How to identify and treat sinusitis: Expert advice

Sinusitis, commonly referred to as a sinus infection, is an ailment that can cause discomfort, pain, and disruption to daily life. This article provides an expert insight into sinusitis, including its symptoms, causes, and the various treatment options available to manage it.

What is sinusitis?

Sinusitis is an inflammation of the sinuses, which are air-filled cavities located in the skull, found behind the forehead, cheeks, nose, and between the eyes. The sinuses produce mucus, which normally drains out of the nose. However, when the sinuses become blocked or filled with fluid, they can become infected, leading to sinusitis.

Sinusitis can be classified into different types based on the duration of the condition:

• Acute sinusitis: Lasts up to 4 weeks and is often caused by a viral infection, such as the common cold.
• Subacute sinusitis: Persists for 4 to 12 weeks and may result from a prolonged infection.
• Chronic sinusitis: Lasts 12 weeks or longer and can recur frequently. This type is often associated with chronic inflammation or structural issues within the nasal passages.

What are the symptoms of sinusitis?

Common signs and symptoms include:

• nasal congestion
• thick nasal discharge with yellow or green mucus
• pain and pressure in the face
• headaches
• a persistent cough
• reduced sense of smell

If you experience any of these symptoms, especially if they persist for more than 10 days, it’s important to consult with an ENT specialist.

How is sinusitis diagnosed?

Your ENT specialist will first ask about your symptoms, their duration, and any previous medical history of sinus infections or allergies. They will also inquire about factors that may contribute to sinusitis, such as smoking or exposure to pollutants.

The ENT specialist will then perform a physical examination, during which they will check your nasal passages for signs of inflammation, blockage, or discharge. They will also gently press on your face to assess areas of pain or tenderness.

In some cases, the ENT specialist will use a nasal endoscope, which is a thin, flexible tube with a light and camera, to look inside your nasal passages and sinuses. This will allow for a detailed examination of the sinus openings and nasal tissues.

If the diagnosis is unclear or if complications are suspected, imaging tests such as a CT scan or MRI will be ordered. These tests will provide detailed images of the sinuses, aiding in the identification of blockages, structural abnormalities, or signs of inflammation.

What treatments are available for sinusitis?

Over-the-counter or prescription decongestants can alleviate nasal congestion by reducing the swelling in nasal tissues. Additionally, nasal corticosteroid sprays reduce inflammation in the nasal passages, making them effective for treating chronic sinusitis or sinusitis caused by allergies.

In cases of chronic sinusitis that don’t respond to other treatments, surgery may be considered. Surgical options include functional endoscopic sinus surgery (FESS), which is a minimally invasive surgical procedure performed using an endoscope, a thin, flexible tube with a light and camera at the end.

During FESS, the endoscope is inserted through the nostrils, providing the ENT specialist with a clear, magnified view of the sinus cavities. The specialist will then use specialised instruments to carefully remove obstructions in the sinuses, such as inflamed or infected tissue, nasal polyps, or bone or structural abnormalities. This will help improve drainage in the sinuses and restore normal sinus function.