Sinusitis

What is Sinusitis?

A condition in which the tissue lining the sinuses (small hollow spaces in the bones around the nose) becomes swollen or inflamed is called sinusitis. It is one of the most common health complaints related to physician visits.

Approximately 0.5% of all upper respiratory tract infections are complicated by sinusitis. The incidence of acute sinusitis ranges from 15 to 40 episodes per 1000 patients per year. The condition is more common in adults than children.

The basic pathology behind sinusitis is oedema and inflammation of the nasal lining secondary to rhino sinusitis caused by the viral upper respiratory infection. This leads to the production of thick mucus that obstructs the paranasal sinuses and allows a secondary bacterial overgrowth.

Aetiology/Risk factors

Viral sinusitis is the most common result of viral upper respiratory tract infection. Other microorganisms involved are Streptococcus pneumonia, Haemophilus influenzae, S. aureus and Streptococcus pyogenes. Other causes include allergens, irritants etc.

Other risk factors or sinusitis include:

• Anatomic defects such as septal deviations and polyps
• Impaired mucous transport from diseases such as cystic fibrosis, ciliary dyskinesia
• Immunodeficiency from chemotherapy, diabetes mellitus, etc.
• Prolonged oxygen use due to drying of mucosal lining
• Patients with nasogastric or nasotracheal tubes

Sign and symptoms

The new term used is Rhinosinusitis because purulent sinus disease without similar rhinitis is rare. The classification is as follows-

• Acute rhinosinusitis: Sudden onset, lasting less than 4 weeks with complete resolution.
• Subacute rhinosinusitis: A continuum of acute rhinosinusitis but less than 12 weeks.
• Recurrent acute rhinosinusitis: Four or more episodes of acute, lasting at least 7 days each, in any 1-year period.
• Chronic rhinosinusitis: Signs of symptoms persist 12 weeks or longer.

The common presenting symptoms are facial pain, facial congestion, nasal obstruction, nasal or post nasal purulence, hyposmia and fever. The sinusitis can affect all the four sinuses- frontal, maxillary, sphenoid, and ethmoid.

Diagnosis

On examination, the specialist must look for facial swelling, erythema, periorbital oedema, cervical adenopathy and pharyngitis. The forehead and cheeks must be percussed to elicit tenderness. A plain sinus X ray is recommended for the diagnosis of all types of sinuses except anterior ethmoidal.

General management

Medications with measures like steam inhalation and humidification are recommended for the management.

Warning: Above information provided is an overview of the disease, we strongly recommend a doctor's consultation to prevent further advancement of disease and/or development of complications.

Disclaimer: The information provided herein on request, is not to be taken as a replacement for medical advice or diagnosis or treatment of any medical condition. DO NOT SELF MEDICATE. PLEASE CONSULT YOUR PHYSICIAN FOR PROPER DIAGNOSIS AND PRESCRIPTION.