DEFINITIONSinusitis is an inflammation of the sinuses that occurs due to allergy or infection with viruses, bacteria and fungi. Sinusitis can occur in any of the four existing sinus (maxillary, etmoidalis, frontal or sfenoidalis).
CAUSESinusitis can be acute (lasting for 3 weeks or less) or chronic (lasting for 3-8 weeks but can continue for many months or even years).
The cause of acute sinusitis:- Virus infection.Acute sinusitis can occur after a viral infection of the upper respiratory tract (eg colds).
- Bacteria.In the human body there are several types of bacteria that normally do not cause disease (eg Streptococcus pneumoniae, Haemophilus influenzae). If the body's defense system decreases or the drainage of sinus congestion due to colds or other viral infections, the bacteria that were not dangerous will proliferate and infiltrate into the sinuses, causing an acute sinus infection.
- Fungal infections.Sometimes fungal infections can cause acute sinusitis. Aspergillus is a fungus that can cause sinusitis in patients with impaired immune systems. At certain people, sinusitis is a type of fungus allergic reaction to mold.- Chronic inflammation of the nasal passages.In patients with allergic rhinitis may occur acute sinusitis. Similarly, in patients with vasomotor rhinitis.- Certain diseases.Acute sinusitis is more common in people with immune system disorders and patients with abnormal secretion of mucus (eg cystic fibrosis).Causes of chronic sinusitis:- AsthmaAllergic diseases (eg allergic rhinitis)Immune system disorders or abnormalities of mucus secretion or disposal.
SYMPTOMSTypical symptoms of abnormalities in the sinus headache that is felt when the patient woke up in the morning. Acute and chronic sinusitis have similar symptoms, namely tenderness and swelling of the sinuses are affected, but there are certain symptoms that occur on the affected sinus:Maxillary sinusitis causes pain on the cheek just below the eyes, toothache and headaches.Frontal sinusitis causes headache in the forehead.Etmoidalis sinusitis causes pain behind and between the eyes and headache in the forehead. Etmoidalis sinus inflammation can also cause pain when the edge of the nose in the press, reduced sense of smell and nasal congestion.Sinusitis causes pain sfenoidalis whose location is uncertain and could be felt at the top of the head of the front or rear, or sometimes causes ear pain and neck pain.Other symptoms are:- Not feeling well- Fever- Tired, lethargic- Cough, which may get worse at night- A runny nose or nasal congestion.
Fever and chills indicate that the infection has spread beyond the sinuses. Mucous membranes of the nose looks red and swollen, pus from the nose may be out of yellow or green.
Sinusitis and Immune System Disorders
In patients with uncontrolled diabetes or people with immune system disorders, fungal sinusitis can cause serious and even fatal.Mukormikosis (fikomikosis) is a fungal infection that can occur in people with uncontrolled diabetes. In the nasal cavity there is a black dead tissue and block blood flow to the brain, causing neurological symptoms (eg headaches and blindness).
Diagnosis based on microscopic examination of the dead tissue.Treatment includes control of diabetes and anti-fungal drug amphotericin B intravenously (through a vein).
Aspergillosis and candidiasis is a fungal infection of the sinuses that can be fatal in people with impaired immune systems due to anti-cancer therapies or disease (eg leukemia, lymphoma, multiple myeloma, or AIDS). At aspergillosis, in the nose and sinus polyps are formed.
Diagnosis based on results of examination of the polyp. The treatment of sinus surgery and the administration of amphotericin B intravenously.
DiagnosisDiganosis established based on the symptoms, sinus x-rays and physical examination. To determine the extent and severity of sinusitis, a CT scan can be done. On maxillary sinusitis, dental X-ray examination for the presence of a dental abscess.
TREATMENTAcute sinusitisFor acute sinusitis is usually given:Decongestants to reduce cloggingAntibiotics to control bacterial infectionsPain medication to relieve pain.Decongestants in the form of nose drops or nasal spray should only be worn for a limited time (due to long-term use can cause blockage and swelling of the nasal passages). To reduce clogging, swelling and inflammation can be given a nasal spray containing a steroid.
Chronic sinusitisGiven antibiotics and decongestants. To reduce the inflammation is usually given a nasal spray containing a steroid. If the disease is severe, steroids may be given by mouth (orally).
The following things can be done to reduce the discomfort:- Inhaling steam from a vaporizer or a bowl of hot water- Drug nasal spray containing saline solution- Warm compresses on the affected sinus area.
If it can not be overcome by such treatment, then the only way to treat chronic sinusitis is surgery. In children, the situation often improves after removal of the adenoids that block the sinuses to the nasal tract.
In adult patients who also have allergic diseases sometimes found polyps in the nose. Polyps should be removed so that the airway open and sinus symptoms decreased. Surgical technique is now widely performed functional endoscopic sinus surgery
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