Sinusitis is a common problem caused by acute or chronic
inflammation of the paranasal sinuses. The paranasal sinuses are
aerated cavities in the bones of the face that develop from the
nasal cavity and maintain communication with it. The main sinuses
are the maxillary, the frontal, the ethmoid, and the sphenoid
sinuses. Maxillary sinusitis is the most common type of sinusitis.
The ethmoid, frontal and sphenoid sinuses are affected less
frequently.
Cause and Pathogenesis
Sinusitis is caused by a variety of bacteria such as streptococci,
staphylococci, pneumococci and Haemophilus influenzae viruses such
as the influenza and the parainfluenza virus and less commonly by
fungi such as aspergillus. Sinusitis often begins after an acute
respiratory infection, which very often could be viral. Less
commonly it may occur after a tooth extraction or other dental
procedures, or after diving or swimming in contaminated water.
Sometimes sudden changes in the climate, especially the sudden
movement into cold climes, can also trigger an attack. Patients
with AIDS, and other immunocompromized patients are more prone to
attacks of fungal sinusitis. An attack begins with the
inflammation of the nasal mucous membrane. This causes an
obstruction of the opening of the sinus leading eventually to
secretions accumulating in the sinus with associated pain and
swelling. The secretions get infected exacerbating the situation.
Symptoms and Signs
Patients with sinusitis usually present with malaise, mild fever
and headache, and nasal discharge. The area of the face over the
inflamed sinus may even appear swollen in some cases. Maxillary
sinusitis may cause pain in the maxillary area of the face,
toothache, and frontal headache. Frontal sinusitis causes frontal
pain and headache. Ethmoid sinusitis causes pain behind the eyes
and frontal headache. Sphenoid sinusitis causes pain in the
occipital region. The risks of sinusitis is that it can become
chronic or lead to complications such as orbital cellulitis,
meningitis and brain abscess, which can even be fatal.
Investigations and Diagnosis
An X-ray of the para nasal sinuses is often the first test done.
Haziness or opacities in the region of the infected sinus is often
seen. Sometimes a CT Scan may be required for confirmation. The
discharge from the sinus is sent for culture and the organism
isolated, and appropriate antibiotics may be given. Sometimes
transillumination of the involved sinus may be helpful. The
affected sinus produces a dark shadow as opposed to a normal
sinus, which produces a light shadow. Tests to check for the
presence of infection and ESR may be done to gather supportive
evidence. Fungal scrapings and smears may be taken from the
discharge and fungal cultures have to be done if a fungal
aetiology is suspected.
Treatment and Prognosis
The treatment may be either medical or surgical. The initial
treatment involves administration of appropriate antibiotics along
with an analgesic and an anti-histaminic. Steam inhalation and
nasal spray could also provide relief and may be used to relieve
the congestion. Avoiding nasal irritants and allergens may help.
Irrigation and drainage of the affected sinus is sometimes done.
Surgical treatment involves puncturing the sinus and making a
window in it to facilitate easy drainage. Other procedures include
the Caldwell-Luc procedure for chronic maxillary sinusitis and
ethmoidectomy for ethmoid or sphenoid sinusitis. The prognosis is
often quite good and depends upon the sinuses involved and the
duration of the infection. Most patients who have acute sinusitis
of a short duration generally recover with appropriate early
therapy. However chronic sinusitis can be quite a problem and even
after drainage patients may be symptomatic. Some patients may
require radical surgical techniques for cure.
Prevention
While there are no vaccines to prevent sinusitis and it is
impossible to predict who will develop it except in a small number
of patients who have an anatomic defect in their nose, early
diagnosis and treatment is the only practical solution.
|
Growing Stronger, Growing
Better
Global Health
Healthcare Provider
Sinusitis - treatment of Sinusitis, Sinusitis
types, Disease medicines, Sinusitis symptoms, Sinusitis and Disease
symptoms, Sinusitis symptoms Disease and diagnosis, Symptoms and Solutions,
Signs and Symptoms, type of Sinusitis, cause common, common Sinusitis,
Sinusitis List, causes list, Infectious Sinusitis, Causes, Diseases , Types,
Prevention, Treatment and Facts, Sinusitis information, Sinusitis:
Definition, Sinusitis names, medical Sinusitis, medical Sinusitis and
disorders, cell Sinusitis, Sinusitis Worldwide, Sinusitis Research,
Sinusitis Control, Sinusitis Center, Digestive Sinusitis Week, Information
about Sinusitis, causes of different Sinusitis, Sinusitis Articles,
Sinusitis and conditions, Health and Sinusitis, Sinusitis Patients,
Sinusitis and Sciences, causes of alzheimer's Sinusitis, Sinusitis causes,
alternative medicine heart Sinusitis, body ailments, Sinusitis medicines,
medical antiques, type of blood Sinusitis