What is sinusitis?
Sinusitis is a swelling or an inflammation of the tissue that lines the sinuses. In a healthy person the sinuses are filled with air, but when they become blocked and filled with fluid then germs can replicate and lead to an infection. Otorhinolaryngologists (also known as ENT surgeons) at Mount Elizabeth Medical Centre are available for consultations for sinusitis.
The major signs of sinusitis are pressure or pain in the face, a “stuffed up” nose feeling, a runny nose, loss of sense of smell, congestion or a cough, a fever, fatigue and, in fewer instances, dental pain.
What are the different types of sinusitis?
There are four classifications of sinusitis:
Acute sinusitis. This type of sinusitis happens suddenly and has symptoms that are very similar to a cold. The symptoms are facial pain and a runny nose, and this can last for one to four weeks.
Subacute sinusitis. Subacute sinusitis has the same symptoms as acute sinusitis, but they last for longer – about one to two months.
Chronic sinusitis. Symptoms for this type of sinusitis are the same, but they persist for at least two months.
Recurrent sinusitis. These symptoms happen several times per year.
What are the causes of and risk factors for sinusitis?
Causes and risk factors for sinusitis include:
· An allergic condition such as hay fever that affects the sinuses
· A deviated nasal septum, nasal polyps, tumors or another nasal passage abnormality
· Certain chronic medical conditions like cystic fibrosis or diabetes, or an immune system condition like HIV/AIDS
· Traveling to high altitudes or dealing with air pollution
· Women tend to have a higher risk than men for sinusitis
Did you know?
While sinusitis can make people feel sick, chronic sinusitis, as well as hay fever, are also linked to an increased risk for depression. ¹
What are the possible complications of sinusitis?
Complications for sinusitis are not common, but if they do happen, they tend to include:
Chronic sinusitis. This can start to occur after acute sinusitis happens a few times over the course of a few years.
Meningitis. A meningitis infection leads to inflammation of the membranes and fluid surrounding the brain and spinal cord.
Infections. Beyond meningitis, infection can spread to the bones, which is called osteomyelitis, or the skin, which is called cellulitis.
Effects on smell. People can experience partial or complete loss of their sense of smell due to the nasal obstruction and inflammation of the nerve that control the sense of smell.
Vision issues. In the event an infection spreads to the eye socket, it can lead to worsened vision or sometimes blindness that can be permanent.
When should I see a specialist for sinusitis?
You should see an ENT specialist for sinusitis if you have been sick for ten or more days in a row without improvement, or if you’ve felt slightly better for a short period of time but then became more sick.
A bacterial sinus infection will require antibiotics, so do not ignore the symptoms in case they continue to worsen.
Other signs that you should see a specialist include:
· A persistent, high fever over 39 degrees Celsius
· An excruciatingly bad headache
· Trouble with vision
· A stiff neck
· A swollen face
How should I prepare for my appointment?
Preparing for an appointment with an ENT specialist does not have to be labor-intensive. Just make sure you’ve made notes of your symptoms and be prepared to possibly undergo x-rays or other minimally-invasive diagnostic techniques.
How do specialists screen for and diagnose sinusitis?
The ENT specialist will check for tenderness in the nose and face area while also looking inside your nose. The major methods used to diagnose sinusitis include:
· Nasal endoscopy
· Imaging studies like a CT scan or an MRI
· Cultures of the nasal cavity and sinus
· An allergy test to determine if the condition has been instigated by an allergic condition.
What treatments are available for sinusitis?
Many people with acute sinusitis are able to heal on their own without needing antibiotics because they tend to be caused by viral infections, however a specialist will help determine whether you have a bacterial infection that would require antibiotics.
All other types of sinusitis usually need antibiotics, and in the worst cases surgery may be required.
Treatment goals for sinusitis are to:
· Improve mucus drainage and reduce swelling in the sinuses.
· Ease the pain and pressure in the sinuses
· Clear up any infections
· Stop the formation of scar tissue and evade any permanent damage to the tissues tat line the nose and sinuses
 Katie M. Phillips, MD, , Lloyd P. Hoehle, , Regan W. Bergmark, MD, , Adam P.Campbell, MD, , David S. Caradonna, MD, DMD, , Stacey T. Gray, MD, , Ahmad R. Sedaghat, MD, PhD. Association between Nasal Obstruction and Risk of Depression in Chronic Rhinosinusitis. Otolaryngology-Head and Neck Surgery. Vol 157, Issue 1, pp. 150 – 155. First Published March 14, 2017.