What is sinusitis?
Sinusitis, also called rhinosinusitis, is the infection and inflammation of the mucus membranes within the sinuses (spaces in your forehead, cheeks and nose that are usually filled with air).
When your sinuses are affected by a bacterial infection, viral infection or allergies, they can become irritated, causing them to fill with fluid and become blocked. This results in uncomfortable swelling and pain across the face, as well as difficulty breathing through your nose.
Causes and symptoms of sinusitis
Symptoms of sinusitis
There are two main types of sinusitis – acute and chronic.
Acute sinusitis causes severe but temporary symptoms which last no more than four weeks. Chronic sinusitis causes the same symptoms, but they last for more than twelve weeks.
Symptoms of sinusitis include:
Nasal congestion
Thick green-yellow nasal discharge
Postnasal drip (mucus dripping down your throat)
Pressure and pain around your cheeks, eyes, forehead, and in your ears
Decreased sense of smell
A cough
A high temperature
Toothache
Tiredness
Causes of sinusitis
The pain experienced with sinusitis is usually caused by a blockage of the sinus opening, which could be caused by infections, irritants, allergies or a structural abnormality.
Infections
Adults can suffer from a cold or upper respiratory tract infection up to three times a year, with children getting them more regularly. Following a cold, when mucus turns yellow or green as opposed to clear it is a sign of a bacterial infection, which, in addition to viral infection, can cause swelling of the lining of the nose and thickening of the normal mucus. Sinus infection may occur as a result of this as it inhibits proper sinus drainage.
Irritants
Swelling of the lining of the nose can also be caused by irritants like air pollution, smoke and chemicals (e.g. some sprays containing pesticides), disinfectants and household detergents. Again, this can impair sinus drainage by narrowing or blocking the opening to the sinuses and in turn causes infection.
Allergies
Allergies can cause inflammation inside the nose as common symptoms of an allergic reaction include nasal stuffiness, runny nose, sneezing and itchy watery eyes. Chronic sinusitis is sometimes associated with asthma and allergies are responsible for asthma in some patients. The nasal stuffiness experienced with allergies makes asthma more difficult to control.
Structural abnormality
Narrowing of the nasal cavity can sometimes be caused by structural problems as a result of trauma or they can develop when growing. If the narrowing is severe then it causes a blockage with mucus building up behind it, leading to infection.
How is sinusitis diagnosed?
At OneWelbeck, our ear, nose and throat (ENT) specialists can make a diagnosis of sinusitis by performing a physical examination, taking a medical history, and examining your nasal lining and sinus openings with a nasal endoscopy.
This simple diagnostic procedure involves inserting a small tube with a camera on the end (endoscope) into your nose. Images will appear on a screen where your consultant will be able to see your sinuses and identify any inflammation and infection. In addition, a Cone Beam CT Scan can reveal inflammation or blockages within the sinuses cavities and could be another way that sinusitis is discovered.
How to treat sinusitis
Acute sinusitis is treated with antibiotics and medication to reduce swelling in the lining of the nose, such as decongestants.
Chronic sinusitis may need longer-term treatment such as antibiotics, decongestants and nasal steroid sprays. Antihistamines may be useful for patients with an allergy.
Most cases of sinusitis will be managed effectively with medications, but in those that are not, surgery may be considered. A number of surgical options are available including endoscopic sinus surgery (ESS). Most surgical options are minimally invasive so do not require making cuts to the skin surrounding the nose.
Your consultant will discuss which treatment option is most appropriate based on the severity of your symptoms.
