Sinusitis

Sinusitis refers to inflammation of the lining of these usually air-filled spaces, which then swell and thicken. Swelling in the sinus drainage pathways into the nose causes retention of fluid within the sinuses. The most common cause of sinusitis is following an upper respiratory tract infection such as the common cold or flu.

You may be at risk of developing recurrent episodes of sinusitis if you have abnormalities within the nose such as nasal polyps, a deviated nasal septum or narrowed sinus drainage pathways.

The main symptom of sinusitis is a blocked, stuffy nose, with a pressure sensation in the mid-face. Other symptoms include:

• Facial pain, pressure or tenderness around the forehead, upper cheeks, eyes and nose
• A reduced sense of smell and taste
• Nasal discharge that can be yellow or green in colour (indicating a bacterial infection)
• Fluid dripping down the back of the throat (called a post-nasal drip)
• Muffled hearing and earache
• A high temperature
• Mouth and dental symptoms such as toothache, taste disturbance or foul smelling breath may be associated.

Young children may suffer with a stuffy nose, be irritable, and breath through the mouth rather than through their nose.

It is common to develop sinusitis after a heavy cold or upper respiratory tract infection. Sinusitis can also be caused or exacerbated by inhalation of toxins such as mould spores or smoke; a dental infection or having an allergy to certain airborne particles, such as pollen as in hay fever.

Having a weakened immune system or a condition such as cystic fibrosis that causes a build-up of thick mucus within the nasal airspaces and respiratory system can also put you at higher risk of developing sinusitis.

If any of these factors cause the sinuses to become blocked, fluid accumulates, which feeds microbes such as bacteria and sometimes fungus. This can become quite serious if not promptly treated.

Sinusitis is often clinically diagnosed by your GP or pharmacist. They may elicit tenderness or pressure around the nose and facial bones. An ENT surgeon can examine the sinus drainage pathways using a thin camera system that is gently passed into your nose.

Long term, or chronic sinusitis is diagnosed with a CT or MRI scan. These will delineate the extent of inflammation as well as define the presence concurrent conditions such as nasal polyps or other anatomical problems. Allergy testing against common air borne allergens will also be helpful in the management.

Mild sinusitis can be treated by home rest and over the counter painkillers and anti-inflammatory medication such as paracetamol, ibuprofen and nasal decongestants. It usually resolves within two to three weeks. Avoiding dust, perfumes, cigarette smoke and other known triggers will help, as will rinsing the nasal passages with a warm salt water solution.

Chronic sinusitis may need to be treated with prescription strength topical nasal steroid spray or drops that may need to be taken for a prolonged period. Antihistamines can also help to reduce swelling and inflammation in patients suffering with allergy. Antibiotics may be appropriate if your doctor thinks you have a bacterial infection.

If these treatments are ineffective, then you should be referred to an Ear, Nose and Throat (ENT) specialist. You may require surgical treatment such as functional endoscopic sinus surgery (or FESS), to open up your sinus drainage pathways and to ensure optimal medication delivery into the sinuses.

If you are suffering with sinusitis and are unsure what treatment you need, or medical treatment hasn’t worked for you, our team of expert specialists are here to help.