Sinusitis

Sinusitis commonly occurs after other illnesses like the cold or flu. Sinusitis happens when the mucosal lining of the sinuses becomes inflamed or infected. Sinusitis is actually very common.

The sinuses are hollow spaces in the facial bones that connect to your nose through small, narrow passages. Sinuses give your voice resonance, and they also lighten the weight of your head. You have four pairs of sinuses.

Causes of Sinusitis

Sinusitis can stem from various factors, but it always results from fluid becoming trapped in the sinuses, allowing germs to grow. Sinus blockage can have a variety of environmental, anatomical, and genetic causes, but the main culprit is swelling of the nasal passages produced by the common cold or allergies. The excess mucus accumulates in the sinuses and causes sinus pressure, congestion, post-nasal drip, headaches, and fatigue. Severe sinusitis can also cause fevers and thick, yellow, foul-smelling nasal discharge.

The most common cause is a virus, but a bacterial infection can also lead to sinusitis. Triggers can include allergies and asthma, as well as pollutants in the air, such as chemicals or other irritants.

Risk factors

The following may increase a person’s risk of developing sinusitis having a previous respiratory tract infection, such as a cold, nasal polyps, which are small benign growths in the nasal passage that can lead to obstruction and inflammation, seasonal allergies, sensitivity to substances such as dust, pollen, and animal hair, having a weakened immune system due to medication or a health condition, or having a deviated nasal septum.

Types of Sinusitis

There are different types of sinusitis, and they can last for various lengths of time. Recovery time and treatment depend on the type of sinusitis. We describe types of sinusitis based on how long it’s been going on (acute, subacute, chronic, or recurrent) and what’s causing it (bacteria, virus, or fungus).

Acute sinusitis symptoms last less than four weeks. It’s usually caused by viruses like the common cold. Recurrent acute sinusitis symptoms come back four or more times in one year and last less than two weeks each time. Subacute sinusitis symptoms last four to 12 weeks.

Chronic sinusitis symptoms last at least more than 12 weeks. Bacteria are usually the cause. Over 50% of people with moderate-to-severe asthma also have chronic sinusitis. Many people with chronic sinusitis suffer with their sinuses for years and years.

Bacteria can cause sinusitis, or they can infect you after a case of viral sinusitis. Only 2% of sinus infections are bacterial, which means only 2% of sinusitis sufferers require an antibiotic. There are millions of bacteria in the noses, and most of the time, they're harmless. Even when a few creep into the sinuses, they don't cause trouble, as long as they keep draining into the nose along with mucus. But if sinus drainage is blocked, glands in the sinuses continue to produce mucus, and the resulting pool of backed-up mucus provides the perfect culture medium. The bacteria grow out of control, causing infection, and the immune system kicks off an inflammatory response. The result is a swelling, which causes headache and facial pain; mucus buildup, which produces congestion; and an influx of white blood cells to fight the bacteria, which thickens the mucus and may tint it yellow or green. Other symptoms include loss of smell or taste, cough, bad breath, fever, toothache, and fullness in the ears.

Some people have one or two sinus infections every year. For them, that’s their typical pattern. But if someone has at least 4 sinus infections every year, we say that they have recurrent acute sinusitis.

Fungal Sinusitis

There are more than 100,000 species of fungi. They live all around us, and most aren’t dangerous. But some fungi can invade the body and multiply, leading to serious health problems. Fungi can enter the sinuses when someone breathes them in.

Sinus infections caused by fungus are usually more serious than other forms of sinusitis. Several types of fungal sinus infections cause similar symptoms. These may include nasal congestion and sinus pain (in the cheeks, forehead and between the eyes).

People who have conditions that weaken the immune system (such as diabetes and leukemia) are much more likely to get fungal sinusitis. They also have a higher risk of complications. Some types of fungal sinusitis can destroy the lining of the nose, spread to the brain and lead to death.

Fungal sinus infections have increased over the last few decades. This may be because healthcare providers are prescribing more antibiotics and immunosuppressant drugs. This increase could also be due to a rise in the number of diseases that weaken the immune system.

Symptoms of Sinusitis

Symptoms vary depending on how long a condition lasts and how severe the symptoms are. The symptoms may include nasal discharge, which may be green or yellow, a post nasal drip, where mucus runs down the back of the throat, facial pain or pressure, blocked or runny nose, sore throat, cough, bad breath, fever, headaches, a reduced sense of smell and taste, tenderness and swelling around the eyes, nose, cheeks, and forehead, and toothache.

Complications of Sinusitis

Acute sinusitis doesn't often cause complications. Complications that might happen include chronic sinusitis, and meningitis. Other infections are not common. But an infection can spread to the bones, or to skin.

Orbital involvement is the most common complication of sinusitis (accounting for 80% of all complications) because of its close anatomical relationship to the paranasal sinuses. Eye complications include infection of the soft tissue surrounding the eye or infection of the eye socket.

Complications in the brain include infection or abscess formation in different parts of the brain, but this is very rare.

Prevention of Sinusitis

It’s always a good idea to wash your hands frequently to avoid contracting the viruses that cause the flu and the common cold – and often lead to sinus infections.

Drink lots of water. Good hydration helps keep the mucus thin and loose. Bathe your nasal passages daily. Run water gently into the nasal passages to help clear excess mucus and moisten membranes. Good times to do it are in the morning and at night, when you brush your teeth. During the day, use nasal saline spray to moisten nasal passages. The nasal cilia (the fine hairs that help fend off infection) function better in a moist environment.

Avoid dry environments. The cold, dry air of winter not only dries out your skin but your nasal passages as well. The dry air will irritate your sinuses and make your symptoms even worse. Utilize a humidifier or vaporizer to add moisture back into the air.

Maintain air conditioning units to prevent mold and dust from collecting. Avoid and manage allergens when possible. Avoid antihistamines unless prescribed. Antihistamines make mucus thick and hard to drain. Be careful with decongestants. Tablets containing pseudoephedrine act on blood vessels to shrink membranes and keep nasal passages open. Using topical nasal decongestants for more than a day or two runs the risk of setting off a spiral of dependency as a result of rebound — increased swelling after the medication wears off. Oral decongestants can cause jitters and increase blood pressure.

Getting at least eight hours of sleep will help your body’s immune system fight against sinus infection. Sleep with your head elevated. Mucus pools in your sinuses at night when your head is down, so have your head propped up with pillows or a wedge during sleep.

Be nice to your nose. Blow your nose gently, one nostril at a time. Forceful blowing can irritate the nasal passages and propel bacteria-laden mucus back up into your sinuses.

Avoid smoking and secondhand smoke. Keep vaccinations up to date. Stay away from people with colds and other respiratory infections.