Overview of Sinusitis
Sinusitis or rhinosinusitis refers to inflammation of nasal sinuses resulting in plugged nose, thick nasal mucus and facial pain. Paranasal sinuses are a group of four paired hollow, air-filled cavities around nasal cavity. Paranasal sinuses include maxillary sinuses (located under eyes), frontal sinuses (above eyes), ethmoidal sinuses (between eyes) and sphenoidal sinuses (behind eyes). Sinusitis would be acute if it lasts for less than 4 weeks, subacute if it lasts between 4-12 weeks or chronic if it lasts for more than 12 weeks. Sinusitis is a common condition and affects 10-30% of people in US and Europe.
Causes and Risk Factors of Sinusitis
Generally, sinusitis can be caused by infections, allergens, air pollution or structural defects in nose. The causes of acute sinusitis include viral infection of upper respiratory tract by influenza virus, rhinovirus, coronaviruses, adenoviruses, human parainfluenza viruses. Bacterial infection by Haemophilus influenza, Moraxella catarrhalis and Streptococcus pneumoniae can also cause sinusitis. Viral sinusitis lasts for 7-10 days while bacterial form is more persistent. Fungal invasion can cause sinusitis in patients with diabetes or suppressed immune system. Cigarette smoke, chlorine fumes and tooth infection can also trigger sinus infection. Chronic sinusitis is a multifactorial inflammatory disorder and can be triggered by allergy, dust, pollution, and bacterial or fungal infection. Another cause of chronic form is hereditary abnormality in which auditory tube is not present at its level. Maxillary sinusitis can also be caused by tooth infection.
Signs and Symptoms of Sinusitis
All the types of sinusitis have similar signs which include headache and facial pain or pressure over the affected sinuses which may worsen upon bending over or lying down. Pain often starts on one side of the head and progresses to both sides. Other symptoms include nasal congestion, fever, cloudy, discolored or green colored nasal discharge with or without pus and blood, sore throat, cough, tooth pain, eye pain, fatigue, and itching and sneezing. Sinus infection can also cause middle ear problem due to congestion of nasal passage which results in dizziness, vibrating sensation in head and pressurized head. Post-nasal drip (accumulation of mucus in the back of nose and throat with sensation of mucus dripping from the back of nose) is also a common sign of chronic sinusitis.