Sinus Care: Prevention and Treatment for Sinusitis

About sinuses

The sinuses are small, air-filled cavities behind the forehead and cheekbones. There are four pairs of sinuses. Sphenoidal sinuses are located deep in the skulls, behind your eyes. Frontal sinuses are in the forehead. Ethmoidal sinuses are located behind the bridge of the nose, between your eyes. Maxillary sinuses are in both cheeks.

The sinuses produce secretion or mucus that traps germs while retaining the inner moisture. Bacteria can grow and cause an infection known as bacterial sinusitis when the sinuses get filled. The maxillary sinus is most commonly affected.

Sinusitis causes

Sinusitis is an inflammation of the lining of the nasal sinuses. The mucus generated by your sinuses generally drains into your nose via small channels. In sinusitis, the sinus linings are inflamed and cause the channels to become blocked. 

Sinusitis is commonly caused by a viral infection that spreads to the sinuses causing blockage of the narrow sinuses.

Bacterial sinusitis is much less prevalent, occurring in about 0.5% to 2% of cases, and is usually a complication of viral sinusitis.

Sinusitis symptoms

Symptoms of sinusitis include: 

• Pain, tenderness, and swelling around your forehead, eyes, and cheeks 

• Reduced sense of smell

• Blocked nose 

• Thick white, yellow, or green discharge from your nose

• Fever

• Bad breath

• Toothache

• Cough 

• Ear pressure

• Tiredness

Sinusitis in children can cause irritability, mouth breathing, and feeding difficulties. Their speech may sound nasal (similar to a blocked nose). Usually, symptoms begin to improve after 7 to 10 days.

Types of sinusitis

Sinusitis can generally be classified into three types. These are:

1. Acute sinusitis: Symptoms last less than 4 weeks

2. Subacute sinusitis: Symptoms last 4 to 12 weeks

3. Chronic sinusitis: Symptoms last for more than 12 weeks

For recurrent acute sinusitis, there are 2 to 4 episodes happening in a year with at least 8 weeks between episodes.

Sinusitis risk factors

Several factors increase the risk of developing a sinus infection which includes:

• Weakened immune system

• Structural abnormality to the nose, such as deviated septum

• History of allergies

• Dental infection

• Smoking tobacco

• Nasal polyps

• Dental infection

• Cystic fibrosis

• Upper respiratory tract infection

• Smoking or second-hand smoking

• Hay fever

• Seasonal allergies

Is sinusitis contagious?

Viral sinusitis is contagious and can spread from one person to another when the infected individual coughs or sneezes. 

Initially, it is difficult to determine if a sinus infection is viral or bacterial. Studies indicate that the duration of symptoms is not always sufficient to differentiate between viral and bacterial sinusitis, even if they last longer than 7 to 10 days.

It may be bacterial sinusitis if symptoms last longer than 10 days or worsen again within the first week ("double worsening").

Sinusitis diagnosis

Your doctor would first question your general health and symptoms and conduct a thorough physical examination. Sinusitis can usually be diagnosed based on symptoms and examination of the nose. 

Some of the other methods of diagnosis include:

• Nasal endoscopy: A thin, flexible tube with a light and video camera at one end (endoscope) is inserted deep into the nose. On a monitor, images captured by an endoscope are presented.

• Allergy test: Your doctor may also recommend an allergy skin test to determine if the sinusitis is caused by allergens. 

• Imaging: Imaging tests are used to view the details of your sinuses. These include magnetic resonance imaging (MRI) and computed tomography (CT).  

Sinusitis treatment options

The primary treatment for sinusitis is symptom relief, as antibiotics are only required in a small percentage of people. Sinusitis often improves without antibiotics as it is usually caused by a virus. 

The following are some of the treatment options for sinusitis:

• Nasal irrigation with saline solution

• Pain medication such as acetaminophen and ibuprofen

• Nasal steroids

• Nasal anticholinergics such as Ipratropium bromide

• Oral decongestants such as pseudoephedrine and phenylephrine

• Nasal decongestant sprays such as oxymetazoline and phenylephrine

• Oral antihistamines such as diphenhydramine

If your symptoms worsen, your doctor may start you on antibiotic treatment. The commonly prescribed antibiotic is amoxicillin.

In some instances, if a patient is not responding to medications, surgery may be recommended. A surgical procedure known as Functional Endoscopic Sinus (FESS) is done to improve the drainage of mucous from your sinuses.

Sinusitis treatment and management at home

If your symptoms are mild, you can try some of the following home remedies to help you feel better.

• Over-the-counter pain medication such as paracetamol

• Decongestant or saline nasal spray

• Steam inhalation.

• Place a warm compress over the forehead to relieve sinus pressure

Prevention of sinusitis

Following are some recommended preventive measures to avoid getting sinusitis:

• Practice good hand hygiene 

• Take the recommended vaccines such as influenza and pneumococcal vaccine

• Avoid smoking and second-hand smoking

• Avoid close contact with people who have respiratory infections

• Keep away from allergens

• Use a humidifier at home 

Prevention is always better than cure. Sinusitis may not be a very serious medical condition, but it can still cause considerable pain and irritation to you. Therefore, it is always best to take good care of your health and lead a healthy lifestyle to avoid getting sick.

Get in touch with us to book an appointment with Ear, Nose & Throat (ENT) specialists at Gleneagles Hospitals today. We assure you the best possible care tailored to your specific needs. 

References

1. Patel ZM and Hwang PH. Patient Education: Acute sinusitis (sinus infection) (Beyond the Basics). In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. [Accessed on 24 October 2022]

2. Patel ZM and Hwang PH. Acute sinusitis and rhinosinusitis in adults: Clinical manifestations and diagnosis. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. [Accessed on 24 October 2022]

3. Sinusitis. Available at https://www.ncbi.nlm.nih.gov/books/NBK470383/ [Accessed on 24 October 2022]

4. Chronic Sinusitis. Available at https://www.ncbi.nlm.nih.gov/books/NBK441934/ [Accessed on 24 October 2022]

5. Management of rhinosinusitis in adults in primary care. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5962231/ [Accessed on 24 October 2022]

6. Current and Future Treatments of Rhinitis and Sinusitis. Available at https://www.jaci-inpractice.org/article/S2213-2198(20)30071-4/fulltext [Accessed on 24 October 2022]