Introduction

Sinusitis is common, treatable and preventable, provided its causes and symptoms are not taken lightly but addressed promptly and on time. As per the National Institute of Allergy and Infectious Diseases (NIAID), sinusitis affects Indians significantly. Nearly 134 million suffer from this condition, and one out of eight Indians is infected by chronic sinusitis. The condition has more prevalence than asthma, diabetes, and coronary artery disease among Indians. The condition demands proper treatment or could aggravate severe complications that could be dangerous to the patient’s health. 

This blog discusses sinusitis, a common condition that must not be overlooked, as the various potential complications it carries if left untreated could be severe and life-threatening.

Sinuses and Sinusitis

Sinuses are cavities in the nasal passage with mucus lining that helps keep the passage moist and lubricated. Healthy sinuses are air-filled without any bacterial or pathogen presence. Sinuses are behind the cheeks, forehead, eyes, and nasal bones. They act as air filters and humidifiers, help enhance voice resonance, and reduce the head’s weight.

Sinusitis is a condition of inflamed sinuses. When the air in the sinuses gets infected with bacteria, viruses, or pathogens, they get inflamed and blocked with mucus, causing difficulty in breathing. It has symptoms similar to the common cold and is often confused with the latter. Though the condition is non-communicable, the infection-causing bacteria or viruses may pass from person to person.

Sinusitis symptoms – The condition causes headaches, facial pain and pressure, stuffy nose, sneezing, eye and nose itchiness, and breathing difficulties. Some other sinusitis symptoms are bad breath, loss of smell and taste, running nose, fever, cough, sore throat, and fatigue.

Causes of sinusitis- Sinusitis could affect anyone at any time. However, people with allergies, bronchitis, asthma, weakened immune systems, nasal polyps or nasal deformity, smokers, and second-hand smokers are more prone to developing sinusitis.

Types of sinuses- The four major types of sinuses are-

• Maxillary sinuses – on each side of the nose, next to the cheekbones (the maxillae), and below the eyes.
• Frontal sinuses – close to the forehead and above the eyes.
• Ethmoid sinuses – close to the eyes on each side of the nasal bridge. 
• Sphenoid sinuses – deeper within your skull, behind the eyes.

Need for Sinusitis Treatment

Sinusitis is a common condition affecting your sinuses with inflammation. Still, it requires adequate and appropriate treatment to prevent its aggravation. It is not just an allergic condition. 

It is more than an occasionally irritating condition requiring just a few doses of medication and rest.

The treatment for the condition starts with self-care, medications, and alternative treatment modalities. If these do not help treat the condition, medical procedures drain the fluid from the nasal passage.

If treated appropriately, one can be relieved of sinusitis symptoms for good, but if not, the condition can worsen and may cause severe health issues. 

Potential Sinusitis Complications from Untreated or Poorly Treated Sinusitis

One must watch for the potential sinusitis complications that may arise in the long term if the condition is left untreated or improperly treated. These complications can adversely affect the overall health of an individual. 

The various complications associated with chronic sinusitis are-

• Loss of smell and taste- The loss of smell renders an individual unable to enjoy food and other finer things in fine, be it food, natural fragrance of flora, or scents. The loss of smell could be partial, called hyposmia, or complete, known as anosmia. The loss of taste makes food taste bland, causing patients to add more salt and other spices that might lead to problems like high blood pressure and gastrointestinal or kidney issues in the long run. Patients often lose interest in eating food, leading to weight loss, nutritional deficiency, depression, and other health problems.
• Infection to other body parts- Though sinusitis is not contagious, the bacteria and viruses that cause the condition can, if not treated, spread to other parts of the body like the eyes, ears, skin, or the brain. The spread of the infection may damage the functionality of the affected part.
• Mucocele- Known as paranasal sinus mucocele, it is a cyst that gets formed when the sinuses cannot drain the mucus. The hardened mass of cysts may grow in size and exert pressure on the nose and sinuses, leading to difficulty in breathing. Infection in this mucocele may need an operation for its removal.
• Meningitis- Meningitis is the inflammation or infection of the membrane or fluid surrounding the brain or spinal cord. The membrane is a protective layer of the brain and spinal cord. Untreated sinusitis could spread infection in the fluid or membrane surrounding the brain, bones, or spinal cord, leading to meningitis, a severe and life-threatening condition.
• Sinus thrombosis- Cavernous sinus thrombosis is the formation of a blood clot in the cavernous sinuses. Cavernous sinuses are cavities under the brain and behind the eye sockets. The blood clot may develop due to infection in the face or skull. Blood clots prevent the spread of infection, but when the clot is in cavernous sinuses, it restricts the blood flow from the brain, creating pressure and damaging the brain, eyes, and other nerves. It could turn fatal without immediate treatment.
• Orbital cellulitis- Infection of the soft tissue of the eye socket behind the orbital septum is known as orbital cellulitis. The orbital septum is a thin tissue that separates the eyelid and the eye socket. Sinusitis can spread infection in the eyes, causing eye irritation, swelling, puffiness, redness, and even vision loss in the long run without adequate treatment.

Conclusion

It is unwise to consider sinusitis a common and less harmful condition and ignore its treatment. Untreated conditions can be potentially dangerous, with severe complications that may adversely affect the individual’s health beyond repair. The potential risk to overall health could be chronic and life-threatening. Ensure your sinus health through hygiene, adequate hydration, and avoiding exposure to sinus irritants. Consult your doctor immediately if you have sinusitis symptoms and get the treatment without any delay. 

References

https://www.mdpi.com/2673351X/5/1/2#:~:text=An%20estimated%20134%20million%20Indians,congestion%20and%20obstruction%20%5B1%5D
https://www.merillife.com/blog/medtech/sinus-causes-symptoms

Say No to Myths

Separating facts from fiction is the first step towards creating awareness about any disease for advancing its prevention, timely diagnosis, and treatment. Myths, as misconceived, misinformed, false, or misleading information about any medical condition, are barriers to achieving the much-needed medical intervention and controlling the spread of diseases. Debunking such myths helps-

• Promote awareness and correct information and knowledge about diseases and
• Curtail the aggravation of the condition and prolongation of the associated discomfort, pain, and agony arising through proper and timely treatment.

This blog discusses a common disease of sinus inflammation, known as Sinusitis and some of the sinus misconceptions that need to be debunked.

Understanding Sinus Health

Sinusitis is a condition of inflammation of the tissue lining in the sinus (cavities or spaces in the forehead, nose, and cheeks that are filled with air). Common colds, virus or bacterial infections, fungi, or allergies cause blockage in the sinuses that get filled with fluid. The pressure of these blocked fluids causes pain in the forehead, face, and nasal congestion.

• Types of sinus infection- Depending on the duration and severity of the infection, it may be Acute (lasts for four weeks or less), Subacute (lasts between four to twelve weeks), Chronic (lasts for a minimum of twelve weeks), or Recurrent (comes and goes four times a year and lasts for less than two weeks each time).
• Symptoms – Some common symptoms are stuffy or runny nose, toothache, pressure or pain on the face, cough, fever, headache, or fatigue.
• Risk factors- People with allergies, asthma, polyps, nasal structural deformity, and weak immune systems are at a higher risk of having this infection.
• Treatment- The treatment and medication (decongestants, pain relievers, intranasal steroids) depend on the type of sinus infection. However, home remedies (humidifiers or vaporizers, steam inhalation, saline nasal spray, warm compress application, or plenty of fluid intake) are the first preference for treating sinusitis. In severe cases, surgery may be recommended.

Sinus surgery treats the disease, relieving symptoms, and related discomfort by removing the blockages and opening the air pathway. The surgery removes nasal polyps, tiny bones, diseased tissue, or tumor growth, blocking the nasal passage. The surgeries to treat sinusitis are-

• Functional Endoscopy Sinus Surgery (FESS): Using an endoscope, an otolaryngologist examines the inside of the nose and sinuses and accordingly conducts the surgery to remove the polyp, bone, or tissue obstructing the drainage of the mucus.
• Sinus Balloon Dilation Procedure: This minimally invasive procedure uses an endoscope and a catheter to guide a balloon to the site of nasal blockage. The balloon at the tip of the catheter is inflated, opening the blocked nasal passage.
• Turbinate Reduction Surgery: Turbinate is a tiny structure in the nose that cleanses the air passing through the nostrils. The surgery reduces the size of the turbinate using a needle-like instrument, thus making space in the nasal passage.

Myths and Facts

The treatment for sinusitis requires awareness of the condition, including but not limited to the causes, symptoms, risks, types, different treatment options, post-operative care, and recovery. Any misconception or misinformation about the condition may hamper its timely treatment and aggravate it. To this end, one must not buy into any myths surrounding the disease. Some of the common myths relating to the disease are-

Myth- Sinusitis is contagious.
Fact- It is not contagious. It is not a communicable disease, but if one gets a viral infection, it can lead to sinusitis.

Myth- Antibiotic is a must for sinusitis.
Fact- Every type of sinus infection does not require an antibiotic. The need for an antibiotic depends on the severity and duration of the condition. Generally, it can be managed by home remedies, rest, nasal spray, or pain medication. Antibiotics are prescribed if the condition does not improve for a week or more.

Myth- Sinusitis can resolve on its own.
Fact- Though a common condition like a common cold, sinusitis requires proper treatment and attention through home remedial measures, medications, and, in chronic or recurrent cases, when these do not work, through surgery.

Myth- Green or yellow mucus is a sign of bacterial infection.
Fact- Green or yellow mucus may be due to the death of infection-fighting white blood cells. It is not the colour but the duration of this mucus drainage that indicates whether it is a sinus or bacterial infection.

Myth- Headaches in the sinus areas are caused by sinus infection.
Fact- Sinus headaches may result from common colds, migraines, allergies, or other neurological conditions.

Myth- Decongestant spray cures breathing problems.
Fact- Decongestant spray temporarily relieves stuffy nose but does not permanently cure breathing. Long-term use of these sprays adversely affects the heart and may lead to other health problems.

Conclusion

Sinusitis, though a common health problem, needs proper attention and care to avoid its aggravation and further complications. It can be managed with home remedies, medications, and, in severe cases, through surgery. Stay away from misleading information and avoid basing your medical decision on myths. It is always wise to stay informed, aware, and updated with the correct information and knowledge about one’s health and related treatment therapies. The right information empowers the right decision.

References

https://houstonadvancedsinus.com/debunking-5-common-myths-about-sinusitis/#:~:text=Myth%202%3A%20%E2%80%9CAll%20Sinus%20headaches%20are%20caused%20by%20sinusitis.%E2%80%9D&text=Common%20cold%20at%20times%20may,lead%20to%20bacterial%20sinus%20infection.&text=Migraine%20attacks%20are%20one%20of,that%20result%20in%20sinus%20headaches.
https://www.healthshots.com/preventive-care/self-care/common-sinus-myths/
https://www.indiatvnews.com/health/here-are-some-common-sinus-myths-you-shouldnt-believe-get-your-facts-correct-latest-health-news-2023-02-21-849197

That constant battle with a stuffy nose, throbbing headache, and facial pain resulting from a sinus infection is exhausting! Sinus infections, or sinusitis, can turn even the brightest day into a foggy nightmare. But fear not! In this article, we will delve into sinus infections and uncover the warning signs and symptoms that should raise your alarm bells.

What is a Sinus Infection?

A sinus infection occurs when the sinuses, the air-filled cavities in the skull, become inflamed and infected. Multiple factors, including allergies, viral or bacterial infections, and structural abnormalities in the nasal passages, can cause this infection. The symptoms may include facial pain and pressure, nasal congestion, thick nasal discharge, headache, fatigue, and cough.

When Should You Seek Medical Help for Sinus Infection? 

While mild sinus infections can often be managed at home with over-the-counter remedies, there are certain situations where it is vital to consult a doctor. If symptoms persist for multiple days, worsen after initial improvement, or are accompanied by high fever, severe headache, neck stiffness, or vision changes, it is crucial to seek medical attention as soon as possible. A doctor’s evaluation can help determine the severity, type, and appropriate treatment for the sinus infection.

Warning Signs and Symptoms of Complications  

In some cases, a severe sinus infection might lead to complications that require immediate medical attention. These complications may include spreading the infection to nearby structures, such as the eyes or brain. Warning signs and symptoms of complications include severe headache, worsening facial pain, swelling around the eyes, double vision, confusion, and high fever.

What to Expect During a Doctor’s Visit 

During a doctor’s visit for a sinus infection, the healthcare provider will typically start by conducting a physical examination. This examination may involve checking for tenderness over the sinuses and examining the nasal passages. In some cases, additional diagnostic tests and procedures, such as imaging studies or nasal endoscopy, may be recommended to confirm the diagnosis and identify the underlying cause of the infection. After confirming the diagnosis, the doctor will discuss the appropriate treatment options.

Coping with Sinus Infection 

In addition to medical treatment, multiple self-care and preventative measures can help manage sinus infections and reduce the risk of future episodes. To manage symptoms at home, individuals can use saline nasal rinses or sprays to keep the nasal passages moist, apply warm compresses to the face to relieve pain and pressure, and stay hydrated. Strategies for preventing future sinus infections include avoiding known allergens, practising good hand hygiene, and quitting smoking.
While self-care measures can be effective in many cases, knowing when to seek medical attention is crucial. If symptoms persist or recur despite home remedies, it is advisable to consult a doctor. Ongoing symptoms may indicate the need for further evaluation or a change in treatment approach. Recurrent sinus infections may require a more thorough investigation to identify underlying factors contributing to the repeated infections.

Conclusion  

Sinus infections can significantly impact one’s quality of life, but recognising the warning signs and symptoms can help prompt timely medical attention. Seeking a doctor’s evaluation is crucial when symptoms persist, worsen, or are accompanied by signs of complications. By understanding when to see a doctor and how to manage sinus infections, individuals can effectively address the condition and minimise its impact on their well-being. Remember, early intervention and appropriate treatment can lead to a faster recovery and a healthier future.

FAQs

Q: What are the symptoms of a sinus infection?
A: Common symptoms of a sinus infection include facial pain and pressure, nasal congestion, thick nasal discharge (often yellow or green), headache, fatigue, and cough. Some people may also experience a reduced sense of smell or taste.

Q: How long should I wait before seeing a doctor for a sinus infection?
A: If your symptoms persist for more than 10 days, worsen after initial improvement, or are accompanied by high fever, severe headache, neck stiffness, or changes in vision, it is recommended to see a doctor promptly. These signs may indicate a more severe infection or potential complications.

Q: How can I manage a sinus infection at home?
A: While medical treatment is often necessary for sinus infections, there are some self-care measures you can try at home to alleviate symptoms. These include using saline nasal rinses or sprays to keep the nasal passages moist, applying warm compresses to the face to relieve pain and pressure, staying hydrated, and getting plenty of rest.

References:
https://acaai.org/allergies/allergic-conditions/sinus-infection/
https://my.clevelandclinic.org/health/diseases/17701-sinusitis
https://www.healthline.com/health/cold-flu/sinus-infection-symptoms
https://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/symptoms-causes/syc-20351661

Headaches are the most common health problem yet they can be complicated than most people realize. Each headache has its own set of symptoms which can happen for unique reasons and also needs to be treated differently. There are over 150 types of headaches. But let’s focus on rhinogenic headaches. It is a major health issue that is frequently encountered in clinical practice. Diagnosing a rhinogenic explanation for headache or facial pain outside of the classic definitions of chronic, acute, and subacute sinusitis is often challenging for the practicing otolaryngologist. Contact-point headaches are clinically characterized as causing facial pain secondary to abutting mucosal contact from the lateral nasal wall to the septum. Otolaryngologists see an outsized number of patients with rhinogenic headaches. The majority of patients with this condition are males aged 10-30 years.

So, what is Rhinogenic Headache?

Rhinogenic headache may be a pain within the head and face due to the intranasal contact point. These headaches have their primary pathophysiology centered in the nose with a headache or facial pain as a result of complex neurohumoral reflexes. Acute rhinosinusitis is that associated with the most common rhinogenic headache. Most cases are caused by viral infections (up to 98%), and only 2% are complicated by bacterial sinusitis. However primary care physicians often treat sinusitis as an acute bacterial infection by prescribing antibiotic therapy and hence contributing to the onset of resistance. Rhinogenic headache is often misdiagnosed as other conditions such as migraine.

Rhinogenic pain is usually unilateral, severe, located on an equivalent side and associated with rhinogenic symptoms, and nearly always amid endoscopic and CT abnormalities. Incidental CT mucosal diseases are often noted in 30% of asymptomatic patients.

The symptoms to look out for to know if you have Rhinogenic headache.

The symptoms of Rhinogenic headache can look like any other health-related issue. Symptoms may be different for each person. They might include:

• Facial pain or pressure that gets worse while leaning forward
• Nasal congestion
• Postnasal drip
• Toothache in the upper jaw
• Fever
• Cough
• Yellowish or greenish discharge from the nose
• Pain in the upper jaw
• Headache
• Deceased smell
• Ear pressure or fullness

If you notice any combination of the above symptoms visit your ENT doctor for appropriate treatment.

Diagnosis and treatment

Rhinogenic headache can often be misdiagnosed which can then lead to improper treatment thus a detailed diagnosis is needed to identify. Once the practitioner has examined you thoroughly the treatment for the same would begin. It can be treated medically as well as surgically, both treatments have significant reduction although surgical treatment has better results.

A thorough history which incorporates elicitation of nasal congestion, symptom, facial pain, pressure, dental pain, anosmia, fever, cough, fatigue, ear fullness or pressure, precipitating factors causing the headache (head movement, stress, or cold weather after which a complete nasal endoscopy and CT scan of nose and sinuses are mandatory to make a diagnosis. Whether or not any consultation to a neurologist, allergist, or TMJ specialist has been performed, and whether or not therapy by these specialists has failed to overcome their headache. Following the history, a thorough ENT is examination is necessary with palpation of the sinuses to elicit tenderness.

Once the diagnosis has been made an aggressive medical therapy is indicated. A referral to a neurologist or TMJ specialist is encouraged as well. This is when there is no evidence or history of sinus disease on an exam or CT scan and especially there are no anatomical abnormalities. The medical therapy includes steam, hot and cold compresses, antibiotics if the sinuses have been noted, saline irrigation, analgesics, treatment of the allergy problem with steroid nasal spray, antihistamines, and leukotriene inhibitors, and time.

If the medical therapy fails then a lengthy discussion must ensue before any surgical intervention. An evaluation by a neurologist and TMJ specialist must be included for a failed medical therapy. Before the surgery full discussion of risks, benefits and alternatives is needed.

Surgery can then be performed to correct any or all of the anatomical variants that are felt to be the cause of the headache. If there is indeed a septal spur, then septoplasty should be performed in whatever manner one prefers, be it endoscopic removal of the spur, submucosal resection, or the traditional Cottle approach. Concerning endoscopic sinus surgery, this too is extremely controversial, in particular, if on a CAT scan there is no evidence of sinus disease. A repeat CT is sometimes necessary since one CT is only a snapshot in time. If indeed there is evidence of sinus disease on CT, then the indications are more definite and one needs to address the sinuses that are involved. If there is no evidence of sinus disease, then one should not operate on the sinuses unless there has been evidence of rhinosinusitis on history and exam.

So if you are experiencing the symptoms don’t ignore them and visit the doctor. The sooner you treat it the better. With proper diagnosis and treatment, it will be gone for good.