Sinusitis refers to inflammation of the sinuses. Sometimes difficult to identify, it can become complicated and/or chronic. How can this be avoided? We explain everything. Nasal congestion, runny nose, feeling of heaviness in the cheekbones, and headaches. There’s no doubt about it, you’re suffering from sinusitis! This ENT infection affects, as its name suggests, the sinuses of the face (small air-filled cavities dug into certain bones of the face): the maxillary sinuses, the frontal sinuses, the ethmoid sinuses, and/or the sphenoid sinuses. In such cases, consulting a Consultant ENT specialist can help confirm the diagnosis and guide you toward the right treatment before the condition worsens.
What is chronic sinusitis? How long does it last?
Sinusitis refers to an inflammation of the sinuses due to the presence of an unwanted microorganism. Concretely, the mucous membrane that lines the sinuses is infected by a virus or bacteria. This is why we distinguish between viral and bacterial sinusitis. When this sinusitis lasts more than 90 days (about three months), we speak of chronic sinusitis. Most often, they are due to acute sinusitis that is not treated or poorly treated. Acute sinusitis is defined as symptoms that last less than 30 days, and subacute sinusitis is defined as symptoms that last between 30 and 90 days. If the patient experiences at least four episodes of sinusitis per year, this is called recurrent sinusitis.
As noted above, chronic sinusitis (just like acute sinusitis) can affect multiple sinuses :
- The frontal sinuses (located above the eyebrows);
- The maxillary sinuses (located at the level of the days);
- The ethmoid sinuses (located on either side of the nasal cavity);
- And/or the sphenoid sinuses (located behind the ethmoid sinuses).
Types of Sinuses
Sinusitis is therefore classified according to the “type” of sinuses affected:
Maxillary sinusitis
Maxillary sinusitis ( the most common), which can appear from the age of 5 to 6 years, often follows inflammation of the nasal cavities, as is the case in the context of nasopharyngitis of viral origin.
Frontal sinusitis
Frontal sinusitis, which usually appears after the age of 10, is manifested by high fever, runny nose, and unilateral, throbbing pain located above one eye.
Sphenoid sinusitis
Sphenoid sinusitis, rather rare in children (sphenoid sinuses develop between 10 and 15 years of age), results in headaches behind the eyes, spreading to the back of the head. A high fever and a runny nose are often associated.
Ethmoid sinusitis
Ethmoid sinusitis (also known as acute ethmoiditis in children) is characterized by swelling of a single eyelid and eye pain associated with a runny nose and high fever.
What is pansinusitis?
Pansinusitis is the inflammation of several sinuses. For example, the maxillary and frontal sinuses may be affected simultaneously, or the ethmoid, sphenoid, and maxillary sinuses, etc.
What symptoms should be a warning sign?
Whether you have acute or chronic sinusitis, symptoms may include:
Nasal congestion
Rhinorrhea (nasal discharge, yellowish or greenish, sometimes purulent) ;
tenderness, pressure, or particular pain in the cheekbones, cheeks, or teeth (maxillary sinusitis), head and forehead (frontal sinusitis), eyes and forehead (ethmoidal sinusitis), or in the front or back of the head (sphenoid sinusitis).
- A feeling of general malaise or general fatigue (especially in cases of chronic sinusitis)
- So many symptoms can have a significant impact on patients’ daily lives, to the point of generating symptoms of anxiety and even depression.
- A decrease in the sense of smell (hyposmia), or even a loss of smell (anosmia)
- A productive cough (chest cough) and sneezing
- A more or less high fever (above 38.5°C)
- Blocked ears and difficulty swallowing
- Bad breath (halitosis)
- Headaches
- Photophobia
The contagiousness of symptoms depends on the type of sinusitis. Viral sinusitis is easily transmissible, as it is transmitted through direct contact with contaminated secretions.
Chronic Viral or Bacterial Sinusitis: What Causes Chronic Sinusitis?
Sinusitis can be caused by a viral infection, such as simple nasopharyngitis, or by a dental infection (cavity, abscess, etc.) that spreads to the nearest sinuses.
But other factors increase the risk of chronic sinusitis:
- Regular swimming sessions in a treated pool ( chlorine irritates the nasal mucosa)
- Living in an environment where the air is humid and/or polluted
- Exposure to irritating chemicals (such as formaldehyde)
- Not blowing your nose when you have a blocked nose
- Smoking or being a victim of passive smoking
- Facial trauma obstructing one or more sinuses
- The presence of recurring nasal polyps
- A deviated nasal septum
- Nasal cocaine use
Is chronic sinusitis dangerous?
Chronic sinusitis can be extremely painful, but most often remains benign. Except in certain cases, when it affects not only the sinuses but also the eyes, meninges, or even the brain. This is why chronic frontal, ethmoidal, and sphenoidal sinusitis, which are much rarer, must be given special attention to avoid complications. The main complication of sinusitis is the spread of the bacterial infection (even more likely when sinusitis lasts for a long time!). Signs that should lead to a quick consultation:
- They increase when you lower your head and at night, when you sleep
- Your runny nose gets worse, and the mucus becomes purulent
- They are present on one side only, and they are pulsatile
- Your infraorbital pain persists and/or worsens
- Your runny nose is one-sided
More rarely, complications are cerebral (brain abscess, meningitis ), which can cause severe headaches and confusion. In very rare cases, sinusitis can also be complicated by an infection of the bones that contain the sinuses, or even septicemia (extremely rare).
How to prevent chronic sinusitis?
If you suffer from nasopharyngitis, follow these tips to prevent it from worsening and leading to sinusitis:
- Stop smoking and do not expose yourself to tobacco smoke (which leads to a reduction in the defense capabilities of the respiratory wall and chronic inflammation)
- Practice good oral hygiene: brush your teeth properly and visit your dentist regularly to prevent the formation of dental abscesses or tooth decay.
- Maintain a temperature of 18°C to 20 °C in your home and, if necessary, humidify your interior.
- Air your rooms regularly (at least ten minutes, morning and evening)
- Blow your nose as often as necessary (one nostril at a time)
- Avoid swimming in pools or diving until healed.
As for sinusitis of allergic origin, it is “sufficient” to avoid exposure to allergenic substances to limit their effects. Anti-allergy or anti-asthma medications can also be effective.
Prevention also involves barrier gestures!
Following barrier measures is essential to prevent sinusitis of infectious origin. The rules are simple:
- Please wash your hands regularly with soap or a hydroalcoholic solution (especially after blowing your nose, coughing, or sneezing, but also before meals or their preparation)
- Cough or sneeze into the crook of your elbow or into a disposable tissue
- Limit direct contact with those around you (no hugs, handshakes, etc.) and wear a mask if necessary; etc.
How to get rid of chronic sinusitis? Which antibiotics should I take?
Treatment of sinusitis is mainly based on local and environmental measures:
Inhalations with essential oils such as eucalyptus or rosemary are highly recommended.
- Just like regular nasal washing (with physiological serum, thermal water, or salt water);
- Hydrate yourself sufficiently and throughout the day
- Do not tilt your head down to avoid additional pain
- Apply warm, moist towels to the affected sinuses
- Avoid tobacco use and limit exposure to irritants
- Use a humidifier to prevent excessively dry air
- Avoid sudden changes in temperature
How to clean your nose properly?
In cases of chronic sinusitis of viral origin, doctors generally prescribe paracetamol for pain and corticosteroids to reduce inflammation. If it is chronic sinusitis of bacterial origin, practitioners may prescribe antibiotic treatment (mainly amoxicillin). In more severe or persistent cases, a sinus surgery specialist may sometimes be consulted to “clean out” the sinuses and remove long-term affected tissue
