Sinusitis demystified: Expert insights

In his latest online article, Mr Cheka Spencer gives us his insights into sinusitis. He talks about the symptoms, how to know if you have sinusitis, the causes, treatment and when to see a doctor.

What are the symptoms of sinusitis?

Sinuses are air-filled spaces within your head that play a crucial role in regulating the temperature and humidity of the air reaching your lungs, among other functions. They achieve this by producing mucus, which moves backward, facilitating the clearing of the nose. However, when inflammation occurs, a condition known as sinusitis, this system malfunctions.

Sinusitis can manifest as acute, often associated with infections such as colds, or chronic, lasting for several weeks. In both cases, there is a noticeable coloured nasal discharge, a congested nose, and pain in the cheeks, eyes, and forehead—regions where the sinuses are located. In acute instances, additional symptoms may include fever and even toothache.

How do I know if I have sinusitis?

Sinusitis can be identified by several key indicators. These include a coloured nasal discharge, a blocked nose, and facial pain, often accompanied by a feeling of fullness or pressure around the cheeks, eyes, or forehead. The pain arises from the blockage of the sinus drainage pathway, resulting in the accumulation of mucus. Additionally, symptoms may include a loss of the sense of smell.

What are the causes of sinusitis? 

Sinusitis inflammation typically stems from infection, commonly viral or bacterial. In response to this infection, inflammation occurs, causing swelling and thickening of the normal mucus. Consequently, the sinus drainage is obstructed, leading to sinusitis. Allergies can also trigger sinusitis through an inflammatory response, resulting in swollen nasal passages and excessive mucus production, further obstructing the sinuses. This allergic response often accompanies symptoms such as sneezing, as well as itchy or watery eyes. Additionally, conditions like nasal polyps or any factors causing narrowing of the nasal cavity can contribute to blocking the sinus drainage pathway.

How is sinusitis treated? 

Acute sinusitis is typically addressed with a combination of antibiotics, saline sprays, and rinses, along with steam inhalation. Decongestant sprays may also be utilised briefly to relieve nasal swelling, but their usage should be limited to no more than five days.

On the other hand, chronic sinusitis, persisting over several weeks, is initially managed with medical interventions such as saline rinses, occasional antibiotics, and predominantly nasal steroids—administered through sprays or drops. In some cases, a short course of oral steroids may be prescribed. All these approaches aim to diminish the internal nasal swelling.

Should these medical interventions prove ineffective, surgical intervention becomes an option. Endoscopic surgery, performed through keyhole techniques without any external incisions, is the chosen method. Preceding the procedure, a CT scan helps assess the extent of the condition and aids in surgical planning. The surgery is typically conducted on a day case basis, allowing patients to return home on the same day.

When should I see a doctor for sinusitis? 

Seeking medical attention is crucial if your symptoms persist, particularly if accompanied by what we term "red flag symptoms." These include one-sided facial pain, unilateral nosebleeds, a single-sided blocked nose, bulging eyes, new eye symptoms, or any recent dental changes, such as the loosening of upper teeth. In such cases, an Ear, Nose, and Throat (ENT) doctor can conduct a Nasoendoscopy or nasal endoscopy, enabling a thorough visualisation of the nasal cavity and sinus openings.

Mr Cheka Spencer is an esteemed ENT specialist. You can schedule an appointment with Mr Spencer on his Top Doctors profile.