Chronic Sinusitis: Your Guide to Understanding and Overcoming It
Chronic sinusitis occurs when the sinus tissues swell and block over an extended period. It’s treatable using medications, surgery, and home remedies.
According to the CDC, about 28.9 million people in the U.S have a type of sinusitis. With such high numbers, it’s essential to understand what causes chronic sinusitis, symptoms to look out for and how to treat it.
What is Chronic Sinusitis?
There are several types of sinusitis, including; Chronic, recurrent, acute, and sub-acute.
Chronic and recurrent sinusitis sound similar, but they are different conditions. Recurrent sinusitis occurs four or more times within one year. Therefore, you’ll have some periods where you don’t experience symptoms.
Chronic sinusitis can last longer, typically about twelve weeks or more. It requires various treatment types and surgery in severe cases that are not responsive to treatment.
For chronic sinusitis, the symptoms tend to be present all through or absent for a few days and then recur.
What is Acute Sinusitis?
Acute sinusitis lasts several days, often less than four weeks, and the symptoms go away with little or no treatment.
Sub-acute sinusitis can resist treatment initially, with symptoms lasting between four to eight weeks. Acute sinusitis comes from a cold, but chronic sinusitis has various other causes.
Sinus Anatomy
Sinuses refer to four pairs of cavities or spaces located in the head. Narrow channels interconnect the spaces so that when sinuses produce thin mucus, it drains out into the nostrils.
This drainage process functions as a filtration system to remove dirt and bacteria. When the sinuses fill up and block, they can get infected, causing sinusitis.
Symptoms of Chronic Sinusitis
Sinusitis becomes chronic if the symptoms are present for 12 weeks or more. For you to get a diagnosis for chronic sinusitis, you should also have two or more additional symptoms such as:
- Facial discomfort or tenderness around your forehead, cheeks, and eyes.
- Difficulty tasting and smelling food or drinks
- Postnasal drip or mucus streaming down at the back of your throat
- Hard or dry mucus obstructing the nasal passages
- Stuffy nose or thick, green or yellow mucus coming from your nose
- Painful or sore jaws and teeth
- Recurrent headaches caused by swelling and pressure in the sinuses
- Nausea and exhaustion
- Sore throat and a cough that worsens at night
- Bad breath or halitosis
- Pain in one or both ears
Sinusitis in Children
Most children with sinusitis experience common symptoms such as:
- Nasal congestion and discharge, with some minor or major coughing. These symptoms last for ten or more days without signs of improvement
- A cold or respiratory infection that seems to clear then returns as worse
- High fever, with a dark-colored nasal discharge that remains for three or more days
What Causes Chronic Sinusitis
The most frequent causes of chronic sinusitis are:
Nasal Blockage Preventing the Sinuses From Draining
Such blockage can result from nasal polyps, tumors, chronic infection, or damage to the face and nose.
If you have a deviated septum, you have a higher chance of developing chronic sinusitis. The uneven tissue between your nostrils can cause limited airflow in your nostrils.
Unusual, Abnormal Infections
Most sinus infections are treatable using regular antibiotics. However, unusual conditions such as antibiotic-resistant and fungal infections prevent conventional antibiotic treatment from working.
Biofilms
A biofilm occurs when a colony of bacteria forms a thick film like the plaque we see on teeth. Biofilms are challenging to clear, but some methods of cleaning the sinuses, such as nasal irrigation, are effective.
Exposure to Allergens and Irritants
People with asthma and nasal allergies have higher chances of developing chronic sinusitis. These conditions irritate and increase pressure on the sinuses and nasal passages.
Environmental allergies like chemicals and pollen can cause inflammation in the nasal passages.
Immune System Issues
Some diseases affect the immune systems, weakening the body’s ability to fight inflammation and infections.
Some health conditions can also increase your vulnerability to chronic sinusitis, such as:
- Gastroesophageal reflux disease (GERD) which affects the digestive tract
- Cystic fibrosis is where mucus accumulates in your body, causing various bacterial infections
- Human immunodeficiency virus (HIV) where the virus weakens the immune system
Risk Factors of Chronic Sinusitis
Some conditions increase the risk of chronic sinusitis, for example:
- Aspirin sensitivity
- Dental infections
- Fungal infections in the respiratory tract
- Nasal tumors
- Frequent exposure to pollutants such as secondhand cigarette smoke
- Hay fever or Allergic rhinitis
- Diseases that affect the cilia function
- Enlarged adenoids
- Weak immune system due to chemotherapy
- Unusual sinus structures
Methods for Diagnosing Chronic Sinusitis
Doctors diagnose chronic sinusitis depending on the symptoms present. They often begin with questions to determine whether your chronic sinusitis is due to an underlying issue.
The doctor also checks your nose for visible deviations or abnormalities of your nasal bones. They also look for any related issues such as nasal polyps or growths.
If the chronic sinusitis fails to respond to regular treatments, the doctor may refer you to an Ear, Nose, and Throat specialist.
Imaging Tests
An MRI or CT scan helps show the nasal area and sinuses in detail. These images highlight aspects that are difficult to identify using an endoscope, such as deep inflammation and physical blockage.
Examining your Sinuses
Doctors also use nasal endoscopy, where a slim, flexible tube fitted with a fiber-optic light examines your sinuses. The tube goes through your nose to allow the doctor to pinpoint any tumors, polyps, or a deviated nasal septum.
An Allergy Skin Test
An allergy skin test is practical when determining whether your chronic sinusitis gets triggered by allergies. The quick and safe test will help narrow down the allergen causing the nasal flare-ups.
How to Treat Chronic Sinusitis
There’s no single one-size-fits-all treatment for chronic sinusitis. The doctor will examine you to determine the best course of treatment.
Chronic sinusitis doesn’t always result from a bacterial infection, but sometimes it does. If your doctor suspects such an infection, you may receive antibiotics such as amoxicillin alongside additional medication.
For non-bacterial chronic sinusitis, treatment methods are:
Nasal Corticosteroids
These are nasal sprays that assist with the treatment and prevention of inflammation. Popular examples are mometasone, fluticasone, beclomethasone, budesonide, and triamcinolone.
Saline Nasal Irrigation
If the nasal sprays fail to be effective, the doctor may prescribe a mixture of a few drops of budesonide and a saline solution. You can use the mixture as a nasal mist or for rinsing to remove allergens and irritants.
Injected or Oral Corticosteroids
These medications are most suitable for people with nasal polyps or severe symptoms. They reduce inflammation but can have significant side effects for prolonged usage.
Aspirin Desensitization Treatment
This treatment benefits people who react to aspirin, causing nasal polyps and severe sinusitis. It involves gradual exposure to high doses of aspirin under medical supervision. The goal is to raise your tolerance levels.
Immunotherapy
Immunotherapy helps if your sinusitis is due to allergies. You’ll receive allergy shots to minimize your reaction to specific allergens to prevent flare-ups.
Balloon Sinus Ostial Dilation
This procedure involves inserting a balloon into your nasal cavity to create more space and open up your sinus cavity.
Surgery
In some cases, chronic sinusitis can become resistant to treatment and medication. The doctor can recommend surgery to remove tissue and polyps or create more room in narrow sinus openings.
There are two types of surgeries for chronic sinusitis:
-
Endoscopic Sinus Surgery
- The doctor inserts an endoscopy tube to check where tissue, mucus, or polyps are congesting the sinuses. They remove whatever is blocking the sinuses and create more space in the sinuses to help with breathing.
-
Nose Surgery (Rhinoplasty) or Deviated Septum Surgery (Septoplasty)
- This procedure involves reshaping or straightening your nose’s tissue or the wall between your nostrils. The goal is to ensure easier breathing from both nostrils.
How to Prevent Chronic Sinusitis
You can prevent chronic sinusitis and infections and relieve the symptoms using methods such as:
-
Moisturizing Your Sinuses
- Breathing in warm, moist air helps to relieve pain and drain mucus. You can place medium-hot water in a bowl, then cover your head with a towel to breathe in the warm vapor.
-
Rinsing Out the Nasal Passages
- Rinsing out nostrils or nasal lavage helps to clear out the sinuses. You can use a neti pot, saline canister, or squeeze bottle for this process.
-
Avoiding Respiratory Infections
- Ensure you stay away from people with respiratory infections and colds. Wash your hands regularly with water and soap, especially before eating.
-
Use a Humidifier at Home
- If you have dry air inside your home, you can add some moisture to prevent chronic sinusitis. Ensure you clean the humidifier frequently to remove dust and mold.
-
Healthy Diet
- You can boost your immune system by eating veggies and fruits with high antioxidants. Ensure you hydrate well and get enough sleep.
Conclusion
Your health is of utmost priority, so avoid postponing treatment if you experience symptoms for prolonged periods. Ensure you monitor the period from when you realize the symptoms.
If your symptoms last for several weeks or are irresponsive to medication, it’s best to visit your doctor. If you experience changes in your vision, swollen eyes, difficulty when thinking or a stiff neck, ensure you seek medical attention right away.
Get in touch with us today for more details and detailed answers to many questions about chronic sinusitis.