Sinusitis

Sinusitis is inflammation and swelling of the tissues that line the sinuses. This interferes with normal mucus drainage, leading to breathing difficulties, pain and pressure. When the condition persists for 12 weeks or longer, it is considered chronic.

What Causes Sinusitis?

Sinusitis is the number one reported chronic condition in the United States, affecting an estimated 37 million Americans. It’s most often caused by an infection brought on by a cold or allergies, but may also be the result of nasal polyps, a deviated septum, trauma to the face, hay fever, complications from immune system disorders or tumors.

What Are the Symptoms of Sinusitis?

Individuals suffering from sinusitis experience a variety of cold-like symptoms such as nasal congestion and discharge, postnasal drip, sore throat, facial pressure and swelling, loss of smell and taste, headache, fever, fatigue and bad breath.

Complications can include asthma attacks, meningitis, vision problems, aneurysms and stroke.

How Is Sinusitis Diagnosed?

In addition to a physical examination and a review of your medical history, your doctor will inspect your nasal passages for polyps and other abnormalities and check for inflammation and a buildup of fluid. Additional tests utilizing nasal endoscopy, CT scans, MRIs and allergy tests can be used to help confirm the diagnosis.

Why do I have Chronic Sinusitis?

This is the “million-dollar question” that rhinologists, allergists, immunologists and ear, nose and throat doctors all over the world are trying to answer. The cause is probably multifactorial. It seems that many patients with chronic sinusitis have an overactive immune response to inhaled foreign particles.

Some researchers believe the chronic inflammation is due to certain bacteria residing in the nose and sinuses which cause a chronic infection that is resistant to standard treatments because they have formed a sticky protective blanket (biofilm) shielding the bacterial cells from antibiotics, nasal rinses and sprays. Others believe that bacteria in the nose and sinuses secrete a toxin ultimately leading to inflammation in the sinuses. Multiple reports also point to inhaled fungal spores, and the body’s reaction to them, as a cause for persistent inflammation. Some patients may have other medical conditions predisposing them to chronic sinus inflammation or infection (Cystic Fibrosis, Wegener’s Granulomatosis, Sarcoidosis, HIV/AIDS, Kartagener’s Syndrome, immunodeficiencies).

A patient’s unique nasal and sinus anatomy (narrow drainage pathways, deviated septum, obstructing sinus cells) may also result in inefficient sinus mucous drainage and subsequent recurrent or persistent inflammation.

Every sinusitis patient is unique and therefore deserves a thorough ENT evaluation. Because the etiology of sinusitis is often multi-factorial, several treatment modalities exist. Treatments are recommended and prescribed based on the patient’s specific contributing factors. Patients are best served by a dedicated, meticulous evaluation and treatment plan rather than a “cookie-cutter” or generic approach to therapy.

How Is Sinusitis Treated?

Treatments will vary depending upon the severity of your sinusitis and whether it’s an acute or chronic condition. Saline nasal sprays and corticosteroids are useful for rinsing your nasal passages and relieving inflammation. Decongestants are a good short-term solution, but extended use can actually worsen the condition. Antibiotics are usually prescribed for bacterial infections. 

Antihistamines, nasal steroid sprays, saline washes and oral steroids all provide long-term relief. More permanent solutions such as immunotherapy (allergy shots) or surgery can bring relief to those suffering from chronic sinusitis.