reliever and a decongestant to reduce congestion. Treatment for acute sinusitis is required for 10-14 days and for chronic sinusitis 3-4 weeks treatment is required. Medications for sinusitis includes

  • Immunotherapy, which includes allergy shots to prevent the disease from coming back
  • Preventing or avoiding any trigger that induces allergy
  • Over-the-counter medicine like acetaminophen can ease sinus headache and sinus pain
  • Corticosteroid nasal spray and anti-histamines to treat swelling, polyps, and allergies
  • Saline nasal spray may help to drain out the mucus and help relieve from congestion. A prescribed nasal spray treats inflammation

Patients whose symptoms doesn’t seem to go away even after 3-4 months of treatment and in patients who experience 2-3 episodes of acute sinusitis every years might require a surgery to clean and drain the sinus. Surgery is performed by an ENT (ear, nose, and throat) surgeon. Most patients with fungal infection require a surgery. Surgery involves correcting the deviated septum and nasal polyps, which prevent the condition from coming back.

Few simple tips may help the patient cope up with sinusitis. Getting complete rest and lying down may help feel better. Drinking plenty of liquids and taking hot liquids often may also relieve the symptoms. Applying moist heat in the face by wetting a towel in warm water and breathing in steam will help relieve congestion. A nasal spray with decongestant should never be used for more than 3 days, as it might worsen the swelling if the medicine is stopped. Alcohol should not be consumed as it worsens the sinus swelling.