Symptoms
The diagnosis of sphenoid sinusitis or sinusitis is usually already obvious when the person affected reports the characteristic complaints/symptoms (headache, sniffles, olfactory/taste disorders, stuffy, runny nose). In order to further confirm the diagnosis, an endoscopic examination can be performed by a physician, in which an endoscope inserted through the nostrils or the mouth visually represents the sinuses. In this way, it is possible to determine exactly which sinus(es) is/are affected and whether there are any anatomical peculiarities that could be a possible cause.
In addition, it is possible to collect paranasal sinus secretions during the endoscopy, so that these can be sent to a laboratory – if necessary – and the causative pathogen can be determined microbiologically. Knowing the exact pathogen makes a very specific therapy possible, as this can then be optimally adjusted to the germ. If the diagnosis based on the patient’s medical history and endoscopy proves difficult or the resulting findings are inconclusive, further imaging procedures can be used: here, CT (computed tomography) is the best method of choice, since the resulting sectional images can show possible secretion congestion, inflammatory reactions, anatomical peculiarities and mucosal swelling in the respective affected sinus. In addition, the preparation of CT images prior to any planned surgical treatment is indispensable in order to obtain a precise overview of the spatial extent of the inflammation.
Therapy
In the treatment of sphenoid sinusitis or sinusitis in general, both conservative and surgical treatment measures are available. In many cases, the symptoms of acute sinusitis even subside on their own after a few days, so that no or only supportive therapy is necessary. On the other hand, chronic, persistent sinusitis can often only be eliminated by surgery.
If acute sinusitis is of viral origin, a nasal spray (or nasal drops) to reduce swelling of the mucous membranes is usually prescribed by the treating physician. The decongestant may also be combined with cortisone to provide an anti-inflammatory effect. Also nasal showers based on sea salt and warm head steam baths can help to get the stuck secretion to flow off.
Other mucolytic drugs (e.g. ACC) can be taken as a support, although an acceleration of healing is not entirely uncontroversial. If there are other symptoms of infection such as fever, additional antipyretic and anti-inflammatory painkillers can be taken (e.g. ibuprofen, paracetamol). As this is usually a virus, the immediate administration of an antibiotic is ineffective.
Only in cases in which a primary bacterial infection or a suspected additional bacterial infection can be proven to exist (usually when the secretion is purulent yellow-green in color) is antibiotic administration indicated. If the cause of acute or even chronic sinusitis is an allergy, antiallergics and hyposensitization are a suitable treatment option. If the symptoms cannot be alleviated by all these means and/or if there is a chronic sinusitis, various surgical interventions can still provide relief: on the one hand, a paranasal sinus puncture can be performed to drain off the accumulated secretion, and on the other hand, anatomical peculiarities can be removed.
These include the straightening of the nasal septum, the removal of nasal polyps or the reduction of the nasal conchae. The surgical procedures are usually performed under general anesthesia and with the help of an endoscope.
