What is sinusitis?
The sinuses are air-filled cavities within the facial bones that open into the nasal cavity through narrow channels. Inflammation of their lining is called sinusitis. When the sinus openings become blocked, secretions accumulate, pressure builds up and infection can develop.
What are the symptoms?
Typical symptoms are facial fullness and pressure, discolored nasal discharge, post-nasal drip, nasal obstruction, reduced sense of smell, headache and facial pain that worsens on bending forward. Acute sinusitis usually follows a common cold and resolves within a few weeks. Complaints lasting longer than 12 weeks suggest chronic sinusitis, where symptoms are milder but persistent.
What predisposes to sinusitis?
A deviated septum, enlarged turbinates, nasal polyps, allergic rhinitis and enlarged adenoids all make blockage of the sinus channels — and therefore sinusitis — more likely. In recurrent or chronic sinusitis, identifying these structural causes is the foundation of the treatment plan. Endoscopic nasal examination is used for diagnosis; a sinus CT scan is requested in chronic or treatment-resistant cases.
Treatment
In acute sinusitis, treatment is based on saline nasal rinses, decongestant sprays and antibiotics when indicated. In chronic sinusitis, long-term intranasal corticosteroid sprays and regular rinses come first; allergy is treated at the same time when present.
When does surgery come into play?
Endoscopic sinus surgery is considered for chronic sinusitis that does not improve despite adequate medical treatment, for nasal polyps, and for structural problems blocking the sinus channels. The operation is performed through the nose with a camera, without external incisions; the aim is to open the natural drainage pathways of the sinuses permanently. See Endoscopic Sinus Surgery for details.
This article is for general information purposes only; please consult your physician for diagnosis and treatment.