Causes Of Sinusitis

Rhinosinusitis, commonly referred to as just sinusitis, is an inflammation in the facial bone cavities, called the sinuses. The most common sinuses involved are the frontal, ethmoid, and maxillary sinuses. These hollow regions in the facial bones have a thin tissue lining that may become inflamed and swollen and secrete excessive mucous and fluid, which can lead to pain and difficulty breathing through the nose.

If the condition lasts for more than twelve weeks, it is chronic sinusitis. Acute and chronic sinusitis have similar symptoms including a headache, pain, swelling, nasal congestion, and post-nasal discharge. Acute sinusitis is usually associated with a cold virus but may persist after the virus resolves. Chronic sinusitis can last years and may be caused by a variety of underlying conditions.

Deviated Septum

This condition, in which the cartilaginous and bony tissue that separates the nasal airway passages, develops off center or becomes crooked due to an accident, can lead to difficulty breathing through the nose and increase the risk of sinus infections. When a deviated septum is the cause of sinusitis, surgical intervention is required through a procedure called septoplasty. This procedure is usually performed on an outpatient basis with same-day discharge. In a septoplasty, the surgeon trims the nasal cartilage and repositions it to allow better airflow in the passageways.

Sometimes incisions into the nasal bones will be required depending on the type of damage or malformation involved. The procedure usually takes from thirty to ninety minutes and has a relatively high success rate. The cartilaginous tissue of the septum can shift during recovery and may need revision in some patients. Possible complications include bleeding, infection continued obstruction in breathing, septal hematoma (blood in the nasal space), and septal perforation.

Allergies

Sensitization to pollen, mold, pet dander, and other irritants can induce the inflammatory response and lead to allergic rhinitis. Nasal tissue swelling leads to obstruction of mucous and bacterial colonization that is the hallmark of chronic sinusitis. Otolaryngologists now recognize rhinitis precedes sinusitis, thus the more proper name rhinosinusitis. When the cause of sinusitis is allergy related, doctors may recommend a nasal spray, which will reduce the inflammatory response mechanism of the immune system and unblock the nasal airway, restoring normal breathing. By counteracting the immune response triggered by allergies, they effectively treat the swelling and pain as well.

Nasal Polyps

If nasal polyps are small, they produce no symptoms. Large polyps can occlude the nasal passageways and block the sinuses, which can lead to difficulty breathing through the nose. Fluid buildup and bacterial overgrowth is often a result. Nasal polyps are most common in adults and are associated with chronic inflammatory conditions such as asthma and allergic fungal sinusitis. Cystic fibrosis, a genetic condition that leads to excessive mucous production also predisposes individuals to nasal polyps.

Symptoms include a persistent stuffy or runny nose, snoring, pain in the upper teeth, frequent headaches and facial pain, postnasal drip, and reduced smell and taste. A surgical procedure known as a nasal polypectomy, done endoscopically, is typically required to treat the nasal polyps. The surgeon will insert tiny instruments into the nasal cavity to locate and excise the polyps. The procedure should take around thirty minutes.

Asthma

Over fifty percent of individuals with moderate to severe asthma will have sinusitis. Along with airway constriction, the inflammatory process of this disease releases chemicals known as leukotrienes, which stimulate excessive mucous production and swelling in the airways. Leukotrienes increase vascular permeability leading to increased fluid in the sinuses and airways. Sinusitis can be a result of this combination of decreased airflow and thicker mucus in the paranasal sinus cavities.

Treatment for this condition consists of bronchodilators for the immediate reversal of airway constriction and long-term medication that counteracts the effects of leukotrienes. Treatment can reduce the recurrence of sinusitis in many patients, and the treatment of sinusitis has been shown to decrease the severity of breathing problems in a substantial number of patients.

Respiratory Tract Infection

Upper respiratory tract infections that cause acute sinusitis are usually viral. Recent data indicated ninety to ninety-eight percent are caused by viruses, the most common of which are rhinoviruses, influenza viruses, and parainfluenza viruses. Other viruses, such as respiratory syncytial virus have been implicated in some cases. The most common bacteria implicated were Streptococcus pneumoniae, Haemophilus influenza, and Moraxella catarrhalis.

Bacterial causes are now known to be behind only a few percent of cases. With this in mind, new guidelines have been established emphasizing more focus on treating the symptoms through natural methods, especially with increased bed rest for affected patients.