Sinus Infection ( Sinusitis )

Sinusitis (Sinus Infection)

Sinusitis is an infection of the paranasal sinuses. The paranasal sinuses are hollow spaces within the skull surrounding the nose. We have four pairs of sinuses and they all drain into the nose through narrow channels. They are the:

  1. Frontal sinuses above the eyes
  2. Maxillary sinuses under the eyes in the cheekbones
  3. Ethmoid sinuses between the eyes
  4. Sphenoid sinuses behind the eyes and located deep in the skull

Sinusitis usually occurs after a cold or flu, which is caused by a virus. From the virus infection, the lining of the sinus channels swell and block up and mucus is trapped in the sinuses. The trapped mucus gets infected with bacteria and this leads to acute sinusitis. Chronic sinusitis occurs when the acute infection is not adequately treated and persists for more than three months.

What are the symptoms?

  1. Nasal congestion
  2. Facial pain
  3. Greenish-yellow nasal discharge
  4. Decreased sense of smell
  5. Fever
  6. Cough
  7. Teeth pain
  8. Fatigue
  9. Ear pain or pressure

How is sinusitis diagnosed?

Your Ear, Nose and Throat (ENT) specialist will take a detailed history and do a thorough examination. This may include a nasopharyngoscopy to examine the sinonasal passages and the throat. This procedure is performed by passing a narrow fibre-optic endoscope through the nose. Local anaesthesia is sprayed into the nose prior to inserting the endoscope. The procedure lasts less than two minutes and often, only a mild discomfort is felt.

Pus coming from the sinuses is often seen and confirms the diagnosis of sinusitis. In long standing cases of chronic sinusitis, there may also be nasal polyps.

Sometimes, samples of the mucus may be taken to investigate the cause of the infection.  

How is sinusitis treated?

To treat sinusitis, your ENT surgeon may recommend:

  1. Antibiotics to control the bacteria infection
  2. Decongestants to relieve nasal congestion
  3. Nasal sprays to reduce inflammation
  4. Nasal irrigation to wash out the mucus and pus

Most cases of sinusitis resolve with medical treatment. However, in some instances, sinusitis may persist despite maximal medical treatment. In these situations, functional endoscopic sinus surgery (FESS) may be necessary and offers an excellent chance of improvement in symptoms. 

What is FESS?

FESS is minimally invasive surgery using endoscopes and specialized instruments to operate through nostrils. No incisions are made on the face. The purpose of FESS is to open up the blocked sinuses, wash out the trapped mucus and pus and restore ventilation and drainage to the sinuses. It is highly effective for acute and chronic sinusitis. 

The procedure is usually done under general anaesthesia and serious complications are very rare, but because the sinuses are very near the eyes and brain, it is not risk free.

Keep in mind that ongoing medical treatment may be required to control the infections even after surgery.

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