The air chambers in the bones behind the cheeks, eyebrows, and jaw are called the sinuses, and they produce a substance called mucus; It is a liquid substance that allows bacteria and other particles in the air you breathe to be expelled. Small, fine hairs called cilia draw mucus from the sinuses to clear it from the nose.
Sinusitis occurs when the mucous membrane of the sinuses becomes inflamed.
Sinusitis usually occurs after a bout of cold, allergy, or irritation from external environmental pollutants. Unlike the common cold, bacterial sinusitis requires a doctor to diagnose and treat with antibiotics to treat the infection and prevent potential complications.
The known symptoms of sinusitis are:
Green or yellow nasal mucus,
Pain around the cheeks, eyes and/or forehead.
Pain in the front of the head.
A temperature above 38 degrees
Decreased sense of smell
We recognize two main types of infectious sinusitis:
Viral, if symptoms last about 10 days or less,
Bacterial, if symptoms persist for more than 10 days and the condition worsens for the worse.
An otolaryngologist should be consulted for the medical and surgical treatment of sinusitis.
Even if the cause is bacterial, people with acute sinusitis can be treated completely without the need for antibiotics.
In the case of chronic disease, the severity of symptoms varies greatly from patient to patient and often requires long-term treatments in order to reduce inflammation; People with chronic sinusitis are more prone to bacterial complications. Even people with a healthy immune system are at risk of developing serious complications if they do not receive proper treatment for the chronic condition.
What are the problems caused by sinusitis?
Sinusitis causes inflammation of the mucous membranes of the nose, sinuses, and throat (upper respiratory tract). Swelling blocks the openings in the sinuses and leads to problems with the normal drainage of mucus, causing facial pain and other symptoms as well.
Sinus obstruction creates a moist environment that facilitates infections. Infected, blocked sinuses fill with inflammatory pus and cause signs and symptoms such as a thick, yellow or green runny nose and other signs of infection.
Acute sinusitis can be caused by:
Viral infection: In most cases, acute sinusitis is caused by a common cold.
Bacterial infection: If the upper respiratory tract infection persists for more than 7-10 days. Bacterial disease is more common than viral.
Fungal infection: Sinus abnormalities or a weakened immune system increase the risk of developing a fungal infection.
Certain health conditions can increase your risk of developing a sinus infection (that is, sinusitis) and also put you at risk of developing a sinus infection that is not caused by a previous infection.
Allergies such as hay fever: Inflammation caused by allergies can lead to blocked sinuses.
Nasal polyps or tumors: This tissue proliferation can block your nostrils or sinuses.
Dental infections: A small percentage of sinusitis is caused by dental infections.
Other medical conditions: Cystic fibrosis, gastroesophageal reflux disease, or immune system disorders can lead to complications that block the sinuses or increase the risk of infection.
Risk factors that lead to sinusitis
Allergic rhinitis or hay fever,
Diseases that prevent the normal functioning of the cilia.
Air altitude changes (flying or diving)
Increasing the size of the adenoids.
Constant exposure to environmental pollutants such as cigarette smoke
Suppression of the immune system (HIV infection or chemotherapy),
Malformations in the nasal passages such as a deviated nasal septum, adenoids or tumors.
Certain diseases such as cystic fibrosis or immune system disorders such as immunodeficiency (eg, immunoglobulin or antibody deficiency due to HIV or chemotherapy).
Sinusitis is classified according to the duration of symptoms:
Acute – symptoms last 4 weeks or less.
Subacute – symptoms between 4 to 12 weeks
Chronic – symptoms persist for 12 weeks or longer
Acute recurrence – 4 or more acute attacks within one year with no symptoms between episodes
Acute chronic sinusitis – an acute attack with a sudden exacerbation of the main symptoms in a patient with chronic sinusitis
Sinusitis can cause different symptoms depending on age:
Younger children often have cold-like symptoms such as a stuffy or runny nose and a low-grade fever. If your child starts to have a fever 5 or 7 days after cold symptoms start, it could be a sign of sinusitis or another infection (bronchitis, pneumonia, or ear infection), so call your doctor right away and tell him or her about your child’s situation. Many parents mistake it for a headache. Colds are caused by sinus infections, but the frontal sinuses do not begin to develop before the age of six or seven and do not develop enough to develop infections before puberty, so the headaches that usually occur in children with colds cannot be linked to sinusitis.
In older children and teens, the most common symptoms of sinusitis are: dry cough all day (does not improve after the first seven days of cold symptoms), fever, worsening congestion, toothache, earache or facial pain. Sometimes teens with sinusitis have stomach pain, nausea, headaches, and pain behind the eyes.
One of the most common symptoms of any type of sinusitis, especially in adults, is pain, the location of which depends on the inflamed sinuses.
Pain in the forehead indicates that the frontal sinuses are affected.
If the pain affects the jaw, the upper dental arch, and the cheeks, the sinuses of the upper jaw may be affected
Pain between the eyes accompanied by painful pressure on the sides of the nose and sometimes swelling of the eyelids and tissues surrounding the orbit, may indicate sinusitis in the ethmoid sinuses.
Pain in the neck and ears with a deep pain in the upper part of the head may be a sign of sphenoid sinusitis (but this type of infection is very rare)
Most people with sinusitis feel pain in various places, and the symptoms are often clearly related to the affected sinuses. Pain in chronic sinusitis is not as widespread as in acute disease.
In addition to pain, people with sinusitis often have thick nasal discharge that can be white, yellow, green, or bloody. In addition, acute and chronic sinusitis is usually associated with nasal congestion and a general feeling of fullness over the entire face.
Less common symptoms of sinusitis (acute or chronic):
Decreased sense of smell (hyposmia)
Cough, with the possibility of recurring at night
Recurrent sinusitis or an infection that lasts for at least three months can be a form of chronic sinusitis. Symptoms of chronic sinusitis may be less severe than the acute form, but untreated chronic sinusitis may require sinus surgery.
People with chronic sinusitis may have the following symptoms for 12 weeks or longer:
Feeling of pain and/or pressure on the face
Dense runny nose,
Inflammation in the nasal passages
These people may also complain of headaches, bad breath, and fatigue.
Asthma; As acute sinusitis can lead to asthma attacks
Chronic sinusitis; Acute sinusitis can be a recurrence of a chronic condition known as chronic sinusitis. Chronic sinusitis is a form of sinusitis that persists for more than 12 weeks or longer
Meningitis; It occurs as a result of infection spreading to the lining of the brain
Poor vision; If the infection spreads to the eye cavity, it can lead to decreased vision or even blindness as well. It is a medical emergency that requires immediate medical treatment to prevent permanent damage.
Ear infection; Ear infection can sometimes arise with acute sinusitis
Diagnosis of sinusitis
The diaphanoscopy test is a long-standing but still widely used test to diagnose sinusitis, which involves inserting a small light source into the mouth.
Modern alternatives are x-rays or computed tomography (BT).
Many sinus infections are resolved by self-treatment. In the case of frequent relapse, the presence of causes that induce inflammation such as adenoids, allergies or other chronic conditions should be excluded.
Doctors may prescribe oral antibiotics to treat bacterial sinusitis.
According to some guidelines, antibiotics should be given for 14 days, or in the case of chronic sinusitis treatment should be given until symptoms disappear for at least 7 days. If there is no improvement after five days of treatment, it is recommended to change the type of antibiotic.
There is no benefit to mucolytics and/or expectorants, according to the authoritative medical articles.
Some doctors may recommend decongestants, antihistamines, or cortisone sprays (which are well tolerated in the long term) to relieve symptoms.
Cases of viral sinusitis usually go away on their own without any medical treatment. Paracetamol and/or warm compresses may also help reduce pain.
In children, over-the-counter cold medicines have not been shown to reduce symptoms or cause unwanted side effects.
Discuss your situation with your doctor in the following cases:
The occurrence of a cold that lasted more than ten days and did not end with recovery
A cold that has worsened after seven days of symptoms
Allergic symptoms that are not treated with regular anti-allergic medications
Also call your doctor if you have other symptoms of sinusitis such as tenderness and thickening of the cheeks, a fever, or a cold that seems worse than usual.
Sinusitis treatment: Are over-the-counter medications helpful?
Many over-the-counter medications are available at pharmacies to relieve pain and pressure from sinusitis and problems caused by allergies and nasal congestion, and are useful in relieving symptoms in mild cases.
Sinusitis treatment: antihistamines
Antihistamines are used to combat allergic problems that cause nasal congestion. Over-the-counter antihistamines such as diphenhydramine or cetirizine can be used to relieve symptoms such as itching, sneezing, or nasal congestion. They are useful in case of preventing runny nose caused by allergies, but not useful against a stuffy nose or congestion. Antihistamines can have a sedative effect and also cause drowsiness and dehydration; In order to overcome this problem, there are currently new non-sedating antihistamines in the hypnotic.
Sinusitis treatment: antihistamines with decongestants
Antihistamines and decongestants are often combined to relieve congestion and runny nose and reduce general side effects. In fact, antihistamines tend to have a sedative effect, but this effect is mitigated by the addition of decongestants. For this reason, combination medications relieve congestion, discomfort and a runny nose as well.
Sinusitis treatment: antibiotics
Antibiotics are substances that prevent the growth of microorganisms.
Acute sinusitis is one of the many illnesses that can be caused by a bacterial infection, but it is important to remember that colds, allergies, and environmental triggers are more common than bacterial sinusitis. It can also cause sinus problems. Antibiotics are only useful for sinus problems caused by a bacterial infection.
Symptoms of a bacterial sinus infection include:
Pain in the cheeks or molars of the upper dental arch
Excessive yellow or green nasal mucus that persists for more than ten days
No effect of decongestants
Symptoms worsen rather than improve after the cold is completely cured
Most patients with acute sinusitis caused by a bacterial infection recover without any antibiotic treatment, and the specialist will first prescribe an appropriate analgesic (pain reliever), antipyretic (antipyretic) and decongestant. However; If symptoms persist, treatment with antibiotics may be recommended.
Acute sinusitis treatment
In most cases, antibiotics are prescribed to patients who have a chronic sinus condition of nasal mucus and facial pain or discomfort that does not improve even after a week of treatment. or those with severe sinusitis symptoms regardless of their duration.
Chronic sinusitis treatment
Even in the case of long-term antibiotic treatment, it can be very difficult to improve the symptoms of chronic sinusitis, but in general, for example, the treatment of chronic sinusitis with antibiotics and decongestants is similar to the treatment of acute sinusitis.
If antibiotic treatment is not effective, the most helpful methods your doctor will recommend for treating chronic sinusitis are:
Research shows that most patients who undergo surgery will experience fewer symptoms and may have a better life in the future.
Sinusitis Treatment: Natural Remedies
Saline nasal sprays (non-drug nasal sprays) are often used in the natural treatment of sinusitis. It is an effective treatment for most problems that affect the nose, as the moisture produced by the saline solution reduces secretions and contributes to the removal of infectious agents. After you spray the spray, wait a few minutes and then you can exhale forcefully through your nose (gently until the congestion doesn’t get worse).
You can use solutions with physiological concentration (useful for washing only) or hypertonic (useful for decongesting thanks to the osmotic effect): your doctor or pharmacist will help you choose the most appropriate natural remedy for your case.
Saline solutions used in the nose are very natural and do not contain the risk of “addiction”. It can be sprayed in the nose up to six times a day or more and for long periods of time as well.
Sinusitis treatment: surgery
Surgery is considered when symptoms cannot be completely controlled effectively when medication is used; The most common technique is endoscopy, which involves inserting a thin tube (endoscope) into the nose to widen the mucus drainage channels between the sinuses and the nose, allowing air to enter the nose and the mucus to exit the nose.