In medical terminology, chronic sinusitis is a permanent inflammation of the sinuses. It is caused by an infection of the nose with viruses or bacteria and can be treated with various medications.
What is chronic sinusitis?
Chronic sinusitis refers to an inflammation of the mucous membrane in the sinuses that does not resolve completely. The term chronic disease is used when symptoms persist after two to three months. The disease occurs relatively frequently and in its acute form mostly affects the maxillary sinus and ethmoid bone. Chronic sinusitis also occurs in these areas, but can spread even further.
Causes
Chronic sinusitis develops as a result of acute sinusitis. This in turn is triggered by an inadequately treated cold or pharyngitis. If this is not responded to in time, the symptoms become chronic. Certain allergies to pollen, house dust or other foreign bodies can also trigger the disease. However, chronic sinusitis can also be cured by taking appropriate measures. The reason for chronic inflammation of the sinuses can also be anatomical. A bent nasal septum, enlarged turbinates or nasal polyps, for example, have a particularly negative effect on the course of the disease.
Symptoms, complaints and signs
Chronic sinusitis can cause a number of symptoms. Typically, the condition is characterized by recurrent colds accompanied by runny nose, headache, nasal congestion and other classic symptoms and discomfort. Usually a discharge presents itself, which is yellow-greenish, purulent and viscous. It drains out of the nose and into the throat, and this causes the nasal cavities to close. Poor nasal breathing occurs, which can cause dizziness, loss of performance, and a severe feeling of malaise. Accompanying this, the perception of smell and taste is usually also reduced. The patient usually also experiences a feeling of congestion in the face, which increases in intensity as the disease progresses. The facial pain is usually stabbing, piercing, or pulsating. They occur more frequently over the forehead, nose or cheek and often radiate to the center of the skull or to the area between the eyes. Typical of the condition, the pain intensifies when the affected person bends forward quickly, stands up, or hops on one leg. Chronic sinusitis can be confined to a single sinus, but it can also occur throughout the nasopharynx. It is often accompanied by fever or polyp formation.
Diagnosis and course
In order to diagnose chronic sinusitis, the acute underlying disease must first be clearly recognized as such. This is done on the basis of the typical complaints of sinusitis. These include pain in the forehead or upper jaw area, purulent rhinitis, problems with the sense of smell and a blocked nose. If these complaints are not present, sinusitis can usually be ruled out. In chronic sinusitis, however, diagnosis is more difficult because the symptoms are much weaker and occur only in episodes. If the probability of sinusitis is high, an endoscopic examination is usually performed to confirm the diagnosis. The endoscope is inserted into the mouth and nostrils in order to detect discharged secretions and swellings. The secretions are also examined to detect the pathogen causing the sinusitis. Following this, the appropriate medication is prescribed. Chronic sinusitis is diagnosed only if various preparations do not have an effect. Further examinations, such as computer tomography and various allergy tests, are also performed so that surgery can be performed. In addition, dental checks and olfactory tests may be useful to avoid concomitant diseases. The disease is usually not fatal for those affected, but severely limits the quality of life and sometimes causes major problems in everyday life.
Complications
One speaks of chronic sinusitis if the inflammation is not cured even after two to three months.After that, there is still a possibility that the disease will recede on its own, but further steps are nevertheless taken to prevent it from spreading. Medication and a change in external circumstances can make chronic sinusitis more comfortable for those affected. However, it cannot always be completely cured and so some patients have to take medication against it for life. Chronic sinusitis can spread, affect and damage neighboring areas of the body. If no medical treatment is given, serious complications can arise. The eyes are particularly at risk. The sinuses and the eyes are separated by a thin bone plate. Inflammation can damage this to such an extent that a perforation occurs and bacteria can enter directly into the eye socket. Severe eye damage, even blindness, can result. The brain is also considered to be at risk in chronic sinusitis. If a breach of the bony separation between the brain and sinuses develops, meningitis may result. Such a condition can pose a life-threatening threat and requires urgent medical treatment. Furthermore, there is a risk of pus settling in the brain structures and abscesses forming. It is also possible for blood clots to form in the brain veins (thrombosis). There is also a risk of encroachment on the teeth. It is not uncommon for inflammation of the roots of the teeth to originate in chronic sinusitis. If left untreated, breathing through the nose also becomes increasingly worse. A consequential problem of this is snoring.
When should you go to the doctor?
Chronification of simple sinusitis should be seen as a complication. For this reason, any chronic sinusitis requires medical treatment. Serious complications can only be avoided if a doctor is consulted in time. In advanced stages, surgical therapy is usually unavoidable. Otherwise, the symptoms will not improve. If a major operation is to be avoided, it makes sense to consult a doctor as early as possible. As a rule, consultation with a physician is appropriate if the symptoms of acute sinusitis persist beyond the usual period of time. In this case, the physician can intervene – often by administering an antibiotic. A significant improvement in the distressing problem can usually be achieved within a few weeks of seeing a doctor. The right contact person in this case is the specialist in otorhinolaryngology, who has a wide range of diagnostic and therapeutic options at his disposal. Consultation of this specialist can also be done without referral by the family doctor.
Treatment and therapy
After chronic sinusitis has been diagnosed, various measures can be initiated. If allergies are the cause, antiallergic drugs and nasal spray are prescribed. So-called hyposensitization is also part of some therapies. In addition, antibiotics and nasal rinses are prescribed to flush out bacteria and relieve symptoms. In some cases, a change in diet can also help against chronic sinusitis. This is the case when there is a food intolerance. In any case, an expert must be consulted to effectively treat the condition. In the meantime, apart from protracted therapies, there is also the possibility to remedy the complaints surgically. In this case, the blocked connecting ducts are dilated with the help of a balloon. However, this so-called siluplasty is only suitable for simple cases of chronic sinusitis. Treatment methods used for acute sinusitis can at least relieve symptoms in the chronic form. Common therapies include steam inhalation, acupuncture, and the use of essential oils.
Outlook and prognosis
The prognosis of chronic sinusitis is individual and cannot be predicted uniformly for all affected individuals. In a large number of patients, there is a cure as well as complete freedom from symptoms despite the chronic course of the disease. Likewise, there is the possibility of a continuous course of the disease, in which the patient has lifelong impairments. If the doctors can restore the ventilation of the sinuses, there is a good chance of recovery.A surgical procedure is performed in an attempt to achieve this goal. The success depends on the severity of the disease, the age of the patient as well as his general state of health. By restoring the ventilation of the paranasal sinus, regeneration of the functional activity of the mucous membranes can take place. This process is essential for a good prognosis and can take place within a few weeks if the operation is successful. In addition, the patient must attend prescribed follow-up and control examinations after the surgery to ensure a good outcome. The prognosis worsens if the disease has already spread to the surrounding regions of the face. If the eyes or teeth are already affected by chronic sinusitis, lifelong damage may result. For example, complete recovery is no longer possible if blindness has already occurred due to chronic sinusitis.
Prevention
Sinusitis becomes a chronic disease mainly due to a lack of early detection of the causes. Thus, a preventive measure is to visit an otolaryngologist when the first symptoms appear. In addition, colds, pharyngitis as well as rhinitis must be sufficiently cured so that chronic complaints do not develop. In general, it helps to drink plenty of fluids, rinse the nose regularly with a lukewarm saline solution and ventilate the home well. In addition, an allergy test can help to curb the symptoms. Hyposensitization also prevents chronic sinusitis. Finally, care should be taken to maintain a healthy, hardened immune system. Sufficient exercise and a healthy diet are essential for the prevention of chronic sinusitis.
Follow-up
Chronic sinusitis is a sinus infection that persists over time. This can cause a great deal of distress to the patient. Therefore, treatment with decongestant cortisone sprays and appropriate follow-up care is necessary after virtually every cold. If necessary, surgery must provide pressure relief. If the connecting passages between the sinuses are narrowed by curvatures in the nasal septum or blocked by polyps, frequent sinusitis is the result. Chronic sinusitis can often be successfully treated by conventional means. Most often, cortisone sprays are used to improve breathing and relieve pressure. However, if conservative treatment is not successful in the long term, the symptoms of chronic sinusitis can only be resolved by means of surgical intervention or paranasal sinus reconstruction under general anesthesia. This often involves surgical correction of the curvature in the nasal septum. Follow-up care is required because bleeding and persistent swelling occasionally occur postoperatively. There is also a risk that the problems may not prove to be corrected in the long term. Complications arise, for example, if the patient must use a nighttime breathing aid because of sleep apnea. The nocturnal breathing aid cools the airways to such an extent that chronic sinusitis is virtually impossible to control. In this case, follow-up measures can only ensure that the patient who has already undergone surgery receives medical pressure relief every time he or she catches a cold.
Here’s what you can do yourself
In the case of chronic sinusitis, the affected person can supportively pay attention to his lifestyle in order to achieve an improvement in his own health. Smoking should be avoided completely, as should spending time in smoking areas or rooms. A healthy diet improves the well-being and stabilizes the immune system, so that the organism can produce sufficient defenses on its own. When it comes to food intake, attention should therefore be paid to a diet rich in vitamins and, in addition, sufficient exercise should be taken. The liquid supply is to be considered. The nasal mucosa needs sufficient fluids in order to regenerate. In the winter months, indoor air is often dry, and in the summer months, outdoor temperatures can promote dehydration of the mucous membranes. With about two liters daily, the organism is therefore to be supplied with liquid. Particularly hygienic behavior should be observed when dealing with other patients. Hands should be disinfected and nasal sprays or handkerchiefs should not be shared with other people.Care should be taken to ensure that no other pathogens can enter the organism. The number of germs is significantly increased, especially in cold seasons. For this reason, preventive action should be taken carefully, so that one’s own immune system is not put under even greater strain and the healing process is made more difficult.
