Sinusitis

The technical term for inflammation of the sinuses is sinusitis. However, apart from the mucus in the sinuses the mucus in the nose is usually inflamed as well. This is referred to as rhinosinusitis. Rhino means nose and sinus means cavity.

The paranasal sinuses are part of the upper airways. They are linked to the nasal cavities and consist of various cavities in the cranium. These cavities stretch upward to the forehead, and downward to the teeth in the upper jaw. The mucus in the paranasal sinuses forms fluid (secretion) that drains via the nose and throat.

Doctors draw a distinction between acute and chronic forms of sinusitis:

• Acute sinusitis may occur several times each year. It disappears after a few weeks, at most.
• With the chronic form, the mucus membranes of the nose are permanently inflamed. Medical practitioners speak of chronic sinusitis when it lasts more than 3 months.

Typical sinusitis symptoms include:

• blocked nose
• difficulty breathing through the nose
• reduced sense of smell
• pressing pain in the facial area

There are sometimes also a high temperature and headaches.

With sinusitis, the mucus membrane swells and fluid accumulates. This blocks the nasal passages, and makes it difficult to breathe through the blocked nose. If the fluid (secretion) is greenish or yellowish, it indicates that germs are present.

Discomfort often occurs in the area of the jaw, forehead or eyes, even occasionally the teeth. If the person leans forward, the discomfort and the feeling of being blocked up usually get worse. This effect occurs, for example, when the person gets out of bed.

In people with sinusitis, the sense of smell is often impaired.

Acute sinusitis often occurs after the flu or a common cold. Colds are usually caused by viruses, more rarely by bacteria. After an infection caused by viruses, though, bacteria may also settle.

When an inflammation is caused by viruses or bacteria, the mucus membranes swell up and it is harder for fluid to drain away. It gets thicker and the cavities fill with sticky slime, often yellow-greenish.

The cause of chronic sinusitis is often unclear. It often occurs in people who have, for example, allergic rhinitis, asthma, or a deviated nasal septum. Taking acetylsalicylic acid (ASA), i.e., aspirin, can also contribute to sinusitis if the individual has an intolerance to the active agent. A weakened immune system, for example, due to the effects of certain medication, can also increase the risk of developing chronic sinusitis. In addition, environmental factors, such as chemicals or smoking cigarettes, may play a role.

Acute sinusitis usually clears up within 1 to 2 weeks with no after-effects. If the inflammation lasts over 3 months, it is referred to as chronic sinusitis. When sinusitis is chronic, nasal polyps may appear. These are growths in the mucus membrane which impair breathing through the nose and the sense of smell.

In very rare cases, sinusitis can spread to adjacent areas such as the brain or the eyes. High fever, swellings around the eyes, or inflamed, reddened skin may then develop. Severe facial pain, sensitivity to light, and neck stiffness are possible indications. If these symptoms occur, a doctor should be consulted immediately.

In diagnosing sinusitis, the doctor will first ask about the symptoms – for example whether the person has trouble breathing through their nose or any smell disorder. They will gently press and tap the face to see whether there are any typical pains.

After that, there are various testing options. For example, the doctor can use an endoscope to examine the inside of the nose. This is a tubular device with a small light which is inserted into the nose. In this way, the doctor can see whether the mucus membrane is swollen and what the color of the nasal secretion is. In exceptional cases a probe is used to take a sample of the secretion and have it examined for pathogens in the laboratory.

If the diagnosis remains unclear or there are any indications of complications, images can also be taken of the inside of the nose – for example, using computed tomography (CT) or ultrasound.

There is usually no need to check whether a sinusitis has been caused by viruses or bacteria. With acute sinusitis, this scarcely impacts the treatment.

With chronic sinusitis, an allergy test may be useful, because an allergy often occurs along with chronic sinusitis. 

Nasal sprays containing cortisone can alleviate sinusitis symptoms. Decongestant nasal sprays help acute sinusitis in the short term, at most, and should only be used for a few days. Their use with chronic sinusitis is advised against completely. Some people are helped by rinsing out their nose or inhaling. Antibiotics are only rarely of use.

In the case of chronic sinusitis with nasal polyps, anti-inflammatory antibodies – known as biologics – may also be considered. 

Some people with chronic inflammation opt to have a surgical procedure, in which the narrow sections of the sinuses are widened and nasal polyps are removed. This type of surgery is an option if other treatments do not result in a sufficient improvement.

For more detailed information, for instance on ways of combating inflammation of the sinuses, go to gesundheitsinformation.de.