Sinusitis or sinusitis is an inflammation of the mucous membrane in the sinuses. It is mostly caused by viruses or bacteria and can be acute or chronic. Typical symptoms are rhinitis and stabbing and throbbing pain in the area of the forehead and eyes.
What is sinusitis?
Sinusitis is also known as sinusitis in medicine. In this case, the paranasal sinuses in particular are inflamed. Sinusitis usually occurs acutely, but can also develop into chronic sinusitis under certain circumstances. Inflammation of the paranasal sinuses occurs quite frequently. In acute disease, the maxillary sinus, frontal sinus, ethmoid bone or sphenoid sinus in the skull are usually affected. In chronic sinusitis, the disease usually spreads only to the ethmoid bone or maxillary sinus. In rare cases, all sinuses are inflamed. This is then called pansinusitis or polysinusitis.
Causes
The causes of sinusitis is divided into acute and chronic causes and will now be discussed in more detail below.
Acute sinusitis
After a pharyngitis or cold, a sinusitis can occur. In this case, viruses are considered to be the trigger, which cause the mucous membrane to swell during the course of the disease and shift the focus of inflammation toward the sinus entrances. A secondary bacterial infection then occurs. Streptococci, pneumococci and the bacteria Haemophilus influenzae play a particularly important role here. In addition, pre-existing nasal polyps, an enlarged nasal concha or a crooked nasal septum promote the inflammation. Likewise, a diseased tooth root or an inflammation caused by a pulled tooth is possible as a supporting trigger. Rather more rarely, acute sinusitis occurs after a bath or swimming, where pathogens in the water can lead to inflammation of the sinuses.
Chronic sinusitis
The causes of chronic sinusitis are mostly insufficient ventilation of the sinuses, which are then narrowed. Likewise, a crooked nasal septum, nasal polyps and enlarged turbinates are among the triggers. Furthermore, aggressive bacterial pathogens coupled with a weakened immune system are also possible. Since mucus transport is impeded over a long period of time in this case, the bacteria can lead to chronic inflammation.
Symptoms, complaints, and signs
Acute inflammation of the sinuses begins with a cold that does not subside in the usual time. Instead, the nasal secretions solidify, and the nose is blocked and cannot be cleared. Nasal breathing is no longer possible, and the sense of smell and taste are impaired. In addition, there is a feeling of pressure in the head and face that intensifies and becomes palpitating when the affected person leans forward, stands up from sitting or hops. Sneezing and coughing also increase the pain. The skin of the face may become sensitive to touch. Which of the sinuses is inflamed is indicated by the areas where the pain is located. If sinusitis is present, the forehead and eyes hurt. If the maxillary sinuses are diseased, the pain is in the cheekbones and upper jaw. This discomfort sometimes feels like a toothache and may even radiate to the lower jaw. If the pain is felt in the temples and back of the head, the inflammation is in the ethmoid or sphenoid sinuses. If sinusitis is not treated, visual disturbances, extreme headaches or sensitivity to light may occur. In addition, if not treated, there is a risk that the disease will become chronic. In this course, the existing pain decreases over time, but the general condition worsens and the performance decreases. The patient feels ill.
Disease progression
The course of sinusitis can be positive if the disease is recognized and treated in time. Acute sinusitis is usually treated quickly by the primary care physician. In case of chronic disease, removal of polyps or surgery of a crooked inner wall of the nose could be considered. Complications can occur in the form of laryngitis or chronic pharyngitis. Likewise, acute bronchitis.In severe and untreated cases, the frontal sinus may even be breached, in which case the skin of the forehead may also become inflamed. In combination with maxillary sinusitis, the inflammation may break through to the orbit. This then sometimes leads to irreversible loss of vision or visual disturbances. If the brain is affected by the sinusitis, meningitis, neck pain and brain abscesses may occur. Lifelong neurological disorders may occur. Paralysis and seizures are particularly noticeable in this case. Various complications can occur as a result of sinusitis. However, these rarely occur with proper treatment. Without appropriate treatment, however, serious effects are imminent.
Complications
The risk of complications with sinusitis exists primarily when the inflammation persists over a longer period of time. It can also take a chronic course or recur again and again. Thus, chronic sinusitis triggers repeated acute episodes. As a result, concomitant diseases such as acute bronchitis, inflammation of the throat or laryngitis also become apparent. In such cases, physicians speak of a sinubronchial syndrome. Another possible problem of sinusitis is its spread to adjacent tissues. For example, the pathogens can cause mild periosteum inflammation or serious inflammation of bone tissue and soft tissue. In some cases, sinusitis can also lead to serious complications such as meningitis (inflammation of the meninges) or even encephalitis (inflammation of the brain). These sequelae become noticeable through sensitivity to light, intense headaches, pronounced fatigue and irritability. If these signs occur, immediate treatment in a hospital must take place. Especially in children, there is a risk that the sinusitis will spread to the eye sockets. In this case, the eyelids swell and become red. Antibiotics are administered for treatment. It is not uncommon for surgery to be required. In extreme cases, there is a threat of blood poisoning (sepsis), which can assume life-threatening proportions.
When should you go to the doctor?
Sinusitis usually goes away on its own with proper rest. However, it is extremely uncomfortable, and a doctor can relieve the discomfort. Persistent rhinitis that does not subside should be presented to a physician. If there is additional impairment of taste perception and pain in the face or head, a doctor is needed. If the affected person cannot clear the nose sufficiently, the help of a physician should be sought. If breathing is disturbed, oxygenation is difficult, and nasal vocalization occurs, there is cause for concern. The affected person needs medical help to avoid an acute condition or the development of various sequelae. Impaired vision, sensitivity to light, and concentration and attention deficits should be discussed with a physician. Toothache or a feeling of pressure inside the head are perceived as extremely unpleasant. Consultation with a medical professional is recommended before taking pain-reducing medications due to the severe side effects. If daily activities can no longer be performed, or if the affected person suffers from irritability or an increased body temperature, a doctor should be consulted. Patients report a throbbing as well as knocking sensation in the head. This is characteristic of a sinus infection and should be clarified by a doctor. If there is discomfort in the head as soon as the affected person leans forward slightly, this should be interpreted as a sign of an existing disease. A visit to the doctor is necessary, because if left untreated, there is usually an increase in discomfort.
Treatment and therapy
In the therapy or treatment of sinusitis, both conservative methods and surgical interventions are considered. Acute sinusitis usually treated with conservative measures. In any case, a doctor should be consulted for further examination. For conservative treatment, decongestant nasal drops have proven particularly effective. These can be administered directly or inserted into the affected nasal cavity with a cotton swab.To relieve the general discomfort and symptoms, such as the stabbing pain of the sinus, antipyretic, anti-inflammatory and expectorant medications (often with the ingredients ibuprofen or paracetamol) are recommended or prescribed by the doctor. Only in rare cases antibiotics must be administered. Supportive red light irradiation helps to loosen the mucus. Likewise, homeopathic remedies and acupuncture can also help. Many doctors also offer sinus irrigation. In the case of chronic sinusitis, surgery is predominantly performed for the causes. In this case, sinus puncture in particular has proven to be successful. During the operation, depending on the cause, either a crooked nasal septum is straightened, polyps are removed or the turbinates are reduced in size. The surgical instrument used is the enoscope with microsurgical attachments. The surgical procedure can be performed on an outpatient basis in small cases or in the hospital for larger surgeries.
Aftercare
A distinction must be made between acute and chronic sinusitis. The acute form of progression heals within a few weeks. Subsequently, no follow-up care is necessary because there is freedom from symptoms. The patient requires neither further medication nor support in his daily life. However, there is also no immunity. The development of a recurrence of sinusitis can best be countered by completely curing a cold. Patients should therefore be sure to follow their doctor’s instructions. The situation is different with chronic sinusitis. It leads to protracted long-term treatment or aftercare. Even a lifelong therapy cannot be excluded. Presentations to a physician are recommended on a quarterly basis. In these, the general and specific state of health is ascertained. This is followed by a physical examination to document the progress. Suitable methods include nasal endoscopy, imaging procedures, and a swab of the cold, which is then examined in the laboratory. The doctor hopes that this will help to prevent complications such as spread to the brain or to be able to react to difficulties as quickly as possible. In addition, the question of surgery can be discussed, which is indicated for certain clinical pictures. In terms of medication, cortisone-containing nasal sprays can help. The patient will receive further prescriptions for this.
Outlook and prognosis
Acute sinusitis usually subsides after a short time. In 60 to 80 percent of those affected, it lasts about two weeks. In contrast, around 90 percent of all cases of acute sinusitis heal within six weeks. In contrast, chronic sinusitis can last for many years. In individual cases, patients even suffer from the disease for the rest of their lives. It is crucial that the causes of the chronic inflammation are eliminated. These can be, for example, constrictions inside the nose. Complications of sinusitis are very rare if treated correctly and in time. However, chronic purulent sinusitis can spread to adjacent periosteum and the bone as well as soft tissue if left untreated. More serious problems threaten those affected if, for example, an eye socket, the meninges or even the brain become inflamed. In the event of such dangerous complications of sinusitis, treatment in hospital is then necessary in most cases. An acute sinusitis that occurs in children usually heals without problems. However, if it has progressed to a chronic inflammation, the prognosis depends on how effectively the causative factors can be treated. Without any treatment, however, sinusitis can cause complications similar to those seen in adults, such as the inflammation spreading to the meninges. However, this rarely happens.
What you can do yourself
The use of nasal irrigation helps support initiated medical treatment for sinusitis. The rinsing of the nose can be used by specially developed rinsing devices and using a saline solution independently. Nasal rinsing promotes the decongestion of the mucous membranes in the entire nasal area. In addition, there is an improved drainage of the nasal secretions.The pathogens are transported out of the nasal area by this process and can be eliminated by the organism. Inhalation with various remedies is also recommended for sinusitis. It can be inhaled with saline solution, but likewise with chamomile. The procedure is possible with or without the use of an inhaler. Encrustations on the nasal walls are loosened, the mucous membrane is moistened and the removal of nasal secretions is promoted. Inhalation is a gentle process that decongests the mucous membranes and expels pathogens. The popularly known pulling up the nose is not recommended. Since a runny nose is an indication of secretion of the diseased secretion, pulling it up would cause crusting and interrupt the healing process. Regular thorough cleaning of the nose is advisable in these cases. Not too much force should be used, as high pressure in the head and sinuses is unfavorable.
