Chronic Sinusitis – What is it, Symptoms and Treatments!

Chronic Sinusitis – What it is, Symptoms and Drug Treatments. Also, Chronic Sinusitis  is a common condition where the cavities around the nasal passages (sinuses) become inflamed and swollen for at least 12 weeks despite attempts at treatment. Also known as chronic rhinosinusitis, this condition interferes with drainage and causes mucus to build up. Breathing through your nose can be difficult.

The area around your eyes and face may feel swollen, and you may have facial pain or tenderness. Chronic sinusitis can be caused by an infection, growths in the sinuses (nasal polyps), or a deviated nasal septum. The condition most commonly affects young and middle-aged adults, but it can affect children as well.

Causes of  Chronic Sinusitis:  Common causes of Chronic Sinusitis include:

• Nasal polyps. These tissue growths can block the nasal passages or sinuses.
• Deviated septum. A crooked septum – the wall between the nostrils – can restrict or block Chronic Sinusitis passages .
• Other medical conditions. Complications of cystic fibrosis, gastroesophageal reflux disease or HIV and other immune-related illnesses can result in nasal blockage.
• Respiratory infections. Respiratory tract infections – most commonly colds – can inflame and thicken the membranes and block mucus drainage. These infections can be viral, bacterial or fungal.
• Allergies like hay fever. The inflammation that occurs with allergies can block your sinuses.

Symptoms of  Chronic Sinusitis:  At least two of the four main signs and symptoms of Chronic Sinusitis must be present with confirmation of nasal inflammation for the diagnosis of the disease. They are:

• Coarse, discolored discharge from the nose or drainage at the back of the throat (post-drainage drainage)
• Nasal obstruction or congestion, causing difficulty breathing through the nose
• Pain, tenderness, and swelling around your eyes, cheeks, nose, or forehead
• Reduced sense of smell and taste in adults or coughing in children

Other signs and symptoms may include:

• Earache
• Pain in the jaw and upper teeth
• Cough that may get worse at night
• Sore throat
• Bad breath (halitosis)
• Fatigue or irritability
• Nausea

Chronic sinusitis and acute sinusitis have similar signs and symptoms, but acute sinusitis is a temporary sinus infection often associated with a cold . The signs and symptoms of Chronic Sinusitis last longer and often cause more fatigue. Fever is not a common sign of chronic sinusitis , but you can have one with acute sinusitis . When to See a Doctor:  You may have multiple episodes of acute sinusitis , lasting less than four weeks, before you develop chronic sinusitis .. You may be referred to an allergist or an ear, nose and throat specialist for evaluation and treatment. Schedule an appointment with your doctor if:

• You’ve had sinusitis multiple times and the condition doesn’t respond to treatment
• You have chronic sinusitis symptoms that last longer than seven days
• Your symptoms don’t improve after seeing your doctor

See a doctor right away if you have any of the following problems, which could indicate a serious infection:

• High fever
• Swelling or redness around your eyes
• severe headache
• Confusion
• Double vision or other vision changes
• Torticollis

Risk Factors for Chronic Sinusitis:  You are at a higher risk of getting Chronic or Recurrent Sinusitis if you have:

• An abnormality of the nasal passage, such as a deviated nasal septum or nasal polyps
• Asthma, which is highly linked to Chronic Sinusitis
• Aspirin sensitivity that causes respiratory symptoms
• An immune system disorder, such as HIV/AIDS or cystic fibrosis
• Hay fever or another allergic condition that affects your sinuses
• Regular exposure to pollutants, such as cigarette smoke

Complications of Chronic Sinusitis:  Complications of Chronic Sinusitis include:

• Meningitis. This infection causes inflammation of the membranes and fluid that surrounds your brain and spinal cord.
• Other infections. Unfortunately, the infection can spread to the bones (osteomyelitis) or skin (cellulitis).
• Partial or total loss of sense of smell. Nasal obstruction and inflammation of the nerve for smell (olfactory nerve) can cause temporary or permanent loss of smell.
• Vision problems. If the infection spreads to your eye socket, it can cause reduced vision or even blindness that can be permanent.

Diagnosis of Chronic Sinusitis:  Your doctor will feel for tenderness in your nose and face and look inside your nose. Other methods to diagnose Chronic Sinusitis include:

• Nasal endoscopy. A thin, flexible tube (endoscope) with a fiberoptic light inserted through your nose allows your doctor to see inside your sinuses. This is also known as rhinoscopy.
• Image studies. Images taken using CT scans or MRIs can show details of your sinuses and nasal area. These can identify deep inflammation or physical obstruction that is difficult to detect using an endoscope.
• Nasal and sinus cultivation. Cultures are usually unnecessary to diagnose Chronic Sinusitis . However, when the condition does not respond to treatment or is getting worse, tissue cultures can help determine the cause, such as bacteria or fungi.
• Allergy test. If your doctor suspects the condition may be triggered by allergies, he or she may recommend a skin allergy test. A skin test is safe and quick and can help identify the allergen responsible for your nasal flares.

Chronic Sinusitis Treatments:  The goal of chronic sinusitis treatment is :

• Reduce sinus inflammation
• Keep your nasal passages running
• Eliminate the underlying cause
• Reduce the number of Chronic Sinusitis attacks

Treatments to Relieve Symptoms:  These treatments to relieve symptoms of chronic sinusitis  include:

• Saline nasal irrigation, with nasal sprays or solutions, reduces drainage and rinses away irritants and allergies.
• Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flonase, Veramist), triamcinolone (Nasacort 24), budesonide (Rhinocort), mometasone (Nasonex), and beclomethasone (Beconase AQ, Qnasl, others).

If sprays are not effective enough, your doctor may recommend rinsing with a saline solution mixed with budesonide drops (Pulmicort Respules) or using a nasal mist of the solution.

• Oral or injected corticosteroids. These medications are used to relieve chronic sinusitis inflammation , especially if you also have nasal polyps. Oral corticosteroids can cause serious side effects when used long term, so they are only used to treat severe symptoms.
• Aspirin desensitization treatment, if you have aspirin reactions that cause sinusitis. Under medical supervision, you are gradually given larger doses of aspirin to build up your tolerance.

Antibiotics:  Antibiotics are sometimes needed for sinusitis  if you have a bacterial infection. If your doctor cannot rule out an underlying infection, he or she may recommend an antibiotic, sometimes with other medications.

Immunotherapy:  If allergies are contributing to your sinusitis , allergy shots (immunotherapy) that help reduce the body’s reaction to specific allergens may improve the condition.

Surgery:  In treatment- or medication-resistant cases, endoscopic sinus surgery may be an option. For this procedure, your doctor uses a thin, flexible tube with an attached light (endoscope) to explore your sinus passages. Depending on the source of the obstruction, the doctor may use various instruments to remove tissue or cut a polyp that is causing a blocked nose. Enlarging a narrow sinus opening can also be an option to promote drainage.