Sinusitis

Sinusitis(鼻竇炎) or preferably termed rhinosinusitis, refers to inflammation or swelling of the sinuses. There are four pairs of air-filled sinuses located in the skull. When the sinuses are infected, the sinuses secrete and accumulate mucus. Some mucus is expelled from the nasal passages, and the rest remains in the sinuses, allowing bacteria to breed and cause further inflammation. Sinusitis is classified as follows:

• Acute: Sudden onset, lasting less than 4 weeks with complete resolution
• Subacute: With continuous signs and symptoms lasting < 12 weeks
• Recurrent: 4 or more episodes of acute attacks, at least 7 days each, in any 1-year period
• Chronic: Signs and symptoms last 12 weeks or longer

Causes of Sinusitis

Common causes of sinusitis include:

>Fungal infections: People with weakened immune systems are more susceptible to fungal infections

>Viral and bacterial infections: Most common causes (predominantly by “cold” viruses) and can speed up recovery with treatment (usually antibiotics for bacterial infections) or supportive care

>Allergic asthma and nasal allergies: People with allergic asthma and nasal allergies are more likely to suffer from sinusitis

>Tooth infection: Tooth infections reaching the roots or deep tissues of the gum and maxilla can reach the sinuses via close proximity

>Irritant infection:

The main cause of chronic sinusitis. Irritants include:

• Pollen
• Cold air
• Alcohol
• Perfume
• Wet weather
• Dust mites, mold and fungi

Symptoms of Sinusitis

Symptoms of sinusitis are more severe than those of the common cold. Symptoms vary depending on the location of the inflamed sinus. The following are common symptoms of sinusitis:

• Headache or “sinus” pain or pressure
• Bad breath
• An unpleasant odor in the nose
• Difficulty breathing due to nasal congestion
• Cough or throat irritation caused by post-nasal discharge
• Tiredness
• Swelling of face
• Fever
• Nausea and dizziness
• Insensitivity to taste and smell
• Nasal discharge that is thick and yellow or green in color

Determination of Sinusitis

The doctor will evaluate your medical history, symptoms and physical condition to come up with a diagnosis of sinusitis, since sinusitis is mostly diagnosed on clinical basis. Adjuncts to diagnosis may include X-ray, computed tomography scan, or magnetic resonance imaging test. If chronic sinusitis is suspected, your doctor may recommend nasal endoscopy for direct visualisation of the nasal passages and sinuses. Culture and biopsy studies may also be done for suspected chronic bacterial or fungal sinusitis.

Sinusitis Treatment

Acute sinusitis

Will sinusitis get better on its own? If you have acute sinusitis, it will resolve independently in most cases. To speed up recovery, in addition to resting more, inhaling steam, increasing water/oral fluid intake and applying warm wet towels to the face, patients may consider taking the following medications:

• Ibuprofen or Paracetamol: Helps relieve pain and help reduce fever
• Decongestants: Such as pseudoephedrine or menthol inhalers, which can help reduce swelling of the nasal mucosa
• Antibiotics: Control  infections from bacterial causes
• Nasal wash: With saline solutions to aid in clearing mucus
• Antihistamines: In cases of allergic sinusitis
• Topical steroids: To lessen swelling in the nasal passages, usually for allergic and chronic sinusitis

Chronic Sinusitis

If you suffer from chronic sinusitis, the main treatment method is to resolve blockage and improve sinus drainage:

• Functional endoscopic sinus surgery (FESS): Uses an endoscope to view the nasal cavity and then remove problematic tissue from the nasal cavity
• Balloon sinus dilation or balloon sinuplasty: A catheter is inserted into the sinus and the balloon attached to the catheter is inflated to open the sinus outlet and drain the pus.

How to prevent Sinusitis

To prevent sinusitis, you need to pay attention to the following things:

• Keep the air in your home clean moist
• Avoid pets
• Investing in a high-efficiency particulate air (HEPA) filter for highly susceptible individuals
• Avoid smoking
• Reduce alcohol consumption
• Do more exercise to increase resistance
• Supplement adequate nutrition to avoid catching colds

OT&P Medical Advice

Sinusitis may cause other complications that affect daily life. If you have severe sinusitis symptoms, especially facial pain, high fever, or symptoms that last more than a week, please seek help from your family doctor as soon as possible.