Sinus infection or sinusitis is inflammation of the sinuses. It commonly starts as a viral infection and becomes secondarily infected with bacteria. In this part of the world, warmth and humidity can also result in fungal infection of the sinuses.
Sinuses are air-filled cavities within the bones of the upper face. When the sinus becomes inflamed or infected, mucus thickens and clogs up the openings of one or more sinuses. This causes fluid to build up inside the sinuses due to pressure, resulting in bacteria becoming trapped, multiplying and infecting the lining.
Common symptoms of sinus infection include:
Sinusitis can be chronic (long-lasting) or acute. Acute sinusitis is more common and even normal people can experience it up to 2-3 times per year. Acute sinusitis typically lasts up to 3 weeks before the body recovers on its own. This type of sinusitis is usually caused by an upper respiratory viral infection.
There are also other causes of sinus infections, which include the following:
During a visit to a sinusitis specialist clinic, besides analyzing your medical history, doctors will conduct a physical examination of your nose, throat and sinuses to check for signs of infections like redness, swelling and nasal discharge discolouration.
The examination of your nose and sinus openings is usually done by inserting a long, thin and flexible tube with a tiny camera and a light attached to one end down your nasal opening. The procedure is not painful but may be uncomfortable for some people, and the doctor may administer a light anaesthetic nasal spray to make patients more comfortable.
If your sinus infection has been persisting for more than 8 weeks, doctors may recommend undergoing a sinus CT scan to define the exact cause and extent of the infection.
Many sinus conditions can improve without treatment. However, some medications have been shown to speed up the recovery period and significantly reduce the chance of the infection becoming chronic. Depending on the severity of the sinus infection, doctors may recommend antibiotic treatments, steroidal nasal sprays, or even surgery.
Antibiotics: Should the doctor suspect that a bacteria infection is causing your sinusitis, they may prescribe antibiotics to treat the infection. Antibiotics help eliminate the source of the infection by attacking the bacteria causing it. They do not alleviate symptoms immediately and may sometimes worsen symptoms as the sinuses drain before symptoms start to improve. Increased drainage is good for the sinuses but may actually increase postnasal drip and cough initially.
Steroidal nasal sprays: These help to reduce inflammation to improve drainage of the sinuses. They may also help to treat underlying allergies. Contrary to popular belief, they are very safe and are now part of international guidelines even for acute infections. For chronic infections, they can be used safely for the long term to prevent recurrence of symptoms. Once again, improved drainage may initially appear to worsen symptoms before they get better.
Nasal decongestants sprays and antihistamines: To treat the symptoms of sinus infections, some doctors recommend taking nasal decongestants sprays to help shrink swollen nasal passages and improve the flow of drainage from the sinuses. These should only be used in acute infections for a short while as symptoms may rebound if used for more than 1 to 2 weeks. Some doctors also prescribe antihistamines or cough mixtures to reduce nasal discharge and postnasal drip which causes a lot of cough especially at night which disturbs rest. These may however thicken mucus and impede sinus drainage, worsening the sinus infection. They should not be used in acute infections but may sometimes be necessary for chronic infections. They should be used sparingly, usually at night to aid sleep and rest which will in turn help with recovery.
Sinus surgery: If your symptoms show no sign of improvement even with drug therapy, sinus surgery may be considered as a last resort. Sinus surgery typically involves the fixing of defects within the nasal passages, removal of nasal polyps and opening of previously closed up passages. It is usually performed under general anaesthesia but can be done under local anaesthesia. Patients can also choose to be discharged on the same day.
Any surgical procedures will have their risks. Most sinus surgeries involve some degree of blood loss that is generally tolerated well. However, significant bleeding may impede visualisation and risk injury to the eye and brain and may rarely result in early termination of surgery. Modern technology like computer-guided surgery has made sinus surgery very safe while ensuring adequate clearance of disease.
There is also the chance of nasal polyps making a return. In the past, nasal polyps were considered a medical disease rather than a surgical disease that would require long term medication to control. A better understanding of disease aided by better technology has greatly improved surgical success in 80 to 90 percent of patients. There is however 10-20 percent of patients who do have polyps that recur even after ‘perfect’ surgical results. Adequate surgery in these patients helps better control with medication. Some patients may however require revision surgery
At Amandela ENT Head & Neck Center, we provide subspecialty care that you can trust and rely on throughout your recovery journey. Talk to our leading sinus specialists to get expert advice and support for sinus treatments today.
Amandela ENT Head & Neck Center Mount Elizabeth Novena
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