Symptoms of Sinusitis: Causes and Treatment
Nasal congestion is a very common symptom at certain times of the year. On many occasions, this congestion is the product of a medical condition called sinusitis, which is nothing more than inflammation of the mucosa that lines the paranasal sinuses. What are the symptoms of sinusitis, and how can we treat it?
The paranasal sinuses are hollow, paired structures found in the frontal, ethmoid, sphenoid, and maxillary bones, close to the nose. These spaces are covered by a layer of mucous cells, which will secrete fluids that flow into the nostrils.
Under normal conditions, air is able to circulate through these structures and all secretions can flow out without problems. However, when a patient suffers from sinusitis, the orifice of the sinuses will be blocked, thus causing the symptoms.
Why is it produced?
This disease is the product of inflammation in the tissue that lines the paranasal sinuses. Such inflammation can be caused by bacteria, viruses, fungi, or allergies. All of these particles and microscopic organisms are capable of lodging in the tissue and causing the condition.
Experts estimate that sinusitis is part of the complication of a respiratory infection in approximately 10% of children, with viruses being the most frequent causative agent. On the other hand, in adults, allergies have a high incidence.
When contact with the pathogenic agent occurs, the body will secrete various substances that promote inflammation. This will cause the surrounding tissue to swell, block the hole, and prevent the flow of air and secretions. In addition to this, extravasation of plasma increases, causing more fluid in the cavity.
Types and symptoms of sinusitis
It can be divided into three different types, according to the duration of the symptoms of sinusitis. They are the following:
- Acute: This is the type in which the symptoms usually last less than 1 month and the most common causative agents are viruses.
- Subacute: This type of sinusitis is characterized by lasting between 1 and 3 months. Pathogens range from viruses to bacteria.
- Chronic: Finally, chronic sinusitis occurs when there are symptoms for more than 3 months, frequently caused by bacteria and fungi.
There’s also a very specific form of this illness called recurrent sinusitis, characterized by the appearance of repetitive episodes of any of the types of sinusitis already described. In general, there’s a gap of between 10 and 20 days between episodes and it’s usually due to the presence of allergies.
What are the causes?
Any trigger that obstructs the drainage hole of the paranasal sinuses, or increases the secretion of fluids in them, can cause sinusitis. In this sense, the pathology may be due to some anatomical alteration.
The presence of a deviated nasal septum, a bone spur, or nasal polyps are trigger factors. In addition, the cells of this tissue have small structures and clearance mechanisms to prevent bacterial adherence, which can be altered by certain conditions.
On the other hand, there are various predisposing factors that can favor the appearance of this disease, among which we can highlight:
- Allergic rhinitis
- Poor immune system
- Exposure to cigarette smoke
- Previous colds or flu
- Assistance to nurseries
Symptoms of sinusitis
The symptoms of sinusitis are usually the same, regardless of the form of presentation. The main difference lies in the duration of the disease. It’s very frequent for it to start between 3 and 7 days after a cold, as part of a complication.
The most characteristic symptom of the disease is pain in the area of the affected paranasal sinuses, especially in the frontal and maxillary sinuses. The pain occurs continuously and usually feels like pressure or a stitch.
Other frequent manifestations are congestion and nasal secretion, as having a greater amount of fluids means the secretions tend to come out through the nostrils. The discharge is usually clear, although it may turn green when there’s a bacterial infection.
People with sinusitis may also have a fever, a cough that worsens at night, a loss of smell, headaches, a sore throat, bad breath, and even a toothache.
Diagnosis
The diagnosis of sinusitis is simple and is usually based on the symptoms suffered by the patient. To confirm the presence of pain, the doctor must check the areas of the paranasal sinuses. In addition, you can also perform a test called transillumination to confirm an obstruction.
Imaging exams aren’t usually necessary in cases of acute sinusitis, however, when there’s chronicity, X-rays or CT scans may be necessary. These will be requested in order to detect the presence of a complication, such as a periapical abscess.
The request for a culture is very rare in cases of sinusitis and is only requested in patients in whom treatment has failed or who are immunocompromised. Taking the sample is a very invasive process as it’s necessary to puncture and extract the tissue, and so it’s preferable to avoid it.
What is the treatment for sinusitis?
Treatment is symptomatic, and it’s intended to reduce the impact of symptoms. In this way, the use of paracetamol is recommended to reduce fever, nasal decongestants, and anti-allergy.
In general terms, antibiotics aren’t necessary to treat these infections, as they subside on their own after a few days. However, in some cases of sinusitis, they could be necessary, as it has been shown that they suppress the chronic variants.
It’s also possible to perform different therapy at home in order to increase ventilation and improve breathing. Among the most effective measures are those of inhaling steam several times a day and applying cloths with warm water in the area of the affected sinuses.
Is it possible to prevent sinusitis?
This condition is more frequent during certain seasons of the year, such as winter and spring, so during this time it’s possible to take measures to prevent its appearance. A good idea is to use humidifiers at home and avoid contact with people with colds.
In the case of children, the influenza and pneumococcal vaccines give them some degree of protection. Also, prolonged exposure to cigarette smoke should be avoided.
Sinusitis isn’t a life-threatening disease. However, extreme care should be taken in patients with existing respiratory disease. In these cases, the condition can worsen the underlying disease and have consequences.
- Martínez Campos L, Albañil Ballesteros R, Flor Bru J, Piñeiro Pérez R, Cervera J, Baquero Artigao F. et al. Documento de consenso sobre etiología, diagnóstico y tratamiento de la sinusitis. Revista Pediátrica de Atención Primaria. 2013;15( 59 ):203-218.
- Méndez Hernández M, Gonzalo de Liria C. Sinusitis aguda. Celulitis periorbitaria. Protocolos diagnóstico-terapéuticos de la AEP: Infectología pediátrica. 89-93. Documento disponible online en: https://www.aeped.es/sites/default/files/documentos/sinusitis.pdf.
- García, Jenny Badilla. “Sinusitis en Pediatría.” Medicina Legal de Costa Rica 35 (2018).
- American Academy of Pediatrics. Subcommittee on Management of Sinusitis and Committee on Quality Improvement. Clinical practice guideline: management of sinusitis. Pediatrics. 2001;108(3):798-808.
- Dykewicz M, Hamilos D. Rhinitis and sinusitis. Journal of Allergy and Clinical Immunology. 2010;125(2):S103-S115.
- Slavin R, Kaliner M, Kennedy D, Virant F, Wald E. The diagnosis and management of sinusitis: A practice parameter update. Journal of Allergy and Clinical Immunology. 2005;116(6):S13-S49.
- Gómez, René Maximiliano. El consumo de tabaco empeora la inflamación nasal y la calidad de vida en pacientes con rinitis alérgica. Diss. Universidad Católica de Córdoba, 2016.
- Fried M. Sinusitis – Trastornos otorrinolaringológicos [Internet]. Manual MSD versión para profesionales. 2019.
