Sinusitis

Introduction

In sinusitis, the mucous membrane of the paranasal sinuses is inflamed. These become inflamed when viruses from the nose enter the sinuses. Experts differentiate between inflammation of the maxillary sinuses (maxillary sinusitis), the frontal sinuses (frontal sinusitis), the ethmoid sinuses (ethmoid sinusitis) and the sphenoid sinuses (sphenoid sinusitis). If several or all sinuses are affected by inflammation, doctors refer to this as poly or pansinusitis.

Inflammation of the sinuses can be acute or chronic. There are also the terms sinusitis or sinus suppuration - this refers to the rarer diseases caused by bacteria. As sinusitis usually occurs together with colds, it is one of the more common infectious diseases in humans - both in children and adults.

Symptoms

Sinusitis often begins with a runny nose that usually lasts a few days. The nose is blocked and thick nasal mucus with a yellowish-green colour develops. In many cases, sufferers also experience a feeling of pressure and congestion in the face or have a headache. The nagging and stabbing pain typically increases when patients bend forward, jump, sneeze or stand up. Fatigue, drowsiness, fever, coughing, toothache or earache may also occur - especially if the inflammation is more severe.

Affected persons with the following symptoms should consult a doctor immediately to avoid complications:

• Nosebleeds
• Severe pain
• Swelling around the eyes, in the eye socket or on the forehead
• Visual disturbances
• Numbness in the face

Verlauf

Acute sinusitis usually subsides within two weeks. If it is treated in time, the disease usually progresses very well. Without treatment, however, an acute illness can turn chronic.
If sinusitis lasts longer than three months, the disease is chronic. In this case, the inflammation returns again and again. Constricted areas ensure that mucus does not drain well. This increases the risk of the inflammation damaging neighbouring tissue. In such cases, surgical intervention may be advisable.
Complications are generally not common. Rare possible complications can include chronic pharyngitis and laryngitis, acute bronchitis, inflammation of the eye sockets or meningitis.

Causes

Acute sinusitis is often caused by a cold. The cold viruses penetrate from the nose into the sinuses: the mucous membranes swell, thick mucus builds up in the nose and breathing becomes more difficult. In rare cases, the viral infection is followed by a bacterial infection.

The severity of the disease depends on various factors: A weakened immune system, aggressive pathogens or anatomical features such as a deviated nasal septum can be reasons why acute sinusitis develops.

Diagnosis

To make a diagnosis, the patient's medical history is taken first and foremost. If the affected person has pain in the forehead or upper jaw area, a blocked nose, a purulent cold or an olfactory disorder, the diagnosis of sinusitis is obvious. The suspicion is confirmed if the pain can be caused by bending the head forward quickly or by pressing on certain nerve points in the face. Experienced doctors can diagnose acute sinusitis well via telemedicine and treat those affected over the phone or by video.

In many cases, further medical examinations are not necessary to diagnose acute sinusitis. However, if there is uncertainty based on the patient's information, an endoscopy of the sinuses can be performed.

Treatment

Acute sinusitis is treated in the same way as colds with a runny nose and nasal congestion. The patient should rest sufficiently, drink enough, keep the room air moist and raise the head end of the bed so that the mucus can drain away.

Inhalations with warm water vapour help to decongest the nasal mucous membranes. It is advisable to inhale with salt water. Those affected can dissolve a teaspoon of salt in a litre of boiling water, allow the water to cool to around 42 degrees and then inhale the steam through the nose and exhale through the mouth.

The use of nasal sprays also helps to decongest swollen blood vessels. The active ingredients in the sprays open up the sinuses and reduce the pressure. However, pharmaceutical nasal sprays should not be used for longer than five to seven days, as some ingredients can attack the nasal mucous membranes if used for longer. Sea water sprays are a suitable alternative without pharmaceutical ingredients.

Substances such as paracetamol and ibuprofen are effective against headaches, high temperatures and mild inflammation. Mild headaches can also be treated with a few drops of peppermint oil massaged into the forehead or temples.

The symptoms can also be alleviated by having the sinuses flushed by a doctor. However, the procedure is very unpleasant.
It is often not advisable to take antibiotics, as most acute sinusitis is caused by viruses. If there is evidence of bacterial inflammation, stronger medication may be appropriate. If the fever continues to rise, the symptoms of the illness increase, and there is a risk of complications or other illnesses present at the same time, the doctor should carry out additional tests.

Prevention

For those who are prone to sinusitis, it is important to treat a cold at an early stage. It is advisable to use salt water inhalations, nasal drops or, if necessary, anti-inflammatory and mucolytic agents to combat the common cold. In general, it helps to strengthen the immune system:

• Eat a balanced and varied diet: fruit, vegetables, vitamins and minerals, drink enough
• Get enough sleep
• Avoidance of stress
• Regular exercise in the fresh air
• Avoiding tobacco and a lot of alcohol

 
Infections can be prevented by avoiding contact with people who have a cold, washing your hands frequently, using tissues only once and ventilating and humidifying rooms several times a day.

In our Medgate Doc Channel, Medgate doctors explain the most important aspects of a clinical picture in a nutshell. Dr Vagma Djallalzada, telemedicine specialist at Medgate, explains sinusitis:
Neurodermitis In progress