Sinusitis (Inflammation of the Paranasal Sinuses)

Typical symptoms of sinusitis include persistent rhinitis, difficulty breathing through the nose, pressure and tapping pain in the cheek, forehead and eye area, and increased secretions in the nose and throat. These symptoms can vary depending on whether the sinusitis is acute or chronic. What does sinusitis feel like? What can be done about sinusitis? We provide information about the causes, symptoms and treatment of sinusitis.

What is sinusitis?

Sinusitis is an inflammation of the mucous membranes in the sinuses that originate from the nose (paranasal sinuses). The paranasal sinuses are air-containing cavities in the adjacent bones of the nose. The paranasal sinuses are divided into:

  • The frontal sinuses (sinus frontalis), which are located behind the forehead to the right and left of the nose.
  • The maxillary sinuses (sinus maxillares), which are located to the right and left of the nose behind the cheeks
  • The sphenoid sinus (sinus sphenoidalis), which is located quite far inside the skull and abuts the back of the pharyngeal wall
  • The ethmoidal sinuses (Sinus ethmoidales), which border the front of the frontal sinus and the back of the sphenoidal sinus.

While maxillary sinusitis or ethmoidal cell inflammation occurs in most cases, frontal sinusitis is less common and sphenoid sinusitis is the rarest. Paranasal sinuses and sinusitis – iStock.com/kowalska-art

The sinuses are lined with the same mucosa as the nasal cavity itself (cavitas nasi). They are in constant communication through fine openings on the lateral and posterior walls of the nasal cavity. In the sinuses, the inhaled air is warmed and moistened and then enters the lower respiratory tract. This close connection is why sinusitis often occurs as a result of rhinitisinflammation of the nasal mucosa, better known as the common cold. When sinusitis and rhinitis occur at the same time, which is often the case, it is called rhinosinusitis. Sinusitis is one of the most common diseases of all – many adults are affected by it at least once a year. Depending on the course, a distinction is made between acute and chronic sinusitis.

Causes of sinusitis

Triggers of acute sinusitis are often respiratory infections such as colds. When the mucous membranes in the nose are swollen and attacked by a cold, the nasal secretions that the body actually produces to clean the nose can no longer drain properly. If the passage between the nasal cavity and the sinuses is blocked as a result, the sinuses are no longer properly ventilated. The secretion accumulates in them and the pathogens find ideal conditions there in the warm, moist climate to multiply. This leads to inflammation of the paranasal sinuses. Acute sinusitis is initially usually caused by viruses. Often, however, an additional bacterial infection settles on it and triggers a purulent inflammation. In both cases, sinusitis can also be contagious. A weakened immune system is basically considered a risk factor for the development of sinusitis. The pathogens can also enter the nose while swimming, this is called bathing sinusitis. In rare cases, acute sinusitis is also triggered by strong pressure fluctuations (for example, when flying or diving). Other possible causes of sinusitis are anatomically caused narrowing, especially in the area of the sinus openings (for example, a curved nasal septum or nasal polyps), inflammation of the teeth or allergies – in these cases, however, it usually comes to a chronic sinusitis. Chronic sinusitis can also develop from acute sinusitis if the latter does not heal properly. Sinusitis: symptoms and home remedies.

Symptoms of acute sinusitis.

The signs of sinusitis can vary quite a bit from person to person. Typical symptoms of acute sinusitis are:

  • Rhinitis with initially watery, later thick nasal secretions (often yellowish-green when purulent).
  • Difficult breathing through the nose due to a stuffy or swollen nose.
  • Impairment of the sense of smell
  • Severe headache, pain in the face and feeling of pressure in various places, depending on the sinus affected (for example, temples, eyes, cheeks), especially in the first half of the day and increased when bending over
  • Knocking pain over maxillary sinus and frontal sinus.
  • Secretory flow in the back of the throat
  • Sometimes there may also be swelling of the face
  • Reddened and swollen eyelids (indicate inflammation spread).
  • General feeling of illness
  • Fever (can rise up to 40 degrees Celsius)
  • Cough (as a result of mucus running into the bronchi).
  • Toothache is possible with inflammation of the maxillary sinuses

As a rule, the signs of disease are more pronounced in acute sinusitis than in chronic.

Symptoms of chronic sinusitis.

Chronic sinusitis is said to occur when symptoms last longer than twelve weeks. If sinusitis occurs more frequently than four times a year, but symptoms resolve completely in between, it is called recurrent sinusitis. The symptoms of chronic sinusitis are similar to those of the acute form, but are usually weaker and do not completely subside over a long period of time. Typical signs of chronic sinusitis are:

  • Increased formation of nasal mucus
  • Obstructed nasal breathing
  • Slight pressure over the affected cavity
  • Tapping the maxillary and frontal sinus is often painful, but this symptom does not have to occur
  • Headache and sore throat are possible
  • Odor and taste disturbance
  • Fatigue and decreased performance
  • Cough

Chronic sinusitis often involves the maxillary sinus and ethmoidal cell system. Sinusitis often occurs in conjunction with chronic bronchitis. This is then called sinubronchitis. In these cases, both must be treated.

Complications of sinusitis

Sinusitis can result in complications if it is not treated properly. For example, the bony sinus wall may also become inflamed and break through. This can cause the inflammation to spread to the surrounding organs, bones and soft tissues, causing inflammation of the frontal bone, for example. A possible consequence in rare cases is purulent meningitis (meningitis purulenta) or inflammation of the brain (encephalitis). If the inflammatory process spreads to the orbit, eyelid edema occurs and later the eyeball protrudes (protrusio bulbi). Eyelid edema occurs more frequently, especially in children, and is manifested by reddened and swollen eyelids. Visual disturbances require immediate surgery of the causative sinus in many cases. Especially in young children, sinusitis can also spread to the ear and result in middle ear infection or inflammation of the Eustachian tube. In the long term, chronic sinusitis can lead to enlargement of the sinuses due to the encapsulation of fluid accumulations. These so-called celes must be removed in surgery.