What is sinusitis?
Sinusitis – Inflammation of the sinuses
Sinusitis is the inflammation of the mucosa inside the sinuses. How does it arise? How do you spot sinusitis and what is chronic sinusitis?
The nasal cleaning system
During sinusitis, the flow of secretions from the sinuses to the nose is disrupted. The sinuses are cavities that are situated near the nose and are connected to it by small passages. Just like airways these passages are lined with mucosa, whose primary task is cleaning.
When healthy, the mucosa transport dust and dirt particles that come into the sinuses back out of them. An undisrupted flow of secretion from the sinuses to the nose is required to remove the dirt from the sinuses. Furthermore, adequate ventilation of the sinuses is important to avoid growth of viruses and bacteria. If this cleaning process is disturbed the sinuses can become inflamed – and sinusitis results.
How does acute sinusitis come about?
Acute sinusitis often arises in conjunction with an ordinary cold. The mucous blocks the nose and prevents adequate ventilation of the sinuses and flow of secretion from the sinuses to the nose. This is a prime reproductive ground for bacteria and represents the beginning of sinusitis causing typical symptoms such as headaches, fatigue and pressure pain in the sinuses.
In most cases, the sinusitis and the cold that triggered it disappear again. However, sometimes there can be longer lasting complications that are triggered by the cold. Therefore treatment with antibiotics is often recommended to counter a bacterial infection if it has lasted for longer than 2 weeks.
What is chronic sinusitis?
Chronic Sinusitis is different to acute sinusitis and can be much more debilitating. Patients present with frequently repeating symptoms of sinusitis are often never completely relieved of them. The illness then occurs in phases but never fully recedes. This can lead to four or more episodes of sinusitis per year.
In these cases the causes of sinusitis are often due to anatomy. Narrow passages to the sinuses or adhesions of the mucosa (so called nasal polyps) can, for example, increase a patient’s propensity to developing chronic sinusitis.
How do you treat sinusitis?
Acute sinusitis is usually treated with nasal decongestants. If the symptoms do not recede after 1-2 weeks, the administration of antibiotics may be necessary in case of bacterial infection. Treatments such as nasal douches or inhalation can support the therapy.
Treatment of chronic sinusitis is much more complex than that of acute sinusitis and strongly depends on the individual case. Steroids can be used to counter the formation of mucosa polyps. Another option is the use of nasal decongestants, however, their use for longer than 2 weeks is unhealthy and hence not advised for the therapy of chronic sinusitis.
Physiotherapy with PEP devices, however, can be effective without the need for medication. Studies have shown that PEP devices produce air pressure and flow vibrations which allow better ventilation of the sinuses and hence reduction of the symptoms.
In some cases, surgery of the sinuses can also be helpful. It is difficult to predict the success of such an operation and this should be carefully considered before one decides to go ahead with one.