Sinusitis: Symptoms, Diagnosis & Treatment

Sinusitis, known to all of us, is one of the diseases that are common to all ages and mainly appears in the winter season.

Let’s see what it is, what reasons increase the likelihood of having it, how it is diagnosed and, of course, how to treat it!

What is sinusitis?

Sinusitis is an inflammatory condition in which the sinuses become inflamed.

The sinuses are air-filled cavities located in the bones of the skull, around the nose. In some cases, when the air does not circulate as it should and there is an accumulation of mucus in the sinuses, a person may develop this condition.

Sinusitis is mainly caused by viruses and usually occurs after a cold.

Symptoms

Sinusitis symptoms range from a runny nose with discharge and a feeling of nasal congestion, to facial pain and loss of smell.

The majority of symptoms are not a serious cause for concern, with most of them (eg stuffy nose, pain) being well managed with medication.

The most characteristic symptoms are the following:

1. Nasal congestion
2. Nasal discharge (green or yellow mucus)
3. Postnasal drip (mucus from nose to throat)
4. Fatigue
5. Headache and feeling of pressure in the forehead
6. Pain around the nose and eyes
7. Decreased sense of smell
8. Pain in the ears
9. Cough
10. Fever
11. Bad breath
12. Altered taste

Among the complications that can be caused by sinusitis – although that rarely happens anymore – meningitis, brain inflammation and inflammation in the eye sockets and surrounding bones stand out.

What causes it?

Sinusitis can be caused by a number of factors, some of which are contagious, while others are not.

The most common ones are the following:

• Viral infections (eg flu)
• Bacterial infections
• Smoking
• Allergic rhinitis
• Crooked nasal septum (nasal septal scoliosis)
• Nasal polyps
• Sinus hypertrophy
• Cystic fibrosis
• Teeth inflammation
• Immunosuppression or weak immune system
• Excessive use of nasal sprays, antibiotics and/or other medications
• Nose injury (or injury elsewhere on the face)
• Increases in atmospheric pressure (e.g. flights)

It most commonly occurs in people with nasal and seasonal allergies, an upper respiratory infection (e.g. a cold), asthma or anatomical problems in the nose, while smokers appear to be at a particularly increased risk.

Types of sinusitis

Sinusitis is divided into four types and can be characterized, depending on the case, in the following way:

1. Acute sinusitis
2. Subacute sinusitis
3. Chronic sinusitis
4. Recurrent sinusitis

Acute sinusitis: It is the most common form of sinusitis and it is mainly caused by viruses and less often by bacteria (acute bacterial sinusitis), while the symptoms – mainly “stuffy nose” and a feeling of pressure in the face – last for less than 2 weeks.

Subacute sinusitis: The above symptoms do not go away completely and last from 2 weeks to 3 months.

Chronic sinusitis: In this case the symptoms are quite severe and last for more than 12 weeks (> 3 months). This type of sinusitis is more likely to occur in people with allergic rhinitis and abnormal airflow through the nose.

Recurrent (acute) sinusitis: In this case the person gets sick at least 4-5 times a year, with symptoms lasting less than two weeks.

Diagnosis

When someone is experiencing symptoms that are characteristic of sinusitis, they should visit an ENT doctor so that the diagnosis is made regarding the person’s health condition.

After a complete medical history is obtained and the patient reports their symptoms, a clinical & endoscopic examination of the nose is performed for a more accurate picture.

In some cases and only if necessary, additional tests such as x-rays, CT scans and/or blood tests may be needed.

Treatment

The treatment of sinusitis should always be determined by the treating physician and depends on several factors, such as the cause, the severity/intensity and duration of the symptoms, and the patient’s medical history.

Sinusitis treatment includes one or more of the following:

1. Nasal washes with salt water (sea water) or saline
2. Nasal sprays / nasal decongestants (do not use for a long time)
3. Painkillers (analgesic)
4. Antihistamines (hypoallergenic)
5. Antibiotics – if necessary
6. Adequate fluid intake
7. Adequate rest
8. Compresses
9. Vapor inhalation
10. Functional Endoscopic Sinus Surgery
11. Nasal septum plastic surgery

It is very important not to take medication without your doctor’s consent, as well as not to exceed the suggested period of time and/or the daily dose regarding your medical treatment.

Is it contagious?

Sinusitis itself is not contagious. However, its cause can be contagious (e.g. influenza virus). In this case, of course, great care is required.

On the other hand, in people who are prone to sinusitis due to allergies or some anatomical problem in the nose area, there is no reason to worry about its transmission.

Prevention

It is important to follow some basic hygiene guidelines in order to prevent the appearance of sinusitis, as well as of other diseases.

Health professionals recommend the following for the prevention of sinusitis:

• Regular hand washing with soap and water
• Avoid exposure to viruses and bacteria
• Avoid exposure to dust, pollen and smoke
• Avoid smoking (active & passive smoking)
• Vaccination against the influenza virus
• Wear a mask in crowded spaces (e.g. buses)
• Deal with your allergies
• Check for anatomical problems in the nose and correct them (if any)
• Get adequate rest and quality sleep
• Proper nutrition and regular exercise

Essentially, the preventive measures taken address the individual risk factors that significantly increase the likelihood of developing sinusitis (e.g. colds and smoking).

Naturally, close contact with people suffering from an upper respiratory infection should be avoided, while contacting the doctor is recommended if:

1. There is no improvement in symptoms after 2 weeks
2. Symptoms (pain, congestion) worsen even with medication
3. You notice swelling around the nose and/or eyes
4. You have fever (above 39℃)
5. You have a reduced sense of smell

In conclusion, sinusitis is a condition that can be caused by various factors and is usually nothing to worry about. It’s all about focusing on prevention, early diagnosis and immediate treatment to avoid any complications!