The term sinusitis refers to an infection, usually bacterial, that affects the epithelium of the mucosa lining the sinuses, which are cavities in the skull that drain their contents (mucus) into the nasal passages through natural openings.
Causes
Any circumstance that favors the stagnation of mucus inside the paranasal sinuses or prevents its correct drainage through the orifices that communicate the sinuses with the nostrils, will favor the accumulated mucus to become infected with some bacteria, giving rise to the clinical picture we know as sinusitis.
The most common causes of sinusitis are an upper airway viral infection or allergy in the case of acute sinusitis (lasting less than 12 weeks) and an anatomical alteration (deviation of the nasal septum) or nasal polyposis in the case of chronic sinusitis (lasting more than 12 weeks).
Symptoms
The most constant symptom is headache, predominantly frontal, generally located above the eyes and also a pain in the region of the cheekbones that generally radiates towards the ears, the jaw or the mouth.
Even so, except in very exceptional cases of some chronic sinusitis, headache is not an isolated symptom and the patient suffering from sinusitis often refers to other symptoms (loss of smell, pain in the cheekbones, fever, thick mucus, bad nasal breathing…). In most cases, a good examination of the nasal cavities by fibroscopy will be essential to discern between sinusitis and other causes of headache.
Other characteristic symptoms are nasal respiratory insufficiency, the presence of abundant and thick mucus, lack or decrease of smell and general malaise. Fever is a very variable symptom. Many sinusitis courses without fever.
Difference between acute and chronic sinusitis
Sinusitis can be acute or chronic. The difference between the two lies in the duration of symptoms (less than 12 weeks in acute sinusitis and more than 12 weeks in chronic sinusitis).
In the case of acute sinusitis, we find an abrupt onset and complete resolution of the picture, as in chronic sinusitis inflammatory changes usually persist in the imaging tests, despite the resolution of symptoms and antibiotic treatment.
Chronic sinusitis, as its name indicates, is a persistent disease, which can only be definitively solved by surgery (correction of an excessively deviated nasal septum or by endoscopic nasosinusal surgery).
Treatment
As it is an infection, the treatment of acute sinusitis is mainly antibiotic (oral or intravenous). Other drugs such as oral and topical (nasal) corticosteroids, antihistamines, nasal decongestants and analgesics are generally used to promote the drainage of mucus stagnant in the sinuses and relieve pain.
As mentioned above, the treatment of chronic sinusitis is mainly surgical.