Sinusitis
Sinusitis — inflammation of the paranasal sinuses — is one of the most common reasons for primary care consultations globally. The paranasal sinuses are air-filled cavities within the bones of the skull that surround the nasal cavity and drain into it through small openings. When these openings become blocked — usually by swelling of the nasal mucosa — mucus accumulates, pressure builds, and the environment becomes favourable for bacterial or fungal infection.
Acute vs chronic sinusitis
Acute sinusitis develops rapidly, usually following a viral upper respiratory tract infection (a cold), and typically resolves within 4 weeks. The vast majority of acute sinusitis cases are viral and do not benefit from antibiotics. Chronic sinusitis — defined as inflammation persisting for 12 weeks or more despite treatment — is a distinct, more complex condition that may involve ongoing bacterial infection, nasal polyps, allergic inflammation, or, less commonly, fungal colonisation.
Symptoms
Classic symptoms include facial pain and pressure (over the cheeks, forehead, or around the eyes), a feeling of fullness or congestion in the face, nasal obstruction or blockage, thick or discoloured nasal or postnasal discharge, reduced sense of smell, and headache — typically worse on bending forward. Fever, bad breath, toothache (particularly of the upper teeth, which lie close to the maxillary sinuses), and fatigue may also occur.
Causes and contributing factors
In addition to viral respiratory infections, contributing factors to sinusitis include allergic rhinitis (which causes mucosal swelling and impaired sinus drainage), nasal polyps, a deviated nasal septum, dental infections, immune deficiency, and — for some cases of chronic sinusitis — sensitivity to aspirin and NSAIDs.
Choosing where to be treated
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