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Sinusitis:
Symptoms, Causes, Risk Factors, Diagnosis & Treatment

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1.What is Sinusitis?

Sinuses are air pockets that are present behind the nose, cheekbones, between the eyes and forehead. These sinuses are responsible for producing mucus, the slimy fluid that protects foreign particles and germs from entering the body via the nasal cavity by trapping them. Bacteria can cause mucus to build-up excessively in the nasal passages which can lead to blockages, leading to bacterial and viral infection, this condition is called sinusitis. Sinusitis affects an estimated 134 Million Indians, severe and chronic Sinusitis can be debilitating and hamper the patients quality of life.

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2.Symptoms of Sinusitis

Sinus Treatment

Symptoms of Sinusitis are often indistinguishable from a common cold. If symptoms do not improve in 1-2 weeks it is necessary to consult a doctor to ensure that the infection is not aggravated.

The symptoms to watch out for are:

  • Runny nose or blocked nose
  • Severe headaches
  • High fever
  • Constant and persistent cough
  • Decreased sense of smell

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3.Types of Sinusitis

Acute Sinusitis

When viral infection caused by the common cold leads to inflammation of the nasal passage it is called acute sinusitis. The symptoms usually last around two weeks and up to four weeks. This kind of Sinusitis can be caused by seasonal allergies such as pollen or dust.

Subacute Sinusitis

When a Sinus infection lasts for up to 3 months it’s called subacute sinusitis. It is recommended to meet a professional if the sinus attack lasts for more than a week.

Chronic Sinusitis

When Sinus infection lasts longer than 3 months it’s called chronic sinusitis, this is mostly the case when patients have structural nasal problems or persistent allergies.

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4. Causes of Sinus infection

The conditions that cause Sinus infection include:

The common cold: If a cold is not treated at the appropriate time, it may aggrave into a sinus infection over time

Allergic Rhinitis: Also known as hay fever, this is an inflammation of the nose that occurs due to a heightened sensitivity to allergens. The symptoms include a constant running nose, itchy eyelids and watery eyes.

Nasal Polyps: These are soft painless growths in the inner lining of the nose, they are benign and non cancerous, however they could cause Sinus Infections to develop.

Deviated Septum: This occurs when your nasal septum, the thin wall between your nasal passages has shifted to one side. This is mostly a congenital condition.

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5.Risk factors

Certain health conditions or risk factors can increase the chances of developing a sinus infection such as:

  • Being born with a deviated septum.
  • Nasal Polyps
  • Severe allergies leading to inflammation
  • Exposure to mould
  • History of smoking
  • Infection of teeth/mouth
  • Cystic Fibrosis (Build-up of mucus in lungs)
  • Respiratory tract infections such as Bronchitis
  • Generally weak immune system

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6.Steps to prevent Sinus infection

  • Maintain strict hygiene and avoid contact with those suffering from Cold and Flu to prevent contracting respiratory tract infection
  • Vaccination against preventable infections such as influenza
  • Diet rich in antioxidants (Fresh fruits like Plums, Cranberry, Grape, Peaches)
  • Reduce daily stress
  • Plan and prevent exposure to seasonal allergens such as pollen by wearing face masks
  • Use OTC antihistamines, nasal sprays to deal with sinus attacks
  • Staying hydrated at all times to keep nasal secretions thing
  • Steaming/ Taking a hot water shower to keep nasal passages moist
  • Avoid smoking/passive smoking

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7.Sinusitis headaches

Sinus Headaches

A Sinus headache is caused when there is a sinus blockage and the sinuses are not drained adequately. The mucus build-up in the sinuses can be breeding grounds for bacteria leading to an aggravation of the problem.

Here’s how to recognize if your headache is being caused by Sinusitis:

  • Pain in the frontal portion of the face towards the cheeks or behind the eyes.
  • Aggravated headache when bending over.
  • The pain is intense in the morning and subsides through the day.
  • Aggravated by cold weather.

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8.Diagnosis

The first step for your doctor will be a physical exam. They will inquire about your symptoms and your medical history. They may examine the inside of your nose to check for blockages and will apply pressure on your nose and cheeks to check for tenderness.

In the case of chronic sinusitis, your doctor may recommend further tests such as a CT scan. This is done to reveal if there are any abnormalities such as a deviated septum or the development of nasal polyps which may require corrective surgery.

They may also choose to conduct a nasal endoscopy, where a camera attached to a fiber optic wire is passed through the nose. The doctor may also obtain a sample of mucus for culture testing to check for the presence of bacterial infection.

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9.Treatment of Sinusitis

Sinus Headaches

Sinus is treated based on the underlying cause of the infection, based on the seriousness of the infection your doctor may prescribe the following courses of action.

Home remedies:

Use a humidifier - This can help to ensure that the air around you is moist and reveal nasal blockage that develops overnight.

Steam - You can also steam or use a hot shower for relief. For steaming fill up a bowl with hot water and lean over it while wrapping yourself in a blanket to prevent steam from escaping. Initially inhale through both nostrils and then alternate between nostrils to ensure the passages are completely clear. Cough up the loose phlegm blow your runny nose to get rid of the blockages.

Essential oils - Oils like eucalyptus can provide relief as well. These can be especially helpful and relaxing if you’re suffering from headaches due to prolonged sinus infection.

Neti (Irrigation of nose) - Irrigating the nose using saline water is an effective home remedy for Sinusitis. Make sure to use distilled and pure water in the case of nasal irrigation to prevent the risk of contaminants.

Use a warm compress - Another go to method to clear up the nasal passages is the use of a warm towel. Placing the towel over the affected area while resting or sleeping can help loosen up the passages and provide relief.

Rest adequately - Sinus can be very taxing on the body especially if over a prolonged period of time. Make sure you get plenty of rest to give yourself a chance to recover.

Nasal decongestant sprays:

These medications are used to clear up the nasal passages and make it easier for mucus to drain out from the sinuses.

Antibiotics:

If Sinus infection is caused by bacterial infection then a course of antibiotics can improve the condition. However, if antibiotics are used indiscriminately they can lead to a cause of antibiotic resistance. Hence antibiotics should be used sparingly and only after consulting with the doctor.

Antihistamines:

If Sinus infection is caused due to seasonal allergies then using an antihistamine can resolve the problem. The Antihistamine fights inflammation caused due to the allergen and prevents the onset of infection.

Pain Remedies: Medications such as ibuprofen can help alleviate symptoms such as headache.

Surgery:

In the case of structural deformities such as a deviated septum or nasal polyps there might be a need for corrective surgery.

Types of Sinus surgery:

Functional endoscopic sinus surgery

In this form of surgery, an endoscope is inserted into the nasal passageway. The doctors then use equipment such as micro telescopes, cameras, and other surgical instruments to remove any kind of blockages such as nasal polyps. The procedure is a minor one and does not leave behind any trace of scarring. If the sinus reoccurs, the surgery can be performed as frequently as necessary.

Caldwell-Luc operation

In this procedure, the surgeon creates a pathway between nose and the maxillary sinus to aid in the easy drainage of any mucus that builds up in the area. The pathway is made by making a cut in the molar region to enter the sinus cavity. The procedure is only recommended if there is a growth inside the sinus cavity that needs to be removed.

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10.Road to recovery and aftercare

The recovery after sinus surgery is usually quick as it is a minor procedure. The doctor might insert a sterile gauze into the nasal cavity to prevent any kind of bleeding after the surgical procedure. In most cases the gauze that is used is dissolvable and is absorbed by the body. In case a non-dissolvable gauze is used, the doctor usually removes it in a separate procedure.

The patients may experience nasal congestion, slight bleeding and fatigue as a result of surgery. The doctor will recommend a course of antibiotics and may also recommend painkillers and saline rinse to ensure the blockages are completely cleared and disinfected.

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11.Risks or complications

It’s important to consider the risks involved while undertaking any surgery. Make sure to consult with the doctor to understand all the possible risks before going ahead with your decision. Here are the possible risks and complications of Sinus surgery.

Eyesight impairment

Sinus surgery can in rare circumstances lead to damaged eyesight if blood seeps into the eye during the procedure. This happens if the layer of bone between the eye and sinus is damaged. In rare cases, the tear glands of the eyes can be affected leading to loss of control and involuntary tearing up. There may also be cases where the muscular structure of the eye is affected leading to double vision and deterioration of eyesight.

Meningitis

In rare cases, the septum may be damaged during surgery and brain fluid can leak into the nasal passages. This can lead to an infection of the brain membrane called meningitis, which can potentially be fatal.

Smell or tasting impairment

After the surgery, there may be complications where infection affects the sense of smell or taste for a short period of time. These usually go away on their own a few days after the procedure.

Blocked airflow

Sinus surgery is usually successful in improving airflow through the nasal passages, however, in rare cases, there may a build-up of scar tissue in the nose that leads to blockage. This will require corrective surgery at a later stage.

Bleeding

As with every surgery, there is a risk of bleeding after the procedure. This is usually prevented by using nasal packaging, but in case of a blood clot, there may be a need for corrective surgery to remove the clotting.

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12.Sinusitis FAQs: All your concerns addressed

Q.  How long can Sinus Infections last?

  1. Depending on the kind of infection it last anywhere between a week upto three months or longer. If it lasts longer than three months, it’s called chronic sinusitis and may be a result of structural deformities.

Q.  What’s the fastest way to get rid of a sinus infection?

  1. Stay hydrated and drink fluids to thin out the mucus.
    Eat foods rich in antioxidants.

Q.  How do I drain my sinuses naturally?

  1. Apply pressure between your eyebrows on the forehead and push your tongue against the top of your palate. The pressure that’s created will lead to your sinuses draining out naturally.

    Warm your hands by rubbing them together. Place your fingers around your forehead above the eyebrows and apply pressure. In a circular motion, massage your temples and apply pressure.
    Repeat the motion for close to 30 seconds.

Q.  How long does Sinus surgery take?

  1. Sinus surgery can take anywhere between two to four hours. It is a minor surgery and usually doesn’t take an overnight stay.

Q.  How is Sinus surgery done?

  1. In Sinus surgery a nasal endoscope is used to perform the procedure, there is no need for any external incisions and it can be performed under general anaesthesia.

Q.  Do Antihistamines help sinus infection?

  1. If the cause of your sinus infection is seasonal allergies such as exposure to pollen, mites, dust, pet hair and the likes, antihistamines may help the problem. However, the constant use of antihistamines can lead to drying up of the sinuses and slow down the draining process. It is not advisable to take histamines without a doctor prescription. Consult with a doctor to diagnose if your sinus infection is being caused by exposure to allergens, your doctor may conduct a patch test or other diagnosis to determine the root cause and recommend the best course of action.

Q.  Can Sinus infection cause fatigue?

  1. Similar to any infection, the body spends energy fighting the bacteria. Since there is a constant mucus production, sufferers may constantly blow their nose in an effort to clear their nose. There may also be prolonged headache during this time leading to the feeling of fatigue.

Q.  How should I alter my diet during Sinus infection?

  1. If you suffer from a sinus infection, you must avoid foods that cause inflammation in the body. It also helps to keep drinking plenty of fluids to ensure that the mucus is easily drained from the body.

The foods to avoid include:

  • Sugars: Avoid desserts, chocolate bars, processed foods, juices and sodas as they have high sugar content.
  • Saturated fats: Junk food such as Pizza, Pasta, Cheese must be avoided as they can trigger fat tissue inflammation.
  • MSG: Canned foods that have a high monosodium glutamate content must be avoided.
  • Refined Carbohydrates: Mashed potatoes, cereals, white bread, dough must be avoided as they have a high glycemic index and cause inflammation.

Foods to include:

To reduce inflammation it is recommended to have diet that is rich in antioxidants and Omega 3 fatty acids.

  • Add fish such as sardines and cod to your diet that are rich in healthy fats.
  • Turmeric which has curcumin can help reduce inflammation in the body.
  • Red bell peppers which are rich in Vitamin C.
  • Leafy vegetables such as asparagus and broccoli.
  • Oranges, grapefruits, berries that are rich in Vitamin C.
  • Green tea can help the body stay hydrated.
  • Cayenne pepper to help in thinning of the mucus and clear out the sinuses.

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13.Outlook and Prognosis

Sinus infections usually last for two weeks and go away on their own. OTC medications and home remedies can help relieve the symptoms. If the symptoms last longer than two weeks it’s recommended to meet a doctor.

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