Sinusitis

Depending on which sinus is involved, sinusitis causes pain along with a feeling of pressure:

• In the forehead
• Over the cheek
• In the upper jaw and teeth
• Behind the eyes
• At the top of the head

Other common symptoms that can be seen along with the pain include:

• Blocked nose
• Nasal discharge
• Mucus dripping down the throat (post-nasal drip)
• Sore throat
• Cough
• Bad breath
• Reduced sense of smell and taste
• Fever
• Frequent headaches
• Fatigue
• Pain in upper jaw and teeth
• Ear pain

Is it a cold or sinus infection?

As the symptoms of both cold and sinus infection are mostly similar, people often get confused between the two. However, both are different conditions. Here are some differences between them which will help you in gauging which one you have.

1. Time duration: This is the first and foremost sign of sinusitis. If you suffer from a common cold, you may have a runny nose for 1-2 days, followed by a stuffy nose for 2-4 days. After this, you may start to feel better. But if you have a sinus infection, then the symptoms may last for around seven days or more.
2. Nasal discharge: Another potentially helpful sign of sinusitis is the color of the nasal discharge. A viral infection may produce colorful discharge, while bacteria produce greenish or yellow mucus.
3. Sinus headaches: The pressure and swelling in the sinus can cause a headache. Sinus pain can also lead to dental pain, pain in the jaws and cheeks, and ear pain.
4. Pain in the sinuses: Pain is a very common symptom of sinusitis. The inflammation and swelling in the sinus cause a dull pressure, leading to pain in your forehead, upper jaws, and teeth, either side of the nose, or between the eyes. This may gradually lead to a headache.
5. Throat irritation and cough: The sinus blockage may cause irritation in the throat. This can also lead to a persistent cough, which becomes more annoying when lying down to sleep.

REMEMBER! The main difference is the duration of symptoms. You will most likely recover from a cold within 5-10 days. However, sinusitis can make you feel run down for 4 weeks (acute sinusitis) or for over 3 months (chronic sinusitis).

Your sinuses are hollow spaces or cavities within the bones of the skull that connect to the nose through small, narrow channels. Sinuses are located behind the forehead, nasal bones, cheekbones, and in between the eyes. They contain mucus, a thin liquid that traps and removes germs, dust, pollutants, and allergens entering the body through the nose. They also help to keep the air you breathe in warm and moist.

Healthy sinuses are filled with air. Sinusitis, or inflammation of the sinuses, occurs when fluid builds up in these air-filled sinuses, allowing germs to grow and cause an infection. The causes of sinusitis can include various pathogens and environmental factors, such as:

• Allergens
• Irritants (animal dander, polluted air, smoke, and dust)
• Bacteria
• Viruses
• Fungi

Sinusitis is more commonly observed in children younger than 15 years of age than in adults, as the sinuses in children are not fully developed. However, adults aged 25 to 64 years can also experience sinus infections due to various triggers. Some common triggers or factors that increase the risk of sinusitis include:

• Respiratory tract infections: Infections of the respiratory tract, such as common colds, may produce excessive mucus, which can block the openings of the sinuses.
• Nasal polyps or nasal bone spurs: These can obstruct the openings of nasal passages or sinuses.
• Deviated nasal septum: A displacement of the thin wall in the nose that separates the nostrils can block or limit sinus passages.
• Seasonal allergies: Allergens such as dust and pollen can contribute to sinusitis.
• Conditions affecting cilia: Factors like dehydration, drying medications (such as antihistamines), and insufficient humidity in the air may prevent cilia from functioning properly, hindering mucus clearance from the sinuses.
• Respiratory diseases: Conditions like cystic fibrosis can impair mucus transport.
• Smoking: This includes both active smoking and exposure to secondhand smoke.
• Enlarged adenoids.
• Dental infections.
• Changes in barometric pressure: These changes can occur during air travel or scuba diving.
• Patients with nasogastric or nasotracheal tubes.
• Weakened immune system: Conditions such as HIV or chemotherapy can compromise immune function.

In most cases, sinusitis can be diagnosed based on the physical examination done by your general physician. This is usually based on your symptoms, which also include the duration and severity. In some cases, your doctor might also ask you to undergo some tests, which include:

• CT Scan (PNS Coronal) or MRI (PNS): Images taken using CT or MRI can show details of your sinuses and nasal area. These might pinpoint deep inflammation or physical blockage, such as polyps, tumors, or fungi, that are difficult to detect using an endoscope. This is why a coronal CT scan or MRI is recommended for the diagnosis of sinusitis.
• Microbial cultures: This test is requested to determine the cause of the sinus infection in cases of bacterial or fungal infection. It is mostly advised in chronic sinusitis and in cases where the condition fails to improve or worsens even after treatment.
• Nasal endoscopy: In this procedure, a thin flexible tube (commonly known as an endoscope) with a light is inserted through the nose to examine the inside of the sinuses.
• Tests for Allergies: If your doctor suspects that the condition might have been triggered by an allergy, then allergy testing might be advised. It is a simple skin test that helps to detect the allergen causing a flare-up. It is a quick and safe test that can help you identify any specific allergen that may trigger a flare-up.
• Biopsy: Although rare, your doctor might recommend a biopsy if he/she suspects a fungal sinus infection that can penetrate through the bone. This can only be determined through tissue biopsy or bone biopsy based on the severity and cause.

You can lower your risk of suffering from sinus infections as well as relieve the early symptoms of sinusitis by following some simple tips and tricks that not only help to keep your nasal passages clear but also improve your overall ability to fight the infection. Here are some of the best ways to prevent sinusitis and stay healthy according to the CDC.

1. Always keep your hands clean
   A proper hand hygiene ritual is the single most important and least expensive means of reducing the prevalence of infections. It also helps prevent the spread of germs and infections to others, reducing your risk of getting sick.
2. Be safe with vaccinations
   The role of vaccines in lowering your risk of infections cannot be underestimated. It is always recommended to receive the flu vaccine and pneumococcal vaccine, which help prevent seasonal flu and pneumonia, respectively. This boosts your immune function and helps you fight infections.
3. Avoid people who have colds or other upper respiratory infections
   It is important to avoid close contact with individuals suffering from viral infections or colds, as these infections can trigger sinusitis.
4. Stay away from triggers
   If your sinusitis is triggered by smoking, it is wise to avoid smoking and secondhand smoke. The same applies to other triggers such as seasonal allergies and dust.
5. Avoid dry environments
   Dry air can worsen sinus issues, so it is recommended to use a humidifier in your home, particularly near your bed. Humidity can help prevent nasal passages from drying out and lower your risk of infections. Remember to keep humidifiers clean to prevent mold growth.

The treatment of sinusitis is based on the cause and severity of the condition. Some of the common treatment options for sinus infection include:

1. Antibiotics
   If you suffer from bacterial sinus infections, antibiotics are the most preferred and effective treatment recommended. Based on the symptoms and severity of the infection, as well as the type of antibiotics, treatment can range from one week to two weeks or longer in case of complications. Chronic infections may require prolonged treatment. However, do not self-medicate, as this can increase the risk of antibiotic resistance. Commonly recommended antibiotics include:
   • Amoxicillin
   • Trimethoprim-sulfamethoxazole
   • Cefuroxime
   • Clindamycin
   • Ciprofloxacin
   • Sulfamethoxazole
   • Metronidazole
2. Decongestants
   These medications help treat sinus infections by causing swollen nasal passages to shrink, allowing proper drainage from the sinuses. They are available in the form of pills, nasal sprays, and topical ointments. Commonly used decongestants for sinusitis include:
   • Naphazoline
   • Oxymetazoline
   • Adrenaline
   • Oxymetazoline + Sorbitol
   • Phenylephrine
3. Antihistamines
   If the cause of the sinus infection is an underlying allergic reaction or allergen, antihistamines are the preferred medications. These work by blocking the inflammation that causes the allergic reaction and help alleviate symptoms. They also treat swollen nasal and sinus passages. Examples include:
   • Cetirizine
   • Chlorpheniramine
   • Clemastine
4. Pain relief medications
   Pain relief medications help treat headaches that often accompany sinus infections. They also improve symptoms and are usually given alongside other medications to treat the infection. Examples include:
   • Paracetamol
   • Ibuprofen
5. Nasal corticosteroids
   These are available as nasal sprays that help prevent and treat inflammation. Common examples include:
   • Fluticasone
   • Fluticasone propionate
   • Triamcinolone
   • Budesonide
   • Mometasone
   • Beclomethasone
6. Oral or injected corticosteroids
   These medications are used to relieve inflammation from severe sinusitis, especially if you also have nasal polyps. A commonly used corticosteroid is:
   • Prednisolone
7. Other options
   Saline nasal irrigation with nasal sprays or solutions reduces drainage and rinses away irritants and allergens. Additionally, using heat pads on the inflamed area can soothe pain, and vaporizers can improve mucus flow from the nose and relieve symptoms.
8. Surgery
   If drug therapies fail to show improvement, surgery may be considered as a last resort. This is primarily performed on individuals suffering from sinusitis caused by underlying anatomical defects. An otolaryngologist (ENT Surgeon) can address defects in the bone separating the nasal passages, remove nasal polyps, and open closed passages.

Most sinus infections usually get better on their own without antibiotics by taking proper self-care measures. Talk to your doctor about the best treatment for your case. Here are a few tips to help you feel better:

• Apply a warm compress on your face to soothe sinus pain.
• Use saline nasal drops daily to clear excess mucus and keep the nasal passages moist.
• Use a Neti pot or saline squeeze bottle to flush the sinuses.
• Keep yourself hydrated to thin the mucus.
• Inhale steam or take a long hot shower to open up your sinuses.
• Use a humidifier at home or in the workplace.
• Keep your head elevated while sleeping.
• Avoid extreme and sudden changes in temperature and sudden bending forward with your head down.
• Take anti-allergic medicines and decongestants only when prescribed.

Sinusitis can be diagnosed based on the symptoms and can be treated effectively with medications such as antibiotics, decongestants, antihistamines, and painkillers. However, if left untreated, it can lead to frontal or sphenoid sinusitis, which can complicate symptom management and result in difficulty swallowing and breathing.

Serious complications of chronic sinusitis are rare but may include:

• Abscess: Collection of pus in the sinus cavity.
• Eye complications: If your sinus infection spreads to your eye, it can cause orbital cellulitis, an infection of the tissue surrounding the eyes that may result in reduced vision or, rarely, loss of vision.
• Infections: Very rarely, people with chronic sinusitis may develop infections such as meningitis (a life-threatening infection that can cause brain and spinal cord damage) or osteomyelitis (bone infection).

Blocked sinuses are mostly a result of a bout of common cold or allergic conditions. More often than not, the sinuses can be freed using prescription drugs or nasal sprays. The nasal sprays can have side effects, and it is best to limit their use. You can try simple and effective homemade remedies that often work better than these sprays and pills. Here are a few remedies that you can try:

• Carom (Ajwain) seeds: Add one tablespoon of carom seeds (ajwain seeds) to a pot of boiling water. Place the bowl under your face and cover your head and neck with a towel so that the steam directly hits your face and does not escape. Take deep breaths to clean your sinuses. You can also add peppermint oil or sage leaves to the water and inhale for 5-10 minutes.
• Turmeric (Haldi): The quintessential Indian spice, turmeric contains an active compound, curcumin, which is a potent anti-inflammatory agent and a powerful antioxidant. Chewing a raw turmeric root on an empty stomach will loosen the accumulated mucus in the sinuses and allow the blood vessels to breathe easily, thereby easing the blockage.
• Garlic (Lehsun): It is one of the most powerful natural antibiotics and helps relieve blocked sinuses when the cause is an infection or allergy. Its active component, Allicin, not only cures the blockage but also prevents it. Have a raw garlic clove on an empty stomach every day.
• Tulsi: Tulsi or holy basil is a revered Ayurvedic medicine that boasts a range of health benefits. Consuming a few raw tulsi leaves and honey on an empty stomach boosts immunity and fights conditions like sinus infections, the common cold, and blockage of sinuses.
• Eucalyptus (Nilgiri) oil: Eucalyptus oil is known for its decongestant and anti-inflammatory properties and provides instant relief from blocked sinuses. Add 3 to 5 drops of eucalyptus oil to boiling water in a large pot. Use a towel to cover your head and slowly inhale the steam through your nose for no more than 2 minutes at a time. Keep your eyes closed. Repeat this twice a day. Alternatively, pour 1-2 drops of the oil on a clean handkerchief and inhale a few times.
• Salt water: Warm some water and add salt. Take a teaspoonful of the lukewarm water and snort it in with either your left or right nostril. It will come out through the other nostril. Do this a couple of times on each side, and your clogging will reduce considerably. Use a Neti pot if you own one.

Living with sinusitis involves knowing the right ways to prevent recurrence of the condition, relieve symptoms, and avoid attacks in case you do not have the infection yet. Here are a few tips on living with sinusitis:

• Avoid foods that can trigger a reaction: Limit or avoid dairy products, refined sugars, and processed foods, as these can increase mucus production and trigger sinusitis.
• Boost your immune system: Individuals with weak immune systems are at higher risk for sinusitis. Consider taking supplements and nutrients such as vitamin C, multivitamins, and zinc.
• Avoid allergens and smoking: If you have indoor allergies, it is recommended to avoid triggers like animal dander and dust mites. Smoking is not advisable; if you do smoke, consider a program to help you quit, as smoke can trigger allergies and hinder mucus removal from the nose.
• Dealing with the symptoms: Relieve sinusitis symptoms by following simple home remedies such as using a humidifier, taking steam inhalation, using saline drops, and staying hydrated.
• Take doctor’s advice: Sinusitis should be taken seriously and may require medical intervention, especially if the infection is chronic. It is also important to treat any underlying infections that may be triggering sinusitis.