Sinusitis: A Chronic Condition That Requires Targeted Treatment

If you experience symptoms such as persistent nasal congestion, facial pain, or if the infection spreads and causes ear pain, you may be experiencing acute sinusitis and should seek medical attention.

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What Is a Sinus?

The sinuses are air-filled cavities located around the nasal passages. These cavities are present on both sides of the face and are divided into four pairs based on their anatomical locations:

• Ethmoid Sinuses: Located between the eyes (one pair)

• Maxillary Sinuses: Located in the cheeks (one pair)

• Frontal Sinuses: Located in the forehead (one pair)

• Sphenoid Sinuses: Located at the back of the nasal cavity, beneath the base of the skull or brain (one pair)

Normally, the sinuses drain naturally through the nasal passages. However, if this drainage becomes blocked, pathogens can accumulate, leading to sinusitis. When sinusitis develops, pus may build up, affecting the respiratory system and the sense of smell, resulting in various symptoms.

What Are the Symptoms of Sinusitis?

Common symptoms of sinusitis include:

• Severe, throbbing facial pain—especially around the eyes, forehead, cheeks, or nose

• Toothache-like pain or pain in the upper jaw

• Pain that worsens in the morning, afternoon, or when bending forward or changing positions

• Headache

• Nasal congestion or reduced sense of smell

• Nasal voice

• Thick yellow or green nasal discharge

• Sore throat with yellow or green phlegm

• Bad breath

• Fever (typically in acute cases)

Due to the sinuses’ proximity to the eyes and brain, complications can occur in severe cases. These may include the spread of pus to the eye, causing vision disturbances, double vision, or even blindness. In rare cases, the infection can reach the brain, potentially leading to permanent disability or death.

Factors Contributing to Sinusitis

• The likelihood of developing sinusitis after a cold is about 0.5–5%.

• Around 1 in 8 people will experience sinusitis at some point in their lives.

• Individuals with nasal allergies have a 50–70% higher chance of developing sinusitis.

• People with structural abnormalities, such as a deviated nasal septum, are more prone to sinus infections.

• Smokers or those frequently exposed to secondhand smoke

• Living in areas with high air pollution

Treatment of Acute Sinusitis

Acute sinusitis is a sudden-onset condition that is often treated with medications, particularly antibiotics to target bacterial infections. Treatment typically lasts 7–14 days. Doctors may take a sample of nasal discharge to identify the specific type of bacteria, allowing for more targeted antibiotic use.

Anti-inflammatory medications and treatments that promote mucus drainage may also be prescribed. These include oral medications or nasal sprays containing corticosteroids. Newer steroid sprays are effective and generally considered safe, with minimal side effects. However, according to a Cochrane Review, these sprays are most effective when they can adequately reach the sinus cavities.

Chronic Sinusitis

Chronic sinusitis is typically managed through a combination of medication and surgical intervention. Surgical options include conventional surgery or balloon sinuplasty. In early stages, surgery focuses on draining the sinuses. In more advanced cases, it involves removing blockages and restoring normal drainage pathways to reduce the risk of recurrence.

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