Chronic Sinusitis
Chronic Sinusitis is a long-term inflammation of the spaces inside your nose and head called sinuses. When the small opening for the mucus to drain out of the nose is disturbed, the nose and the surrounding areas including the area around your eyes get either swollen or tender. This also causes a stuffy nose or difficulty breathing. The conditions can affect either children or adults.
Symptoms
People with chronic sinusitis may experience signs and symptoms including nasal inflammation which may cause thick, colorless discharge from the nose, and reduction of sense of smell and taste. Some people may have post-nasal drainage in the back of the throat. Nasal obstruction is also a common symptom of chronic sinusitis. Pain, tenderness, and swelling often occur around the nose, forehead, cheeks, and eyes. The pain may spread to an ear in some cases as well as aching in your upper jaw and teeth. The discomfort in your throat may include coughing, throat clearing, and soreness. Because of the undrainable mucus, several patients tend to have bad breath. Patients with chronic sinusitis usually feel fatigued.
Most signs and symptoms cannot be used to differentiate between chronic sinusitis and acute sinusitis. Acute sinusitis relates to a cold which leads to a temporary infection of the sinuses. On the other hand, chronic sinusitis lasts at least 12 weeks. However, the acute sinusitis may develop into the chronic sinusitis if it is untreated properly.
When to see the doctor
You may see the doctor if you have experienced sinusitis many times and the conditions have not responded to the treatment. The symptoms of sinusitis last more than 10. Moreover, seek the doctor immediately if swelling or redness around your eyes appears. Fever, severe headache, forehead swelling, and stiff neck are the signs of a serious infection. Some people may experience confusion and vision changes including double vision which are signs showing that there is a serious infection and that immediate medical care is needed.
Causes and risk factors
Several reasons are causing chronic sinusitis. The growing of tissue called nasal polyps that block the nasal passages, or sinuses can be found in some cases. A deviated nasal septum is an abnormal positioning septum that blocks or restricts the sinus passage. If this happens, it usually worsens the symptoms. Moreover, some medical conditions including HIV, cystic fibrosis, and other immune system-related diseases are the risk factors that lead to chronic sinusitis, as well as asthma. Respiratory tract infections such as colds are one of the most common triggers that thicken and inflame the sinus membranes and disturb mucus drainage. Besides viral infections, the causes of the infections may include bacterial or fungal. Allergies such as hay fever are one of the factors of chronic sinusitis as well. Allergies cause inflammation and result in blockage in the sinuses.
The use of some medications may also increase the risk of chronic sinusitis. There are some cases of chronic sinusitis that show the relationship between aspirin sensitivity and chronic sinusitis. Cigarette smoke and other regular exposure to pollutants are also the factors found in number of cases.
Diagnosis
In the first step of the diagnosis, the doctor often evaluates the symptoms of chronic sinusitis by feeling the tenderness in your nose and face before looking inside the nose. Other methods that are used to diagnose chronic sinusitis may include:
- Imaging tests
The details of the sinuses and nasal area are taken with CT or MRI . These methods may examine the physical obstruction or a deep inflammation which is not shown by using an endoscope.
- Exam the sinuses
The inside of the sinuses is detected by inserting a slim rigid tube with a fiber-optic light through the nose.
- An allergy test
Since allergic conditions are one of the common factors triggering chronic sinusitis, this safe and quick allergy skin test is recommended to help the doctor examine the kinds of allergy that may cause chronic sinusitis.
- Samples from the nasal and sinus discharge (cultures)
In case the conditions do not respond to the treatment or the symptoms are worsening, the doctor may need to collect the samples by swapping the inside of your nose. Samples from the nasal and sinus discharge are cultured to seek for the causes of chronic sinusitis such as bacteria or fungi.
Treatment
There are several choices of treatment for chronic sinusitis including medications, immunotherapy, and surgery.
Medications
- Nasal corticosteroids
The purpose of nasal corticosteroids is to prevent and treat inflammation including fluticasone, triamcinolone, budesonide, and mometasone.
- Saline nasal irrigation
Saline nasal irrigation with solutions or nasal sprays washes away irritants and allergies as well as reduces drainage.
- Oral or injected corticosteroids
These medications are used to relieve inflammation in severe sinusitis specifically in the patients with nasal polyps. However, because using corticosteroids in the long term may lead to some serious side effects, these kinds of medications are used only in the patients who have severe symptoms.
- Aspirin desensitization treatment
Sensitivity of aspirin is one of the factors causing chronic sinusitis. Larger doses of aspirin are sometimes given in order to increase your tolerance.
- Antibiotics
If a bacterial infection causes chronic sinusitis, antibiotics may be necessary.
Immunotherapy
Allergy shots called immunotherapy are used when chronic sinusitis is contributed by allergies. This treatment helps decrease the reaction of the body to the specific allergens which develop the conditions.
Surgery
Endoscopic sinus surgery is an alternative for the cases that do not respond to other treatments. Depending on the conditions and factors in each case, the surgery may aim to enlarge the narrow sinus opening to promote drainage or to remove tissue or polyps blocking the nasal passages. Generally, a small slim tube attached with light which is called an endoscope is used to explore the sinus passages.
