Causative & risk factors
Common causes of chronic sinusitis include allergies, nasal polyps, and nasal tumors, trauma to the face or a deviated nasal septum. It can also be caused due to a viral, bacterial or fungal infection. An infected tooth can also cause sinusitis.
Several conditions increase the risk of developing chronic sinusitis such as cystic fibrosis, smoking or a weak immune system.
Clinical presentation
The affected sinus is painful and tender. Thus pain may be experienced around the nose, forehead, eyes or cheeks. There is usually a thick green/yellow coryza. This discharge may also be post-nasal (down the throat). The nostrils feel blocked and the sense of smell may be reduced. Fever is usually absent.
Additional symptoms include headache, sore throat, toothache, halitosis or cough. The patient may feel tired, irritable and have a nasal speech with a sense of fullness in the ear.
Investigations
Visual inspection of the nostrils is done to look for obvious causes of chronic sinusitis. X-rays of the paranasal sinuses are performed. When the cause is unclear, specialized investigations like a nasal endoscopy, allergy testing or CT/MRI scans of the sinuses are suggested.
In persistent cases, the discharge from the nose or sinuses is cultured.
Treatment
The nasal sinuses can be irrigated at home using certain devices.
Painkillers and decongestant drugs are prescribed for relief. Antibiotics and anti-fungal medications are needed only in case of bacterial or fungal sinusitis respectively. Corticosteroids are prescribed in the form of tablets, injections or sprays to reduce the inflammation.
Any underlying cause such as allergies, nasal tumors etc. must be treated appropriately. Resistant cases may require endoscopic nasal surgery to explore the sinuses and treat the cause.
Recent updates
Recent research has revealed that the antioxidants found in broccoli sprouts help to fight inflammation associated with chronic sinusitis.
Research studies by Mayoclinic have revealed that the inflammation in chronic sinusitis resembles an immune response to fungal organisms. Further research is yet underway to validate this finding.
Alternative treatment options like homoeopathy and ayurveda are also good treatment options for chronic sinusitis.
Facts and figures
In the USA, about 37 million people suffer from sinusitis annually, which equates to about 1 in 7 people.
