*SINUS*

A sinus is a hollow space in the body. There are many types of sinus, but sinusitis affects the
paranasal sinuses, the spaces behind the face that lead to the nasal cavity.

The paranasal sinuses have the same mucous membrane lining as the [Link] produce a slimy
secretion called mucus. This keeps the nasal passages moist and traps dirt particles and germs.

Sinusitis occurs when mucus builds up and the sinuses become inflamed.

*SINUSITIS*

Sinusitis is a common inflammation of the paranasal sinuses, the cavities that produce the mucus
necessary for the nasal passages to work effectively.

It can be acute or chronic, and it can be caused by viruses, bacteria, fungi, allergies, or even an
autoimmune reaction.

Although uncomfortable and painful, sinusitis often goes away without medical intervention.
However, if symptoms last more than 7 to 10 days, or if there is a fever or a bad headache, you
should see your doctor.
*TYPES*

Sinusitis always involves nasal swelling and a buildup of mucus, but there are different types, and
they can last for different lengths of time.

The different types are:

•Acute sinusitis: This lasts up to 4 weeks and is the most common type.

•Subacute sinusitis: Symptoms last longer than the normal acute period, for between 4 and 12
weeks.

•Chronic sinusitis: Symptoms persist, or continually return, after 12 weeks. It may need more
invasive treatment, and possibly surgery.

*CAUSES*

Sinusitis can stem from various factors, but it always results from fluid becoming trapped in the
sinuses. This fuels the growth of germs.
•Viruses: In adults, 90 percent cases of sinusitis result from a virus

•Bacteria: In adults, 1 case in 10 is caused by bacteria

•Pollutants: Chemicals or irritants in the air can trigger a buildup of mucus

•Fungi: The sinuses either react to fungi in the air, as in allergic fungal sinusitis (AFS), or they are
invaded by fungi, as in chronic indolent sinusitis

*RISK FACTORS*

The following may increase a person’s risk of developing sinusitis:

• Previous respiratory tract infections, such as the common cold

• Nasal polyps, or small growths in the nasal passage that can lead to inflammation

• Weakened immunity, due, for example, to a health condition or some kinds of treatment

• An allergic reaction to substances such as dust, pollen, and animal hair

• Structural problems in the nose, for example, a deviated septum

The septum is the bone and cartilage that divides the nose into two nostrils. When this is bent to
one side, either through injury or growth, it can lead to repeated infections and inflammation.

*SIGNS AND SYMPTOMS *

Symptoms vary, depending on the length and severity of the infection.

If the patient has two or more of the following symptoms and thick, green or yellow nasal
discharge, they may be diagnosed with acute sinusitis.

facial pain and pressure

blocked nose

nasal discharge

reduced sense of smell

congestion
cough

In more advanced cases, the following symptoms may also be present:

fever

halitosis, or foul-smelling breath

tiredness

toothache

headache

If these symptoms continue for 12 weeks or longer, the doctor may diagnose chronic sinusitis.

*DIAGNOSES *

A doctor will carry out a physical examination and ask the patient about their symptoms. This is
usually enough to make a diagnosis.

The doctor may visually examine the nasal cavity with a light source, or a small, handheld device
with a light attached called an otoscope, which can also be used to examine the ears.

If symptoms persist, a doctor may refer a person with sinusitis to an ear, nose, and throat
specialist (ENT) for a more in-depth examination. They may insert an endoscope into the nose, a
small, thin, flexible tube with a light and camera attached. This can provide more detailed images.

In cases of persistent or severe sinusitis, a CT scan may be needed.

*TREATMENT *

Treatment options depend on how long the condition lasts.

*Acute and subacute sinusitis*

A nasal spray may relieve symptoms.

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Most acute cases will resolve without treatment.

However, sinusitis can be uncomfortable, so people often use home remedies and over-the-
counter (OTC) medications to relieve symptoms.
In the following cases, the person should see a doctor:

Symptoms persist longer than 7 to 10 days.

There is a fever higher than 101.5° Fahrenheit, or around 38.6° Celsius.
There is a bad headache that does not resolve with over-the-counter (OTC) drugs.
Visual disturbances occur, or there is swelling around the eyes.
Symptoms continue after taking antibiotics prescribed by a physician.
If the sinusitis has a bacterial cause, a doctor may prescribe antibiotics. If symptoms remain after
the course of medication is finished, the individual should return to the doctor.

*Chronic sinusitis*

Chronic sinusitis is not usually bacterial in nature, so antibiotics are unlikely to resolve symptoms.
A fungal infection can be treated with antifungal drugs.

Corticosteroid sprays can help in recurrent cases, but these need a prescription and medical
supervision.

In allergic sinusitis, treating allergies with shots or reducing and avoiding exposure to allergens
like animal dander or mold can lessen the occurrence of chronic sinusitis.

*SURGERY *

Structural issues, such as a deviated septum, may need surgery. Surgery may also be advised if
there are polyps, or if the sinusitis has resisted all other treatments.

Functional endoscopic sinus surgery (FESS) is the main procedure used for treatment, but other
surgeries may be required as other parts of the nose are often affected. If a deviated septum is
causing recurrent infections, for example, a septoplasty will be used to straighten out this bone
and cartilage.

Treatment may still be required following surgery to prevent the return of sinusitis.

Surgery should always be the last resort on sinusitis in children, and obtaining a second opinion is
recommended before proceeding

*HOME REMEDIES *

Less severe or recurrent cases of sinusitis can be treated at home without the need to visit a
doctor.

These remedies can reduce pain and unblock the sinuses to allow proper drainage.
Home remedies for sinusitis include:

*•Nasal irrigation*: Also known as sinus irrigation, sinus rinse, or sinus lavage, this home
procedure involves rinsing and clearing the nasal passages with salt water or a saline solution.

*•Warm compress*: Applying a warm compress gently to the affected areas of the face can
relieve some swelling and discomfort.

*•Painkillers*: These can reduce symptoms of pain and fever.

Steam inhalation: Breathing hot, moist air can provide relief from congestion. At home, steam
from a bowl of hot water, possibly with some drops of essential menthol or eucalyptus oil, can
help unblock the sinuses. Essential oils should not be applied directly or swallowed.

*•Decongestant tablets and sprays*: These may reduce swelling and allow the sinuses to drain.
Patients should not use sprays for more than 3 days. Decongestant tablets and sprays are
available

*•Hydration and rest*: Drinking fluids regularly and avoiding overexertion can help the symptoms
to pass.

A doctor or pharmacist can advise about these options and how to use them.

*PREVENTION *

The following may help prevent sinusitis:

Practice good hand hygiene.

Avoid smoking and second-hand smoke.

Keep vaccinations up to date.

Stay away from people with colds and other respiratory infections.

Use a humidifier to moisten the air at home, and keep it clean.

Maintain air conditioning units to prevent mold and dust from collecting.

Where possible, avoid allergens.

*COMPLICATIONS *

• Infection of the eye and its surrounding tissue

• Sinus cavity blood clot (thrombosis)

• Meningitis

•Brain abscess

• Bone infection