Sinusitis
| Sinusitis | |
|---|---|
| Specialty | Otorhinolaryngology  |
| Sinusitis | |
|---|---|
| Specialty | Otorhinolaryngology |
Sinusitis is inflammation, either bacterial, fungal, viral, allergic or autoimmune, of the paranasal sinuses.
Classification
By location
Sinusitis is classified by the sinus cavity which it affects:
- Frontal sinusitis - causes pain in the frontal sinus cavity (located behind/above eyes), headache (J01.1/J32.1)
- Sphenoid sinusitis - causes less generalized pain, headache (J01.3/J32.3)
Acute vs. chronic
Sinusitis can be acute (going on less than four weeks), subacute (4-8 weeks) or chronic (going on for 8 weeks or more).
Both types of sinusitis have similar symptoms, and are thus often difficult to distinguish.
Acute sinusitis
- Acute sinusitis is often brought on by bacteria, such as Haemophilus influenzae, streptococci, or staphylococci.
It is usually precipitated by an earlier upper respiratory tract infection, generally of the viral type.
Chronic sinusitis
- Chronic sinusitis is one of the most common complications of the common cold.
Symptoms include: Nasal congestion; facial pain; headache; fever; general malaise; thick green or yellow discharge; feeling of facial 'fullness' worsening on bending over.
In a small number of cases, chronic maxillary sinusitis can also be brought on by the spreading of bacteria from a dental infection. Chronic hyperplastic eosinophilic sinusitis is a noninfective form of chronic sinusitis.
Diagnosis
Factors which may predispose to developing sinusitis include: allergies; structural problems such as a deviated septum; smoking; nasal polyps; carrying the cystic fibrosis gene (research is still tentative).
When imaging techniques are required for diagnosis CT scanning is the method of choice. If allergies are suspected, allergy testing may be performed.
Treatment
Therapeutic measures include simple painkillers (aspirin, paracetamol (acetaminophen) or similar), inhaling steam, nasal irrigation or jala neti using a warm saline solution, hot drinks including tea and chicken soup, over-the-counter decongestants, and getting plenty of rest. If sinusitis doesn't improve within 48 hours, or is causing significant pain, one should see a doctor, who may prescribe antibiotics or nasal steroids. If the recommended doses and duration of antibiotic treatment(s) are ineffective, one should consult a doctor; who may suggest further treatment by a qualified specialist.
If left untreated, sinusitis can lead to bronchitis and pneumonia.
For chronic or recurring sinusitis, referral to an otolaryngologist is indicated for more specialist assessment and treatment, which may include nasal surgery.
A recent advance in the treatment of sinusitis is a type of surgery called FESS - functional endoscopic sinus surgery, whereby normal clearance from the sinuses is restored by removing the anatomical and pathological obstructive variations that predispose to sinusitis. This replaces the less effective Caldwell-Luc surgery.
External links
- Acute sinusitis - MayoClinic.com, from the Web site of the Mayo Clinic.
- Sinusitis at eMedicine
- NIH
- NHS Direct