What is sinusitis?
Sinusitis is a condition that occurs when the sinuses become inflamed and swollen. The sinuses are the cavities around your nasal passages. Inflammation to this area thus blocks drainage and causes mucus build-up in your nose.
The condition is quite common, with around 90% of adults getting the condition at least once. In Singapore, this is even more so due to the climate. The symptoms can range from mild to severe, with some cases clearing within a few days or weeks without intervention, while some other cases may last longer, requiring antibiotics and even surgery.
What are the symptoms of sinusitis?
The symptoms of sinusitis include:
- Stuffy, blocked nose
- Thick, yellow or green mucus discharge
- Difficulty breathing through the nose
- Slight loss of smell and taste
- Pain, pressure, or discomfort around the cheeks, forehead, and behind the eyeballs
- Heavy feeling in the head and face
- Bad breath
Some patients also experience aching pain around the jaw and teeth, ear pain, headache, sore throat, fever, nausea, and fatigue.
What are the types and causes of sinusitis?
There are 2 types of sinusitis:
· Acute sinusitis
· Chronic sinusitis
The differences between these 2 types will be discussed in the next section.
There are also a few different causes, including:
- Viruses – the most common cause, usually easily treatable; is contagious
- Bacterial – usually last longer and respond well to oral antibiotics
- Fungal – quite rare, usually happens in those with a weakened immune system or those with certain pre-existing conditions
- Some medical conditions and anatomical abnormalities, such as:
- Crooked nasal septum
- Untreated allergic inflammation (ex: hay fever)
- Nasal polyps
- HIV and other immune system-related diseases
- Cystic fibrosis
- Tooth infections
What are the differences between acute sinusitis and chronic sinusitis?
The main difference between the two is the persistence of the symptoms.
Acute sinusitis is also known as acute rhinosinusitis. This condition happens when the symptoms last up to 12 weeks. As the name suggests, sinusitis develops suddenly, often along with a common cold.
Symptoms include runny and stuffy nose and facial pain that persists for 10 days or more. This kind of sinusitis often responds well to home remedies, antibiotics, decongestants, and other oral medications. A sub-type, known as recurrent acute sinusitis, refers to the condition where sinusitis symptoms come back 4 or more times in a year, with each one lasting less than 2 weeks.
On the other hand, sinusitis is classified as chronic sinusitis if the symptoms last more than 12 weeks, even with medical interventions. Note that chronic sinusitis may happen as a complication of acute sinusitis.
Also, symptoms of chronic and acute sinusitis are similar, but fever is not typically experienced by chronic sinusitis patients. For chronic sinusitis cases, oral medicines may not be able to successfully treat the condition and surgical intervention may be necessary. More details on the treatment options will be discussed in the following sections.
What complications can arise from untreated sinusitis?
Very rarely, in some cases, untreated sinusitis may cause complications such as:
- Eye infections, reduced vision, and possibly even blindness
- Worsening of pre-existing asthma
Is sinusitis contagious?
This depends on the cause of the sinusitis. Bacterial and fungal sinusitis are not contagious, but viral sinusitis are! The virus may spread through:
- Direct contact with the body fluid on an infected individual (saliva, mucus)
- Contaminated objects (doorknobs, tables)
- Virus-laden aerosols (cough/sneeze of an infected person)
When should I go to a doctor for sinusitis?
You should visit a doctor if:
- Your symptoms persist for more than a week
- Symptoms that worsen after seeming to improve
- Your symptoms don’t improve after medications and other treatments
- You experience persistent fever
- You have a history of recurrent or chronic sinusitis
For your visit, take note of:
- Your symptoms and how often they occur
- Allergies, asthma, and other medical conditions
- History of medical conditions in your family
- Medications, vitamins, and supplements you are currently consuming
Do visit the doctor immediately if you experience:
- Pain, swelling, or redness around the eyes
- Double vision or other vision changes
- High fever
- Severe headache
- Stiff neck
These symptoms are signs of a serious infection, and you should get it checked immediately! Your ENT specialist can run a thorough diagnosis and create a personalised treatment plan.
How is sinusitis diagnosed?
Sinusitis, especially for chronic cases, is diagnosed through a nasoendoscopic examination. This involves using a small camera that is attached to a tube that will be inserted into the nose to visually inspect the sinuses. This is a really quick procedure that can take less than 3 minutes. The procedure may be uncomfortable but is completely painless for the most part.
If an anatomical abnormality is suspected to be the cause of your condition, a CT scan might also be taken to see the severity and complexity of your condition. This is usually only for chronic or recurring cases.
On top of that, a sample of your nasal discharge may also be taken and examined to determine the exact cause of your condition. This is critical in determining the type of treatment that will be suitable for your case.
Also, if your sinusitis is suspected to have developed following an allergic reaction, your doctor may also recommend an allergy skin test. It is a very quick, painless procedure that can help pinpoint the allergen causing your inflammation and, with that, help you prevent subsequent flare-ups.
What are the treatment options for sinusitis?
For cases of acute sinusitis, the symptoms tend to clear by themselves within a few days. Some treatments that may help you manage the symptoms include:
- Spraying saline nasal spray to rinse the nasal passages
- Using nasal corticosteroids to help prevent and treat inflammation
- Decongestants (may be liquids, tables, or sprays)
- Over-the-counter (OTC) pain relievers
That said, if the symptoms persist, do get a prescription from a doctor. Depending on the cause of your sinusitis, your doctor may prescribe antibiotics or antifungal medications to help clear the condition. If you do get antibiotics, remember to take the whole course prescribed to you, even if the symptoms have cleared out. This is to prevent recurrent sinusitis that may be harder to treat.
If allergies are the main cause of your sinusitis, your doctor may also use immunotherapy, also known as “Allergy Shots”. This helps reduce your body’s reaction to specific allergens thus helping you manage the inflammation and other symptoms.
Surgical treatment for sinusitis
If oral medications are unable to treat the condition, a surgery called functional endoscopic sinus surgery (FESS) may be necessary. First, your doctor will use a thin, flexible tube (endoscope) to explore the sinus passages. Then depending on your condition, your doctor will remove or shave away tissues that are causing the nasal blockage. Another method is to enlarge a narrow sinus opening.
Home remedies to alleviate sinusitis symptoms
Above medications and treatments, there are a few lifestyle changes that will help you manage the symptoms of sinusitis. This includes:
- Having lots of rest
- Moisturising your sinuses by:
- Drape a towel over your head and breathing in the vapour from a bowl of warm water
- Taking a warm shower, breathing in the warm and moist air
- Doing a warm compress on your nose and forehead
- Rinsing out your nasal passages
Can sinusitis be prevented?
Yes! Steps to prevent developing sinusitis include:
- Avoiding respiratory infections by:
- Avoiding people with colds and other contagious infections
- Washing your hands frequently with soap and water
- Managing your allergies – talk to your doctor to keep your symptoms at bay
- Avoiding cigarette smoke and polluted air
- Using a humidifier – make sure to keep the humidifier clean and free of mould
If you are currently experiencing some of the symptoms mentioned in this article, do visit a doctor to get your condition checked. Sinusitis is definitely treatable, especially if treated promptly. Also, take note of the tips mentioned to help relieve the symptoms! Now after reading this, just take a deep breath, have some rest, and relax.
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