Sinusitis: causes, types and diagnosis

Sinusitis is a fully treatable disease, especially if it is diagnosed early. Despite this, it causes pain, breathing difficulties and other discomfort.

Sinusitis is a disease of the paranasal sinuses, small empty spaces in which the air that circulates between the bones of the nose passes. They are divided into three groups: frontal sinuses, ethmoid sinuses and maxillary sinuses.

Under normal conditions, air moves smoothly through these cavities. Conversely, when the sinuses become inflamed, breathing difficulties and other discomfort arise such as pain that can sometimes be very intense.

If the sinuses are healthy, there are no bacteria or other microorganisms present. In this case, the mucus comes out and flows to the nose without any problem.

If too much mucus accumulates or if there is a blockage in the paranasal openings, a favorable environment is created for the development of different types of microorganisms. This gives rise to sinusitis.

The origin of sinusitis

Excessive mucus segregation and / or sinus blockage have several origins . The most frequent are:

  • Allergies and colds, which contribute to producing a greater volume of mucus
  • Abnormal bony protrusions of the nose
  • Septum deviation
  • Presence of nasal polyps
  • Problems with hair located in the sinuses, which cannot clear the mucus

Some risk factors are associated with sinusitis. The main ones are: suffering from cystic fibrosis, hay fever or allergic rhinitis.

Other triggers are a weak immune system, having adenoid hypertrophy , being subjected to physical pressure or gravity and, finally, smoking.

Types of sinusitis and symptoms

There are different types of sinusitis, which differ according to the time of duration. Basically, four types are distinguished:

  • Acute – lasts up to 4 weeks,
  • Subacute – lasts 4 to 12 weeks,
  • Chronic – lasts more than 12 weeks,
  • Recurring – multiple attacks occur within the same year.

Some symptoms are common to all types of sinusitis. The most important are:

  • Loss of smell and bad breath
  • More intense cough at night
  • Fatigue
  • Feeling unwell
  • Headache
  • Feeling of internal pressure in the area surrounding the nose
  • Pain behind the eyes
  • Toothache
  • Sensitivity in the face
  • Nasal congestion
  • Postnasal mucus
  • Sore throat

In acute sinusitis, symptoms appear seven days after contracting a cold. 

In the case of chronic sinusitis, all the symptoms are similar although they tend to be milder and, as mentioned, last longer.

Diagnosis of the disease

In most cases, a diagnosis of sinusitis is made starting from an inspection of the nasal cavities. The doctor casts a light on the area looking for polyps or signs of inflammation .

It is also common to apply pressure to the area to check for pain. The onset of pain suggests the presence of sinusitis.

To make a certain diagnosis, one or several of the following clinical tests are generally prescribed: rhinoscopy, computed tomography or magnetic resonance imaging.

Radiographs hardly get a reliable result.

Doctors may request other complementary tests, such as: nasal mucus culture, blood tests to evaluate immune system conditions, allergy tests , nasal hair function, and cystic fibrosis.

Prognosis and complications

Sinusitis treated in time usually has a very favorable prognosis . If proper treatment is followed and the necessary care is taken, the patient will recover completely.

If recurrent episodes occur, however, it means that the cause of the disease has not been eradicated.

Complications of sinusitis are infrequent. However, if they arise, they must be treated very carefully, as they could have a dangerous course. The most frequent are:

  • Asthma seizures resulting from chronic sinusitis.
  • Vision problems . They occur when the infection spreads to the eye and, in some cases, result in loss of vision or even blindness.
  • Blood clots or aneurysm . Sinusitis can damage the veins around the sinuses. In these cases, blood flow is cut off and there is a risk of suffering from a brain hemorrhage that occurs when the inflammation advances towards the brain.

Other less frequent complications are bone infections ( osteomyelitis ) and skin infections around the eyes.

All complications must be treated as quickly as possible in an appropriate facility.

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