Sinusitis refers to the inflammation of the sinuses, a pair of paranasal sinuses, and is one of the most common otorhinolaryngological diseases. The paranasal sinuses are cavities with air located in the face, within the bones of the skull, near the nose. Normally, this air circulates between the sinuses, the nasal cavity and the external environment. The interruption of the normal flow of air and the accumulation of mucus in the sinuses leads to the manifestation of infection, i.e. sinusitis. This condition causes discomfort, pain and a series of symptoms that can significantly affect the patient’s quality of life. Many cases of sinusitis can be effectively treated with conservative treatments. However, if the condition becomes chronic or relapses, more invasive procedures are likely indicated. It is important that sinusitis receive substantial and effective treatment in order to avoid unpleasant or even dangerous complications.
Types of sinusitis
Sinusitis, depending on the intensity and duration of its symptoms, is divided into acute, subacute, chronic and recurrent. Acute sinusitis initially manifests itself with common cold symptoms such as a runny nose, nasal congestion and a feeling of pressure on the face. Gradually, as the condition progresses, toothache, earache, headache, fever and cough may occur. If the sinusitis symptoms last for a period of 4 to 12 weeks, then it is subacute sinusitis.
Chronic sinusitis presents with symptoms that do not go away and last for more than 3 months. These symptoms include purulent nasal or postnasal discharge, pain and pressure in the facial area, headache, cough and smell disturbances. Certain factors help facilitate the onset of chronic sinusitis. These are the existence of a scoliotic nasal septum or nasal polyps but also allergic rhinitis, conditions which prevent the smooth flow of air inside the nasal cavity. Finally, recurrent sinusitis is characterized by the occurrence of acute sinusitis episodes several times (usually 4-5) during a year.
Sinusitis: Causes & symptoms
Certain factors facilitate the onset of sinusitis. These include upper respiratory tract infections, allergic rhinitis, nasal polyps, scoliosis of the nasal septum, any dental inflammations, cystic fibrosis, smoking or sudden changes in atmospheric pressure due to flying or diving. Symptoms of the condition include headache, nasal congestion, purulent discharge from the nose, post-nasal drip, feeling of pressure on the face near the nasal area, cough, fever, tooth or ear pain, bad breath and olfaction disturbances.
Sinusitis diagnosis
The diagnosis of the condition initially involves taking a complete medical history in order to gather information regarding the symptoms and any predisposing factors. This is followed by a thorough clinical examination of the nasal passages, sinuses and facial structures. Then, a nasal endoscopy is performed with special endoscopes to visualize the interior of the nasal cavities, allowing a detailed assessment of the pathology but also finding accompanying issues such as scoliosis of the nasal septum or the existence of nasal polyps.
Sinusitis and complications necessitating targeted treatment
Sinusitis requires immediate and targeted treatment in order to relieve symptoms and prevent annoying or even dangerous complications. The most common complications of the condition are the frequent occurrence of otitis, tonsillitis or lower respiratory tract infections that may trigger the onset of asthma. Frequent sinus infections may have negative effects on the Eustachian tubes of the ear, facilitating the occurrence of conditions such as acute or chronic otitis media. Chronic sinusitis can also cause serious complications related to nearby organs, such as the eyes or brain. More specifically, an extremely dangerous situation is the extension of the inflammation to the eye in the form of an abscess or the brain, in the form of either an abscess or meningitis.
Sinusitis and conservative treatment
Most cases of acute sinusitis can be effectively treated with conservative treatment. Treatment includes nasal washes with special solutions, use of decongestant and corticosteroid nasal sprays, painkillers and administration of targeted antibiotic treatment. The duration of application of nasal sprays containing cortisone should not exceed one week, as prolonged use may lead to the development of rhinitis medicamentosa and an increase in nasal congestion.
Sinusitis and surgical treatment
If sinusitis and its symptoms do not subside despite conservative treatment, then surgical intervention by a specialized ENT surgeon is deemed necessary. More specifically, Functional Endoscopic Sinus Surgery (FESS) is indicated for the endoscopic surgical cleaning of the sinuses. This procedure is indicated in cases of chronic or recurrent sinusitis or nasal polyps. The purpose of the procedure is to restore the normal function of the paranasal sinuses. This is achieved by opening the blocked sinus cavities and then removing the pathological or hypertrophic tissue, with the aim of restoring the condition and preventing future recurrences.
If nasal polyps are found, they are also removed during the endoscopic procedure. At the same time, modern nose surgery allows the simultaneous treatment of many diseases in the same surgical time. Thus, it is possible to simultaneously surgically correct a scoliotic nasal septum or any hypertrophy of the nasal conchae through endoscopic septoplasty and endoscopic conchaplasty, respectively, with the aim of fully restoring nasal breathing. In fact, the repair of scoliosis of the nasal septum is performed primarily for surgical purposes, in order to facilitate access to the paranasal sinuses. Functional Endoscopic Sinus Surgery (FESS) is painless and patients notice immediate facilitation of breathing after surgery, as the nasal mucosa is kept intact. ENT surgeon in Athens, Dr. Olga Papadopoulou, applies the most modern endoscopic surgical techniques so that sinusitis can be effectively managed and treated.