What is Chronic Sinusitis?

In medical terminology, chronic sinusitis is a permanent sinus infection. It is caused by a virus or bacterial infection in the nose and can be treated with a variety of medications.

What is Chronic Sinusitis?

According to DigoPaul, chronic sinusitis is an inflammation of the mucous membrane in the paranasal sinuses, which does not go away completely. One speaks of a chronic illness when the symptoms persist after two to three months.

The disease occurs relatively frequently and in its acute form mostly affects the maxillary sinus and ethmoid bone. Chronic sinusitis also occurs in these areas, but it can spread further.

Causes

Chronic sinusitis occurs as a result of an acute sinus infection. This is in turn triggered by an inadequately treated cold or a sore throat.

If there is no timely response, the symptoms will become chronic. Certain allergies to pollen, house dust or other foreign bodies can also trigger the disease. However, chronic sinusitis can also be cured by taking appropriate measures.

The reason for a chronic inflammation of the paranasal sinuses can also be anatomical. A bent nasal septum, enlarged turbinates or nasal polyps have a particularly negative effect on the course of the disease.

Symptoms, ailments & signs

Chronic sinus infection can cause a number of symptoms. Typical of the disease are recurring colds, which are accompanied by runny nose, headache, stuffy nose and other classic symptoms and complaints. Usually there is a discharge that is yellow-greenish, purulent and viscous.

It drains from the nose and down the throat, closing the nasal cavities. This leads to poor nasal breathing, which can lead to dizziness, decreased performance and severe discomfort. As a rule, the perception of smell and taste is also reduced. The patient usually also feels a feeling of congestion in the face, which increases in intensity as the disease progresses.

The facial pain is usually stabbing, piercing, or pulsating. They occur more often over the forehead, nose or cheek and often radiate into the middle of the skull or into the area between the eyes. It is typical of the disease that the pain increases when the person concerned bends over quickly, stands up or hops on one leg. Chronic sinusitis can be limited to a single paranasal sinus, but it can also occur in the entire nasopharynx. It is often accompanied by a fever or polyp formation.

Diagnosis & course

In order to be able to diagnose chronic sinusitis, the acute underlying disease must first be clearly identified as such. This is done on the basis of the typical symptoms of a sinus infection. These include pain in the forehead or upper jaw area, purulent runny nose, problems with the sense of smell and a stuffy nose.

If these symptoms are not present, sinusitis can usually be ruled out. In the case of chronic sinusitis, however, the diagnosis is more difficult because the symptoms are much weaker and only appear in episodes.

If the likelihood of sinusitis is high, an endoscopic examination is usually done to confirm the diagnosis. The endoscope is inserted into the mouth and nostrils in order to identify emerging secretions and swellings. The secretions are also examined in order to be able to detect the causative agent of the sinusitis. The appropriate medication is then prescribed. Chronic sinusitis is only diagnosed when various preparations fail.

In addition, further examinations such as computed tomography and various allergy tests are carried out so that an operation is possible. In addition, dental checks and smell tests can be useful in order to avoid concomitant diseases. The disease is usually not fatal for those affected, but it severely limits the quality of life and sometimes causes major problems in everyday life.

Complications

One speaks of chronic sinusitis if the inflammation has not cured even after two to three months. After that, there is still a chance that the disease will resolve on its own, but further steps will be taken to prevent it from spreading. With medication and a change in external circumstances, chronic sinusitis can be made more comfortable for those affected.

However, it cannot always be completely cured and some patients have to take medication against it for life. Chronic sinusitis can spread, spread to neighboring areas of the body and damage them. If no medical treatment is given, serious complications can arise.

The eyes in particular are particularly at risk. The sinuses and eyes are separated by a thin plate of bone. Inflammation can damage it so much that a breakthrough occurs and bacteria can get directly into the eye socket. This can result in serious eye damage or even blindness.

The brain is also considered to be at risk from chronic sinusitis. If the bony separation between the brain and the paranasal sinuses breaks through, meningitis may be the result. Such a threat can be life-threatening and requires medical treatment. There is also the risk that pus will settle in the brain structures and abscesses will develop. It is also possible that blood clots form in the brain veins (thrombosis).

There is also the risk of encroachment on the teeth. It is not uncommon for tooth root inflammation to have its origin in chronic sinusitis. If left untreated, breathing through the nose worsens. A consequential problem is snoring.

When should you go to the doctor?

A chronification of the simple sinus infection is to be seen as a complication. Because of this, any chronic sinusitis requires medical treatment. Serious complications can only be avoided if a doctor is consulted in good time.

In advanced stages, surgical therapy is usually unavoidable. Otherwise the symptoms will not improve. If major surgery is to be avoided, it makes sense to consult a doctor as early as possible. As a rule, it is advisable to consult a doctor if the symptoms of the acute sinusitis persist beyond the usual period. In this case the doctor can intervene – often by giving an antibiotic.

A significant improvement in the stressful problem can usually be achieved just a few weeks after seeing a doctor. In this case, the right contact person is the specialist in ear, nose and throat medicine, who has a wide range of diagnostic and therapeutic options available. This specialist doctor can also be consulted without a referral from the family doctor.

Treatment & Therapy

After chronic sinusitis is diagnosed, various measures can be initiated. If allergies are the cause, antiallergic drugs and nasal sprays are prescribed. So-called desensitization is also part of some therapies. In addition to antibiotics and nasal irrigation prescribed to bacteria flush out and relieve the symptoms.

In some cases, a change in diet can also help against chronic sinusitis. This is the case when there is a food intolerance. In either case, an expert must be consulted in order to effectively treat the condition. In addition to lengthy therapies, there is now also the option of resolving the symptoms surgically. The closed connecting ducts are expanded with the help of a balloon. This so-called siluplasty is only suitable for simple cases of chronic sinusitis.

Treatment methods that are used for acute sinusitis can at least alleviate the symptoms in the chronic form. Common therapies include steam inhalation, acupuncture, and the use of essential oils.

Outlook & forecast

The prognosis of chronic sinusitis is individual and cannot be predicted uniformly for all affected persons. In a large number of patients, despite the chronic course of the disease, there is a cure and complete freedom from symptoms.

There is also the possibility of a continuous course of the disease in which the patient has lifelong impairments. If the doctors can restore ventilation to the sinuses, there is a good chance of recovery. A surgical procedure tries to achieve this goal. The success depends on the severity of the disease, the age of the patient and their general health.

By restoring the ventilation of the paranasal sinuses, the functional activity of the mucous membranes can be regenerated. This process is essential for a good prognosis and can take place within a few weeks if the operation is successful. In addition, the patient must take part in specified follow-up and control examinations after the procedure, so that a good course can be guaranteed.

The prognosis worsens if the disease has already spread to the surrounding regions of the face. If the eyes or teeth have already been attacked by chronic sinusitis, lifelong damage can result. A complete recovery is no longer possible if, for example, blindness has already occurred due to chronic sinusitis.

Prevention

Sinusitis becomes a chronic disease mainly due to a lack of early detection of the causes. So a preventive measure is a visit to an ENT doctor when the first symptoms appear.

In addition, colds, sore throat and runny nose must be cured sufficiently so that no chronic complaints develop. In general, it helps to drink a lot, to rinse your nose regularly with a lukewarm saline solution and to ventilate the apartment well.

An allergy test can also help to contain the symptoms. Desensitization also prevents chronic sinusitis. Finally, a healthy, hardened immune system should be ensured. Getting enough exercise and eating a healthy diet are essential to preventing chronic sinus infections.

Aftercare

Chronic sinusitis is a persistent sinus infection. This can put a lot of strain on the patient. For this reason, treatment with decongestant cortisone sprays and appropriate aftercare is necessary after every cold. If necessary, an operation must provide pressure relief.

If the connecting passages between the sinuses are narrowed by curvatures in the nasal septum or blocked by polyps, sinus infections are common. Chronic sinusitis can often be successfully treated with conventional means. Most of the time, cortisone sprays provide better breathing and pressure relief.

However, if the conservative treatment is not permanently successful, the symptoms of chronic sinusitis can only be remedied by means of surgical intervention or sinus rehabilitation under general anesthesia. The curvature in the nasal septum is often surgically corrected. Follow-up care is required because postoperative bleeding and persistent swelling may occasionally occur.

There is also a risk that the problems will not prove to be resolved in the long term. It becomes more complicated, for example, if the patient has to use a nightly ventilation aid because of sleep apnea. The nocturnal breathing aid cools the airways so that chronic sinusitis is practically impossible to get under control. Here, the follow-up measures can only ensure that the patient who has already been operated on experiences pressure relief with medication every time he catches a cold.

You can do that yourself

In the case of chronic sinusitis, the person affected can supportively pay attention to their lifestyle in order to improve their own health. The smoking is to completely avoid, as well as a stay in smoking areas or spaces. A healthy diet improves well-being and stabilizes the immune system so that the organism can independently produce sufficient defenses.

When it comes to food, it is important to ensure a diet rich in vitamins and, in addition, sufficient exercise should take place. The hydration is to be observed. The nasal mucosa needs sufficient fluid to be able to regenerate. In the winter months the air inside is often dry and in the summer months the outside temperatures can encourage the mucous membranes to dry out. The organism must therefore be supplied with fluids with around two liters a day.

Particularly hygienic behavior must be observed when dealing with other sick people. The hands are to be disinfected and nasal sprays or handkerchiefs are not to be shared with other people. Care should be taken to ensure that no further pathogens can enter the organism. The number of germs is significantly increased, especially in cold times of the year. For this reason, it is important to act carefully as a preventive measure so that your own immune system is not even more stressed and the healing process is made more difficult.

Chronic Sinusitis