Those who suffer from inflamed sinuses can give evidence as to how painful the condition can be. Find out more about sinuses and what causes them to get inflamed , leading to a condition called sinusitis.
What are sinuses?
Sinuses are air-filled cavities in the skull. Humans have four pairs of sinuses, above and behind the eyes, as well as behind the ethmoid – a bone in the skull that separates the nasal cavity from the brain. The sinuses are connected to the nose by small passages and the opening into the nose is called ostium. The role of sinuses is to warm the inhaled air, act as a cushion in case of injury to the face and providing a cushion for delicate facial structures like nerves and the eye.
Listed below are the names of each sinus, also called paranasal sinuses as they are close to the nose:
- Frontal sinus (in the forehead)
- Maxillary sinus (in the cheeks)
- Ethmoid sinus (between the eyes)
- Sphenoid sinus (deep behind the ethmoid)
Classification of sinusitis
Sinusitis can be classified into three types, depending on how long the symptoms last:
- Acute sinusitis: symptoms last for about 4 weeks
- Sub-acute sinusitis: symptoms last for 4-12 weeks
- Chronic sinusitis: symptoms last for 3 months or longer
Causes of sinusitis:
- Infection: Bacteria, viruses and fungi can infect the sinuses. Acute sinusitis is generally bacterial, while chronic type can be bacterial or fungal.
- Common cold and allergies may block the opening of the sinuses.
- Physical blockage due to growths like polyps (soft tissue growth like lollipops) , spur (bony growth) and deviated nasal septum.
- Abnormality of cilia: Small hairs called cilia in the sinuses help to move the mucus out but in certain medical conditions like immotile ciliary syndrome, they do not function properly.
- Forcibly blowing the nose may spread infection from the nose to sinuses. To avoid this, blow one nostril at a time after blocking the other nostril.
- Swimming and air travel also predispose the body to an attack of sinusitis.
- Neighbouring infections: dental infection of the upper molars may cause maxillary sinusitis. Also worth a mention are chronic tonsillitis (infection of the tonsils) and adenoids.
- Cold weather, pollution and smoking aid sinus infections.
- Other medical conditions like cystic fibrosis of the lungs, HIV and chemotherapy causing weakened immune systems increase the chances of getting sinusitis.
Symptoms of Sinusitis
Symptoms of acute sinusitis:
- Fever and body ache
- Headache – a pressure-like pain and pain behind the eyes or above lips or tenderness of the face
- Cough which gets worse at night
- Nasal discharge and stuffiness
- Sore throat and postnasal drip
Symptoms of chronic sinusitis: In chronic sinusitis, the symptoms are the same, but milder.
Diagnosis of sinusitis:
A detailed history and physical examination point the physician to the diagnosis.
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Investigation of sinusitis
If sinusitis is suspected, a physician will conduct a series of tests to confirm the condition:
- X-rays sometimes can reveal chronic sinusitis.
- An ENT specialist may pass a rhinoscope to view the sinuses.
- An MRI is advised if an infection or tumour is suspected.
- If cystic fibrosis is suspected, a sweat chloride test is needed.
- Allergy tests to determine which allergen is causing repeated attacks.
Blood tests for HIV, ciliary function tests and nasal cytology which involves taking a sample of cells from the affected area and examining under a microscope may be conducted.
Complications arising due to sinusitis
Complications of sinusitis are extremely rare. An abscess (accumulation of pus), meningitis, orbital cellulitis (skin infection around the eye) and osteomyelitis (bone infection) are possible complications.