Sinusitis: what it is, causes, symptoms & treatments

• Sinusitis can affect our olfactory system and limit phonation when speaking due to inflammation and infection.
• In many cases sinusitis can be treated with pharmacological remedies, but if the disease persists the only option is surgery.
• Endoscopic sinus surgery is performed with the aim of eliminating the discomfort caused to the patient and improving their quality of life.

Sinusitis is a condition of the paranasal sinuses. These sinuses are air-filled cavities in the bones of our skull that filter the air we inhale. They also help us with phonation when we speak and are part of our olfactory system.

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When the sinuses, cavities surrounding the nasal passages, become inflamed, sinusitis, also known as rhinosinusitis, occurs.

Sinusitis leads to sinus and nasal cavity restrictions due to inflammation and infections caused by bacteria, fungi, viruses or recurrent allergies.

This condition involves the appearance of polyps or the accumulation of purulent mucus, so that breathing through the nose can become difficult and difficult. Our face may even become sore, as the eyes and face often swell as a symptom.

Some of the symptoms caused by sinusitis can be obstruction of the nasal passages, i.e. nasal congestion, facial pain, nasal discharge, purulent rhinorrhoea, partial or total loss of sense of smell, the appearance of polyps and mucous oedema.

All these problems associated with sinusitis can be one-off or recurrent throughout life.

There are two types of sinusitis depending on how long they last in the person who contracts it. Acute and chronic sinusitis, as well as having this difference defined by time, share other differences in relation to their causes, symptoms and treatments.

• Acute sinusitis: Symptoms of acute sinusitis do not last more than four weeks. It is usually caused by a common cold or, in the worst case, by a bacterial infection. Acute sinusitis usually resolves within a week to ten days. It is usually treated with medication or even home remedies. If it persists for more than twelve weeks, it can lead to serious infections and other complications. In these cases, it is called chronic sinusitis.
• Chronic sinusitis: in these cases, symptoms persist for more than three months. It is usually caused by an infection, an enlarged sinus or a deviated nasal septum. In this type of sinusitis, bacteria are as present as fungi, causing infections that are difficult to treat. In addition, the symptoms are not so obvious and present themselves in different ways: obstruction of the nasal passages, mucoid rhinorrhoea, which is a continuous runny nose, hyposmia, reduction or disappearance of the sense of smell, etc. This disease is not age-specific, as it can be contracted by young or middle-aged adults as well as children.

There are a large number of causes that can lead to sinusitis, so a detailed analysis by an ENT specialist is always recommended to determine which of them is affecting us. 

Excess mucus and clogging of the paranasal openings make it easier for bacteria and other microorganisms to reproduce. 

Thus, some of the causes of sinus obstruction and the accumulation of mucoid secretions are as follows:

• Infection of the cilia, the hair inside the nasal openings, causes blockage and thus poor mucus flow out of the sinuses.
• Colds and allergies can cause an increase in mucus secretion, leading to obstruction of the sinuses.
• A deviated septum, nasal polyps, a nasal bone spur or hypertrophic turbinates can also block the sinuses.
• In children, the possibility of hypertrophy of the adenoid tissue, i.e. adenoids, must be taken into account and may need to be removed. You can read more about the latter at this link: Adenoidectomy (adenoids removal).

In addition to those mentioned above, there are risk factors that increase the chances of suffering from this disease, such as smoking, allergies, a disease that affects the cilia (the hairs in the nose), a weak immune system caused by HIV or strong treatments such as chemotherapy, having vegetations or being exposed to high-risk sports such as high-altitude sports, diving, high mountain climbing, etc.

Sinusitis manifests itself in different ways. Acute sinusitis usually occurs about a week after contracting a cold that has not been properly treated, either not treated or under-treated.

Sinusitis presents with some primary symptoms and obvious nasal inflammation. 

The symptoms that diagnose sinusitis are:

• Headache: headache, pressure and discomfort around the eyes, gums and cheeks.
• Mucous secretion and nasal congestion: making it difficult to breathe through the nose.
• Hyposmia: the sense of smell is partially reduced and it is more difficult to perceive smells.
• Mucous discharge: either yellow or greenish, from the nose or throat.
• Pain in the face, swelling and pressure in the area of the eyes, cheeks, nose or forehead. In addition, this pain is increased by palpating the face or bending the head.

Other symptoms or signs of sinusitis include:

• Pressure or pain in the ears.
• Tiredness and general malaise.
• Coughing.
• Bad breath.
• Pain in the teeth and jaw.
• Nausea
• Runny nose

When it comes to acute sinusitis, the usual treatment is usually sufficient. However, a third of cases do not. It is in these cases that we speak of chronic sinusitis. The discomfort caused by this disease is extreme in many cases. 

If it is not possible to solve the problem by conservative means, a nasosinusal endoscopy surgery is usually considered to solve the problem and give you back the quality of life you have lost.

We recommend that you request a surgical assessment consultation with one of our ENT specialists so that they can indicate the best option for your case of chronic sinusitis:

Do you need surgery to eliminate sinusitis?

Request a free and immediate appointment with our specialists in Otorhinolaryngology

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Endoscopic sinus surgery can be performed for different reasons, although the aim of all of them is to alleviate or reduce the discomfort caused to the patient due to problems affecting the nasal and sinus passages.

The aim of pharmacological treatments is to achieve the correct functioning of the respiratory system, as well as to protect our organism from germs present in the air we breathe. Even so, there are cases in which the inflammation and infection do not subside, and nasosinusal endoscopic surgery is necessary.

A perfect candidate for nasal and sinus surgery is characterised by the following reasons:

• Due to the contraction of sinusitis, both acute and chronic. This occurs when there is an increase of bacteria and germs in the sinuses causing a viral or bacterial infection. Sinusitis can be treated with medication, but if it is not treated correctly, it can recur. Therefore, if medication does not make the symptoms disappear, the only definitive solution is endoscopic sinus surgery.
• Appearance of nasal polyps. These are abnormal growths of the internal nasal tissue or mucosa that appear due to prolonged irritation or inflammation of the nose. They are usually treated with nasal inhalers or pills to reduce their size, but, as in sinusitis, surgical treatment is much more effective.
• Episodes of epistaxis. These nosebleeds are usually caused by trauma to the blood vessels on the surface of the nasal cavity, as it is when the blood vessels rupture that blood leaks out. To restore the proper functioning of the nasal passages, nasosinusal endoscopic surgery is necessary.
• Due to the appearance of nasal and sinus tumours. For this problem, the only solution is surgical treatment, regardless of its type or the aerodigestive area in which it appears.

In order to detect and make a clear diagnosis of sinusitis, the specialist may perform various tests and examinations such as:

• Rhinoscopy. A nasal endoscopy in which a tube is inserted into the nasal cavity to perform an exploration and examination of the paranasal sinuses.
• Computed tomography. This is done with a scanner that emits X-rays. The machine rotates around the patient creating separate images of the body area called slices. This test is done to view the sinus openings and look at the condition of the tissues and bones.
• MRI. This closely follows the CT scan procedure except that it does not use x-rays. This test is done to check for tumours or infections in the sinuses.
• Transillumination. The test aims to check whether the breasts are inflamed or infected. This is done by dimming the lights in the room or turning them off so that the area of the body, where the specialist will shine a light, can be seen more easily. 
• Apply pressure to the sinus area to check for pain and to check for inflammation or infection.

If you need any of the tests mentioned above, please contact our patient service team so that they can arrange it for you at one of our hospital centres. It is possible that our ENT specialists may require some of them to determine whether or not surgery is necessary, as well as to know what type of intervention to carry out.

As previously mentioned, there may be different treatments for sinusitis depending on its severity and chronicity. Among them we differentiate between pharmacological and surgical treatments:

Pharmacological treatment

If we talk about acute sinusitis, we can say that, in most cases, it disappears with time, although a two-week antibiotic treatment is usually necessary.

With chronic sinusitis, however, the disease must be treated for 21 to 31 days. If the disease is caused by fungal growth, specific treatment for fungal infections is necessary.

Nasal sprays containing corticosteroids and antihistamines can be used to reduce swelling due to nasal polyps. If it is a case of allergy, injections may be appropriate, as they can prevent the disease from recurring once it has been cured.

Surgical treatment

If the symptoms do not disappear within three months of starting treatment or if more than three episodes of acute sinusitis are repeated in a year, surgery is necessary to eliminate the symptoms. This is done to open the openings and drain the sinuses. It should therefore be added that most nasal infections, caused by fungi, require surgery.

Conservative or preventive treatments

Various aspects can be taken into account to prevent sinusitis and reduce the chances of sinus congestion.

Some of the recommendations to reduce symptoms include the following:

• Drink water or inhale steam to thin secretions.
• Use a humidifier if the air around you is dry, such as when the heating is on. Keep the humidifier clean and check it regularly.
• Use nasal decongestants.
• Avoiding tobacco smoke or polluted air in general can irritate and inflame the lungs and nasal cavities.
• Keep your allergies under control with regular medical check-ups.
• Reduce contact with people who have colds and wash your hands frequently, especially before meals.

If you are considering undergoing endoscopic sinus surgery with Operarme, you can request a free surgical assessment consultation with one of our ENT specialists by clicking on the following image:

Do you need surgery to eliminate sinusitis?

Request a free and immediate appointment with our specialists in Otorhinolaryngology

Make an appointment