Our sinuses are located within cavities beneath the formation of our cheekbones, called maxillary, behind the forehead and eyebrows, called frontal, on both sides of the bridge of the nose, called ethmoid, and behind the nose, in front of the brain, called sphenoid.
Each sinus cavity is joined to an opening into a continuous membrane, called the nasal passage, that allows to breathe in and exhale air and to eliminate mucous However, when the nasal passage becomes swollen, either due to swelling caused by a cold, narrow nasal openings, a deviated septum, nasal polyps or allergic rhinitis, the sinus openings become blocked, and sinus drainage, blood flow and ventilation impaired. This occurrence enables bacteria in the sinuses to multiply, causing an infection.
Sinusitis, “itis” meaning inflammation, can or cannot be caused by an infection. Often caused by bacteria, acute sinusitis usually develops as a result of a viral respiratory infection, or common cold. Most of the time, the common cold subsides on its own without medical treatment. However, a small percentage of cases, the common cold progresses into acute sinusitis.
When sinusitis lasts more than three months, the sinusitis is considered to be chronic. Unfortunately, chronic sinusitis is more complicated and difficult to treat than acute sinusitis. Also, chronic sinusitis is commonly seen in patients with a medical history of allergic rhinitis, asthma or nasal structural problems.
Typical symptoms of acute sinusitis include cough, sinus pressure, facial pain, toothache, a stuffed nose, postnasal drip, yellow-green nasal discharge or even fever. For patients with chronic sinusitis, symptoms may be less sudden, but may still include facial pain and pressure, cough, nasal congestion with colored discharge, in addition to reduced sense of smell, loss of taste, foul breath, hoarseness and recurrent sore throat.
If you have sinusitis, and in addition to a detailed history and physical examination, your allergist may perform allergy skin testing, and order a sinus x-ray, CT scan and even endoscopic examination to rule out other possible underlying causes of chronic sinusitis.
While, treatment for acute sinusitis must include a course of antibiotics, oral decongestants, nasal corticosteroid spray, nasal irrigation with salt water and saline nasal spray, prolonged antibiotic treatment for several weeks for chronic sinusitis may be necessary to completely eliminate bacteria to prevent recurrent sinusitis. Surgical intervention by an ENT (ear, nose and throat)specialist is also indicated for patients with chronic and recurrent sinusitis with structural problems. It is not uncommon patients with recurring or chronic sinusitis to have both allergic rhinitis and structural impairment; therefore, addressing only one issue may not be the sole answer in preventing or treating chronic sinusitis.