Sinusitis is a bacterial or viral infection of the moist membrane that lines the air-filled sinuses in the face. The sinuses are aerated cavities in the bones of the face that develop from the nasal cavity and maintain communication with it. They lie in the skull bone below, above, between and behind the eyes and are connected together and to the nose by small holes and drainage tubes.
Some people secrete excess amounts of fluid in the sinuses because of hay fever, smoking or irritating fumes, while others may have drainage holes and tubes that are too small to cope with the secretions produced. An attack begins with the inflammation of the nasal mucous membrane. This causes an obstruction of the opening of the sinus leading eventually to secretions accumulating in the sinus with associated pain and swelling. The secretions get infected exacerbating the situation. If bacteria or viruses infect the sinus lining or secretions, sinusitis results.
Sinusitis causes thick and pus-like phlegm to drain from the nose and down the throat, the face is very painful and tender and there is fever, headache and tiredness. The infection may spread to the middle ear. The risks of sinusitis is that it can become chronic or lead to complications such as orbital cellulitis, meningitis and brain abscess, which can even be fatal. An X-ray of the para nasal sinuses is often the first test done. Haziness or opacities in the region of the infected sinus is often seen. A CT Scan is usually required for confirmation.
Swabs may be taken from the back of the nose so that the type of bacteria causing the infection can be determined and the correct treatment selected. The treatment may be either medical or surgical. The initial treatment involves administration of appropriate antibiotics along with an analgesic and an anti-histaminic. Steam inhalation and nasal spray could also provide relief and may be used to relieve the congestion. Avoiding nasal irritants and allergens may help. Irrigation and drainage of the affected sinus is sometimes done. In patients who suffer from repeated attacks, minimally invasive surgical procedures are done to drain the sinuses more effectively.
The prognosis is often quite good and depends upon the sinuses involved and the duration of the infection. Most patients who have acute sinusitis of a short duration generally recover with appropriate early therapy. However chronic sinusitis can be quite a problem and even after drainage patients may be symptomatic. Some patients may require radical surgical techniques for cure.