Brief overview
- Symptoms: Impaired nasal breathing, pressure pain in the face, possibly nasal discharge, bad breath, altered sense of smell and taste, fatigue and tiredness.
- Treatment: nasal sprays containing cortisone, saline solutions as drops, spray, rinsing or inhalation, in individual cases antibiotics or other special medications, possibly surgery.
- Course of the disease and prognosis: Often the course is protracted over years, sometimes problems persist for a lifetime. The prognosis depends, among other things, on the treatability of the cause of the disease.
- Cause and risk factors: Infections and mucosal diseases, anatomical changes that impede ventilation and drainage of secretions from the sinuses, allergies.
- Examination and diagnosis: anamnesis, endoscopy, computer tomography (CT), rarely magnetic resonance imaging (MRI), e.g. in children, possibly smear test to detect pathogens, allergy test if necessary.
What is chronic sinusitis?
Sinusitis is the medical term for an inflammation of the paranasal sinuses. If sinusitis symptoms persist for more than twelve weeks, doctors refer to it as chronic sinusitis.
Chronic sinusitis is relatively common. It is estimated that around eleven percent of Europeans are affected by it every year. The frequency increases with age. People with respiratory diseases such as asthma, COPD and allergies are more likely to suffer from chronic sinusitis. In addition, it occurs more often in women than in men.
What are the symptoms of chronic sinusitis?
The symptoms of chronic sinusitis are basically similar to those of acute sinusitis. However, the symptoms are sometimes less characteristic and not as pronounced.
For example, typical symptoms of chronic sinusitis include:
- Stuffy nose or difficult nasal breathing
- @ Nasal discharge
- Pain in the face, if applicable
- Bad breath, if any
The symptoms of chronic sinusitis also differ somewhat depending on whether or not polyps are present. Without polyps, there are basically the same symptoms as in acute sinusitis, but in a weakened form. With polyps, nasal breathing is more obstructed and headaches and facial pain are more prominent.
Nasal polyps are growths of the nasal mucosa.
In addition, chronic sinusitis is sometimes stressful for the psyche of those affected. Thus, the discomfort of chronic sinusitis often leads to a feeling of reduced quality of life. Sleep is often impaired. This in turn leads to sufferers feeling tired and less able to perform during the day.
How can chronic sinusitis be treated?
Chronic sinusitis can be treated with medications, herbal remedies, home remedies and sometimes surgery.
Doctors usually prescribe nasal sprays containing cortisone to treat chronic sinusitis. More rarely, cortisone preparations are used that act in the entire organism (i.e., systemically) and are taken as tablets, for example.
On the other hand, decongestant nasal sprays are not recommended for the treatment of chronic sinusitis. If they were used for many weeks, the mucous membrane would become accustomed to the active substance. Symptoms such as nasal congestion would then be exacerbated or lead to a vicious circle.
Certain agents from the group of so-called biologics (for example, special antibodies) have shown positive effects in studies. However, biologics are rarely used to treat chronic sinusitis.
Chronic sinusitis: surgery
In certain cases, doctors advise surgery for chronic sinusitis. However, this is only necessary in special situations, for example, when none of the conservative measures have been successful. Also, if it is determined that the ventilation and drainage of the sinuses cannot be established in any other way, the doctor may recommend surgery.
There is also an indication for surgery if there are serious complications such as infection of the bone or abscesses have developed.
Herbal remedies for chronic sinusitis
The research to date does not provide a clear answer to the question of how much herbal preparations benefit chronic sinusitis.
Do home remedies help with chronic sinusitis?
Doctors recommend the use of saline solutions as a home remedy for chronic sinusitis. These can be used in various ways, for example as nasal drops or sprays or in the form of nasal rinses. Saline solutions improve the removal of mucosal secretions and promote swelling of the mucous membranes.
Saline inhalations are also sometimes helpful in chronic sinusitis.
Home remedies have their limitations. If the symptoms persist for a long time, do not get better or even get worse, you should always consult a doctor.
Do homeopathy or acupuncture help with chronic sinusitis?
There are some studies on the use of homeopathy and acupuncture for the treatment of chronic sinusitis. However, experts consider the data situation so far too unclear to derive any benefit from this.
The concept of homeopathy and its specific efficacy are controversial in science and not clearly proven by studies.
What is the course of chronic sinusitis?
The course of the disease in chronic sinusitis is often protracted and the chronic inflammation sometimes persists for years – in extreme cases, those affected have to deal with the sinusitis for the rest of their lives. However, with appropriate and consistent therapy, the symptoms often improve.
In principle, the cause of chronic sinusitis plays an important role in the prognosis. The better the cause can be eliminated, the more likely a favorable prognosis is.
A subjective improvement of the symptoms is also important. This is because the consequences of chronic sinusitis often put a strain on the patient’s psyche. The quality of sleep often suffers as a result of the impeded nasal breathing. Therefore, people with chronic sinusitis often describe constant fatigue.
What is the cause of chronic sinusitis?
There are various causes of chronic sinusitis. Sometimes the chronic inflammation is preceded by an infection of the respiratory tract, especially the nasal mucosa with viruses and/or bacteria. Important risk factors also include narrowing of the nose, which makes it difficult to ventilate the sinuses and drain secretions.
Conversely, however, there is a risk that constrictions will form as a result of chronic inflammation.
In addition, allergies sometimes increase the risk of chronic sinusitis.
However, the exact mechanisms that take place in the mucosa during chronic sinusitis are not yet fully understood. Researchers suspect, among other things, that local defense functions are disturbed.
How does the doctor diagnose chronic sinusitis?
The physician then performs various examinations to determine chronic sinusitis. Nasal endoscopy with an endoscope is particularly important. This is a long narrow rod with a light source and camera at the end.
The doctor carefully pushes the endoscope into the nasal opening and examines the inside of the nasal cavity, the nasal passages and the narrow accesses to the sinuses. In doing so, he looks for signs of inflammation as well as anatomical constrictions.
In addition, physicians have various imaging techniques at their disposal. An ultrasound examination has the advantage that it carries practically no risks. However, of all the sinuses, only the maxillary sinuses and the frontal sinuses can be examined using ultrasound. The significance of the examination is limited.
Normally, no laboratory tests are required for the diagnosis of chronic sinusitis. However, if there is a suspicion of another underlying disease (such as cystic fibrosis, specific immunodeficiencies, sarcoidosis or others), the physician will arrange for an appropriately targeted laboratory test.
In certain circumstances, the physician will take a swab from the nose to accurately determine pathogens involved.
In addition, the physician may arrange for allergy testing, especially in patients who have chronic sinusitis but do not have nasal polyps.
How can chronic sinusitis be prevented?
Not all causes of chronic sinusitis can be prevented. However, to prevent acute sinusitis from becoming chronic sinusitis, it is important to cure it consistently.
In general, to prevent infections and chronic inflammation, it is helpful to ensure a healthy immune system. Support your immune system with a healthy lifestyle. This includes a healthy, varied diet with plenty of fresh vegetables and fruits, fish and moderate to little meat.
Try to be physically active and exercise. Daily walks in the fresh air are a good start.
If possible, avoid factors that are harmful to your health or weaken your defenses. Avoid stress and make sure you get enough sleep. Do not smoke, because smoking irritates the mucous membranes persistently.
