Sinusitis

Sinusitis

Sinusitis

​​​​What is Sinus?

The air space in the cheek, forehead, eye and nasal regions of the skull and conjoining the mouth canal with the nasal air channel are called sinus. The sinus cleans, humidifies and heats the air taken through the nose, and provides acoustic resonance.

The sinuses, which are the primary defense mechanism protecting vital organs and structures in the skull such as the brain and eye against impacts, reduce the weight of the skull and keep the head upright and balanced.

The sinuses are divided into 4 groups according to their location in the skull:

Maxillary Sinuses: They consist of 2 sinuses, one on the right and one on the left cheek. They develop in line with the embryo development, exist from birth and reach a significant size at the age of 3.

Ethmoid Sinuses: They consist of many air cells around the eyes and on the upper part of the nose. They develop in line with the embryo development, exist from birth and reach adult size at the age of 12.

Sphenoid Sinuses: They locate in the back of the nose, in the deeper part of the skull. Their formation is completed at the age of 2 and filled with air at the age of 5.

Frontal Sinuses: They consist of 2 sinuses in the forehead. Their formation is completed at 6 to 8 years of age and separates from the ethmoid sinus. They reach their normal size in the next 8-10 years.

Sinus bone surfaces are covered with a mucus-like mobile layer that secretes mucous. The epithelium (tissue structure) in the sinuses is the same as the tissue structure of the nose and all sinuses have a connection with the nasal cavity. Any infection in the nose causes swelling and edema in it. This prevents the passage of mucus, which is produced by the sinuses and sent through the nasal cavity to the throat and gorge, into the nasal cavity. Mucus accumulates in the sinus and increases the pressure.

What Causes Sinusitis? 

Nose and sinuses are the structures that clean the air taken; in other words, they restrain dirt, dust, viruses, bacteria and toxins and send the clean air to the lungs. Therefore, viruses and bacteria that may cause infection are always found in these areas. No inflammation occurs in the sinuses that can function. However, if a pathological and/or environmental impact such as upper respiratory tract infection, allergic reactions, concha hypertrophy (nasal flesh enlargement), deviation (bone/cartilage curvature), obstruction of sinus canals, adenoid enlargement in children, sudden pressure changes during submarine diving and air travel, excessively polluted air and smoking, then sinus ventilation disrupts and inflammation occurs. Inflammation of the mucosa (mucus) covering the sinus cavities is called Sinusitis. They have different names according to the progression and duration of the inflammation:

Acute Sinusitis: Sinusitis that takes less than 2 weeks.

Subacute Sinusitis: Sinusitis that takes 2 weeks to 3 months.

Chronic Sinusitis: Sinusitis that takes more than 3 months.

Recurrent Sinusitis: this recurs at least 4 months within a year.

 Keeping away from staying in cold environments for a long time, drying the hair after a bath or rain and not leaving it wet, adjusting the oxygen, humidity and heat level of the living environment, not breathing cigarette smoke, avoiding from places where dust and smoke that may cause allergies are intense are some measures preventing the formation sinusitis.

What are the Symptoms of Sinusitis?

Symptoms of sinusitis vary from person to person and depend on the severity of cold or flu infection, the immune system, and whether there is a pathological problem in the nose area. The most common symptoms are:

Pressure giving a feeling of pain and fullness in the head and face areas including the sinus (increases when lowering head),

Nasal obstruction, snoring,

Sore throat, voice distortion, increased cough at nights,

Yellow/green intense nose and/or postnasal drip,

Halitosis, tooth and gingival pain,

Smell and taste disorder,

Weakness and mild fever,

Cough, loss of appetite, nausea and vomiting (in children).

One or more of the methods of endoscopic examination, imaging and tomography are used to do diagnosis correctly.

How is Sinusitis Treated?

Sinusitis affects the quality of life both physically and psychologically. The problems faced also cause secondary problems in the stomach, intestines and lungs. As a result of the spread of inflammation to the eye sockets, visual disturbances and blindness may occur; meningitis or abscess may develop with its spread into the cerebral cortex and interior of the brain; and cysts that dissolve bone tissue may develop. Therefore, sinusitis must be treated medically or surgically to eliminate the factors that cause sinusitis.

The purpose of sinusitis treatment is to destruct the viruses and bacteria that cause inflammation by suppressing and opening the closed channels and holes which expand from the sinuses to the nasal cavity. Therefore, drug treatment should be considered comprehensively to use the necessary one/ones among antibiotics, antihistamines, decongestants, pain medication and sprays. Surgical methods such as Endoscopic Sinus Surgery and Balloon Sinuplasty Surgery are used for the treatment of sinusitis that does not respond to medical treatment and cannot be cured; and the interventions used are reduction of the bone causing obstruction, reduction of the tissue or concha, and widening of the sinus canal.

Since the formation of sinus in children is not yet complete, surgical intervention is performed only in necessary cases. Adenoid or tonsil removal operations and their supportive medical treatments are applied.

Medical dressing, cleaning the nose after surgery, is very important. In particular, the allergic sinusitis may recur after a while.

Acute Sinusitis

Sinus inflammation which takes maximum 2 weeks and mostly seen after upper respiratory tract infections such as cold and flu is called Acute Sinusitis. Nasal obstruction, yellow/green and dense nose and/or postnasal drip, sore throat, cough, increased pressure when lowering head, pain and fullness in the sinus areas of the head and face, pain in the mouth and jaw, nose bleeding, halitosis, infection around the eyes, voice change, and mild fever are common complaints. Diagnosis is made by physical examination or by radiographic imaging, when needed.

Acute Sinusitis Treatment

Acute sinusitis is usually treated with antibiotic medication for a period of 10-14 days, sometimes up to 21 days. The drug treatment should certainly continue for 7 more days after the dense yellow/green nose and/or postnasal drip terminates. Nasal sprays, allergy and common cold medicines, nasal wash kits and painkillers are also used as supplements. In serious cases, aspiration can be applied to remove the fluid in the sinus.

What is Chronic Sinusitis?

Sinus inflammation which lasts at least 3 months is called Chronic Sinusitis. Besides acute sinusitis complaints such as constant nasal congestion, non-colored and dense nose and/or postnasal drip, sore throat, cough, increased pressure when lowering head, pain and fullness in the sinus areas of the head and face, pain in the mouth and jaw, nose bleeding, halitosis, infection around the eyes, voice change and mild fever, fatigue is also a common complaint. Diagnosis is made by sinus endoscopy or by sinus tomography, when needed.

Chronic Sinusitis Treatment

Chronic sinusitis is primarily treated with antibiotic medication. However, surgical intervention is applied in those who resist to drug therapy. Functional Endoscopic Sinus Surgery (FESS) or Balloon Sinuplasty Surgery (BSS) method is used in surgical intervention. In Functional Endoscopic Sinus Surgery, pathological disorders that block the ducts expanding from the sinuses to the nasal cavity are repaired and channels are opened. In Balloon Sinuplasty Surgery, as in the stent application in cardiovascular surgery, a deflated balloon is placed in the closed sinus canal area and inflated to open the airway.

If you are constantly experiencing problems such as increased pressure when lowering head, pain and fullness in the sinus areas of the head and face, nasal obstruction, snoring, voice distortion, increased cough at nights, nose and/or postnasal drip, smell and taste disorder, fatigue and fever, you can reach us via our contact information.