The sinusitis
Sinusitis frontalis can be further divided into an acute and a chronic form. The underlying cause of both acute and chronic sinusitis is a ventilation disorder that is accompanied by subsequent bacterial infection of the sinuses. In the acute form of inflammation, which by definition lasts less than 30 days, rhinitis is the main cause.
Viscous nasal secretions cause the narrow connecting passage between the frontal and nasal cavities to be blocked, resulting in a disruption in the flow of mucus from the frontal sinus. Bacteria settle in the viscous mucus, which can lead to an inflammation of the sinus cavity. The chronic form of sinusitis, which lasts for 90 days, is often caused by acute sinusitis that has not healed properly.
Other causes that lead to permanent disturbances in the ventilation of the sinuses and thus to chronic sinusitis are anatomical conditions. One example is a severe nasal septum curvature, which makes adequate ventilation of the sinus difficult. There are also extremely close connections between the frontal and nasal cavities, which can be relocated quickly.
Other causes are polyps, i.e. benign mucous membrane growths, or tumors that obstruct the excretory duct and thus promote sinusitis. Other risk factors for sinusitis are allergies that affect the nasopharynx or general weakening of the immune system, which often leads to infections that cannot be fought as effectively as with a healthy immune system. The main symptom of sinusitis is an unusually long cold, which is usually accompanied by very severe headaches in the area of the forehead or eyes.
This headache is usually perceived as an oppressive pain that is intensified when the head is bent forward, for example when tying shoes. A pain over the frontal sinus is also often triggered by pressing or tapping lightly. Pain can be accompanied by pain in the jaw and in the area of the cheeks, which painfully impairs chewing.
Since the frontal sinus, by providing a resonance chamber for the voice, is partly responsible for its individual sound, the voice usually sounds different when the frontal sinus is relocated.The sense of smell and taste can also be impaired in the case of sinusitis. Pus can accumulate in the inflamed sinus (empyema), which can also cause the nasal secretion to be purulent. As is typical of an infection, acute sinusitis is often accompanied by fever and fatigue.
In the chronic form, there is no fever, but there is a permanent feeling of pressure in the head and a permanently blocked nose with purulent secretion and often a reduced sense of smell (hyposmia). Particular dangers of sinusitis are its close proximity to the eye socket and the brain, which in rare cases can cause the inflammation to spread to these structures. This can result in a so-called orbitaphlegmon or meningitis.
It is therefore very important to consult a doctor if the symptoms of sinusitis do not improve after a few days, in order to clarify the causes and further treatment. The sinusitis is diagnosed by taking a medical history, which includes the duration of the rhinitis and the characteristics of the headache. During the clinical examination, the doctor checks whether the sinuses are knocking, which is indicative of sinusitis.
In the case of chronic inflammation, nasal secretion is obtained by means of a smear, which is then examined for the pathogen in the laboratory, which then allows a therapy specifically tailored to the pathogen to be initiated. If bacteria are not the cause of the sinusitis and an allergy is suspected, an allergy test is performed. If the symptoms persist despite treatment, a referral is made to an ear, nose and throat doctor, who can perform a rhinoscopy and take a close look at the nasal mucosa.
If even then the cause of the inflammation cannot be found or a tumor is suspected, imaging measures such as computer tomography are used. In the case of sinusitis, it is important to take it easy and stay in bed. The aim of the treatment is to make the connection between the frontal and nasal cavities, which was blocked by nasal secretions, continuous again.
This is achieved with mucolytics, temporary use of nasal sprays, which help to reduce swelling of the mucous membranes, and inhalation with essential oils. It is also very important to drink sufficient quantities (at least two liters a day) so that the mucus becomes more fluid and can drain more easily. Antibiotics are used to combat infection by bacteria.
Symptomatically, painkillers such as ibuprofen and paracetamol can be administered, which, in addition to relieving pain, fight the inflammation in the body. In rare cases, depending on the cause, an operation may be necessary, for example to straighten a nasal septum curvature or to remove a polyp. Acute sinusitis usually heals within 30 days without further complications.
In chronic inflammation, the prognosis depends on the underlying cause. The best prophylaxis for sinusitis is a well-functioning immune system that effectively fights pathogens. This is also achieved by adequately treating and adjusting pre-existing conditions such as allergies.
