Breathing is a bodily function we take for granted. We are breathing every moment we are alive and we do it without thinking about it. It is only when we experience difficulty in breathing that we think about it and realize how important it is to every aspect of our existence. One of the most common ailments that causes difficulty in breathing is sinusitis.

The Sinuses

These are spaces inside the nose and head that are filled with air and which produce the mucus that drains out of the nose. This mucus helps to keep the nasal passages clean and free of allergens, bacteria and other pathogens. When the sinuses become inflamed and blocked, a patient feels heaviness and pressure around the nose, has difficulty in breathing and feels that the head has become heavy. There are various types of sinusitis:

• Acute sinusitis is associated with the common cold and typically lasts about 4 weeks.
• Chronic sinusitis lasts for more than 12 weeks and is often caused by bacterial infection.
• Recurrent acute sinusitis occurs 4 or more times in a year and the attacks last for about 2 weeks. This is also the result of a recurring infection.

Causes

The triggers that set off an attack of sinusitis are not completely known. In some cases, sinusitis may be hereditary. Medical conditions such as cystic fibrosis can also cause sinusitis, especially in children and young adults. Some medical conditions could also trigger the attacks or make them worse. These include:

• Common colds, flu and other viral infections that affect the nose or sinuses
• A deviated nasal septum or polyps or tumors in the nose

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Sinusitis Symptoms

The symptoms of sinusitis may vary from patient to patient, but in general, the common symptoms are:

• A runny nose with a flow of thick mucus
• Mucus dripping down the throat (postnasal drip)
• A blocked or congested nose
• A feeling of pressure around the nose, eyes and forehead that may become worse when bending down
• Pain in the teeth or gums
• Pressure or pain in the ears
• Headache
• Fatigue
• Coughing
• Bad breath
• Bad taste in the mouth
• Fever

Diagnosis

A doctor will perform various tests to diagnose the condition. These include examining the patient’s medical history and examining the ears, nose and throat for signs of blockage or swelling. An endoscope which is a small lighted instrument used to obtain a better view of the affected areas may be used. In some cases, fluid samples may be taken from the nose for laboratory examination. A CT scan could also be ordered to enable a better understanding of the condition of the sinuses. If the condition is chronic, allergy testing may be required to identify the cause of the problem.

Complications

In rare cases, sinusitis may result in the following complications:

• If the infection spreads to one or both the eye sockets, it could cause vision problems which may, in the worst case, result in blindness.
• A sinus infection could spread to the fluid and membranes around the spinal cord and brain. This could cause meningitis.
• Sinus infections may spread to the skin and cause cellulitis.
• Infections may also spread to the bones resulting in the development of osteomyelitis.

If any of the following symptoms develop, the patient should seek urgent medical care:

• Confusion or other mental changes
• Vision changes
• Pain or swelling near the eyes
• High fever (over 40C or 103F)
• A stiff or painful neck
• Seizures

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Also Read: Sore Throats and Their Treatments

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Treatment

Once a diagnosis of sinusitis is confirmed, the next step is to determine whether the condition is acute, chronic or recurring. The treatment will depend on this.

• For acute sinusitis, the treatment will normally include:
  1. Over-the-counter cold and allergy medications
  2. Nasal decongestants
  3. Nasal saline rinses
  4. Fever medication (if required)
  5. Consuming lots of fluids
• If the condition is chronic, the treatment may include, in addition to the medication for acute sinusitis:
  1. Antibiotics
  2. Decongestants – topical or oral
  3. Prescription steroid nasal sprays
• If the condition is recurring, then additional treatment could include:
  1. Topical antihistamine sprays or oral pills
  2. Intranasal steroid sprays
  3. Other prescription medication
  4. If polyps or fungal infections are the cause of the problem, surgery may be advised to treat any structural issue that may be present.

Prevention

Those who are prone to sinusitis should take the following precautions to reduce the risk of requiring medical treatment:

• Avoid contact with people suffering from colds, flu and other infections.
• Wash hands frequently so that germs from the hands are not transferred to the nose.
• Avoid places where there is cigarette (or other) smoke.
• Stay away from places where the air is polluted.
• If you have allergies, avoid places and things that tend to trigger allergic reactions.
• If the air in the home is dry, a humidifier should be used to add moisture to the atmosphere. The humidifier should be regularly cleaned to keep it free of mold and other toxic substances.

Millions of people suffer from chronic or recurring sinusitis. It is not a life-threatening condition and so patients tend to ignore it as just a symptom of cold or flu. While the condition may clear up with time or with the use of over-the-counter medication, if the condition is so severe that normal functioning is affected or if it keeps recurring, getting the right treatment is important. For this, it is important that the patient goes to an ENT (ear, nose and throat) specialist for diagnosis and treatment. If the patient can go to a multispecialty hospital with a dedicated ENT department, then that is the best choice. In case there are other medical issues that are related to sinusitis, the multispecialty hospital will have all the diagnostic and treatment services and facilities available to provide quick and complete care so that recovery too is quick.

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