Sinusitis

Sinusitis

Sinusitis is an inflammation of the mucous membranes in one or more of the sinuses. Common symptoms are a stuffy nose and pain over the sinuses, some also experience a fever. Antipyretic medicine and nasal sprays can be used to relieve the symptoms.

What is sinusitis?

Sinuses are cavities in the facial skeleton. These are presumably there to protect the brain in the event of a stroke or trauma. The sinuses have a thin layer of mucous membrane, so they are moist and can remove microorganisms. We have sinuses in the forehead, behind and between the eyes and in the cheekbones. Sinusitis occurs when the mucous membranes in one or more of these cavities become infected or irritated. When the mucous membrane becomes inflamed, it will swell due to increased blood and fluid supply, and extra mucus is also formed. This can clog the passages between the sinuses and the nose, and means that mucus and snot cannot drain out, but accumulate inside the sinuses. This creates an increased pressure in the sinuses, which leads to pain and the pressure you can feel in the forehead or cheeks with a sinus infection.

Sinus infections are divided into acute and chronic, and these can be distinguished from each other based on duration. If the sinus infection lasts more than 3 months, it is considered chronic.

Acute sinusitis

An acute sinus infection lasts less than 4 weeks, and can be caused by both viruses and bacteria. Most acute sinus infections are caused by viral infections. Only 0.5-2% of cases are due to bacteria. It can be difficult to know which type you have, but if symptoms last longer than 10 days, bacteria may be involved. It may also be that the symptoms have initially improved, but suddenly worsen again within the first 7 days.

An acute sinus infection caused by a virus starts when the virus comes into direct contact with the nasal mucosa. The virus begins to divide, and on the first day after the virus has attached, you can start to notice symptoms. Rhinovirus and Influenza virus are the virus types that most often start the infection. The virus then spreads to the sinuses, where it is believed that cheating may play a role in the spread. The virus will cause inflammation in the mucous membranes in the sinuses, and you will get swelling and increased secretion of fluid as part of an immune reaction. The virus can also have a direct harmful effect on the cilia, small hairs that carry mucus and snot out of the nose. This may mean that they are no longer able to carry out the purification. Swelling, thick nasal secretions and poorer cleansing together lead to blocked sinuses and the further symptoms.

Acute sinus infections caused by bacteria are caused by bacteria getting stuck in an already inflamed sinus. As a rule, this happens after a viral infection, but it can also come from allergies, nasal anatomy - such as your nose being damaged or crooked, or from a weakened immune system.

Symptoms of acute sinusitis

Symptoms of acute sinusitis are:

Nasal congestion
Large amounts of mucus and snot from the nose, often yellow-green
Pain or a feeling of pressure in the cheek, upper jaw, next to the nose or above the eyes. Typically, the pain will be worse when you bend forward
Fever
Impaired general condition
Reduced sense of smell and bad taste in the mouth
Toothache or pain when eating
Headache
Ear pressure

Who gets acute sinusitis?

About 1 in 7 people get an acute sinus infection every year, so it's a very common problem. More women than men get acute sinusitis, and most between the ages of 45 and 64.

Risk factors for getting acute sinusitis include:

High age
Smoking
Air pollution
Flights
Pressure changes (e.g. diving)
Swimming
Asthma
Allergies
Dental diseases
Impaired immune system.

Chronic sinusitis

Chronic sinusitis lasts more than 12 weeks, and has at least two of these symptoms:

Stuffy nose
Mucus drips from the nose and into the back of the throat
Facial pain or pressure
Reduced sense of smell

Unlike acute sinus infections, which are often caused by an infection, chronic sinus infections are more complicated. A chronic sinus infection is caused by a long-term inflammation of the mucous membranes in the sinuses.

There are different types of chronic sinus infections:

Chronic sinusitis without nasal polyps can be caused by an allergy or irritation to something in the air you breathe.
Chronic sinusitis with nasal polyps, which are growths inside the nose, can result from the polyps themselves leading to blockage of the sinuses. These are treated with both medication and sometimes surgery.
Chronic sinusitis can also come from an allergy to a type of fungus found in the sinuses and in the air.

Who gets chronic sinusitis?

These factors can increase your risk of developing chronic sinusitis:

Allergies, especially to things that are in the air all year round. This could be an allergy to mites, pets or mould.
Exposure to tobacco or airborne pollution
Impaired immune system
Recurrent viral infections
Crooked nose, either congenital or after an injury. This can lead to blocked nostrils.

Is sinusitis contagious?

Neither acute nor chronic sinusitis is contagious, but often comes as a result of other respiratory infections, such as colds or flu, or other conditions.

Preventive advice against acute sinusitis

When you catch a cold or get a stuffy nose, it is important that you avoid the passage between the sinuses and the nose becoming blocked. Rinse with salt water to avoid nasal congestion. Mucosal decongestant nasal sprays/drops can also help, and in that case should be used after a saline spray/nasal rinse. Mucosal decongestant nasal sprays/drops should not be used for more than 7 consecutive days as this can lead to a blocked nose again.

Treatment of acute sinusitis

Acute sinusitis is often painful, and painkillers such as paracetamol and ibuprofen can be used.
Rinsing the nose with salt water can help the passage between the nose and sinuses to open more quickly.
Use of mucosa-decongestant nasal sprays or drops can also help with acute sinusitis. Mucosal decongestant nasal spray should not be used for more than 7 consecutive days.
The nasal spray Physiomer Sinus has been developed specifically against sinusitis and contains a plant-based active ingredient that should clean the sinuses and nose. This nasal spray should not be used by children under 12 years of age. Read the package insert very carefully before use. At the start of treatment with this nasal spray, it is normal to feel a little worse before recovery.

If the alternatives above are not sufficient, the doctor can prescribe mucosal decongestant tablets and/or nasal sprays containing anti-inflammatory agents. In some cases, the doctor can give you antibiotics if it is suspected that the infection is caused by bacteria.