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What is it about ?
Sinuses are spaces filled with air, located in the bones of the skull. They are connected to the nose and throat (nasopharynx) by small openings.
There are different sinuses:
- The sinuses of the forehead bone (the frontal sinuses),
- The sinuses on either side of the nose, in the jaws (the maxillary sinuses),
- The sinuses above and behind the bone of the nose (the ethmoid sinuses),
- The sinus at the height of the temples, in the center of the skull (the sphenoidal sinus).
Sinusitis is inflammation of the lining of the sinuses.
Sinusitis usually begins with a simple common cold. The lining of the nose swells and produces a lot of mucus. This can “block” the opening between the sinuses and the nasopharynx. The mucus becomes thicker and can (almost) no longer drain. The sinus is too full and you may feel pressure or pain.
Frontal sinusitis
In frontal sinusitis, it is the sinuses of the forehead that are inflamed. The cause can be:
- A viral infection of the upper respiratory tract (for example, a common cold);
- An allergy ;
- A large difference in atmospheric pressure, which blocks the sinuses, for example during a diving session or a plane trip.
Often the maxillary sinus is also inflamed. You may then also feel pain in the upper molars and canines.
At whom and how often do we meet it?
The general practitioner regularly diagnoses sinusitis: each year, in more or less 28 people out of 1,000.
Frontal sinuses form after the age of 8 to 10 years. Frontal sinusitis therefore exclusively affects older children, adolescents and adults.
How to recognize it?
The main symptom is pain above the eyes and in the face. The pain increases when you lean forward or when you lie down. Most of the time, symptoms start with a common cold.
In addition to pain in the face, you may also suffer from:
- Purulent nasal discharge;
- Cough persistent;
- Persistent runny nose;
- Stuffy nose ;
- Loss of sense of smell ;
- Headache.
How is the diagnosis made?
Usually, the doctor makes the diagnosis based on symptoms and a physical examination.
It is sometimes difficult for the doctor to distinguish a common cold associated with sinusitis (rhinosinusitis) of a common cold. The sinuses are often (partially) affected in both conditions.
What can you do ?
Sinusitis almost always heals on its own within 10 days.
If you have a cold, make sure you keep your nose clear. This will help prevent the development of sinusitis.
- Blow your nose delicately. The pressure in the sinuses increases when you breathe hard.
- Try to avoid rapid changes from hot to cold, and vice versa.
- It is also advisable to rinse your nose regularly with physiological saline. This can alleviate the symptoms.
- You may use painkillers (paracetamol for example), drops or a nasal spray (see below). Consult your pharmacist.
What can your pharmacist do?
The pharmacist can advise you on saline solution (physiological serum), pain reliever, and nasal drops or spray to relieve your symptoms.
Saline solution
The symptoms in the nose can be alleviated by rinsing with saline solution.
Painkillers
Painkillers can relieve pain in the head, from muscles and joints. the paracetamol must be privileged. You will find here different brands of paracetamol.
Nasal drops or sprays
The pharmacist will advise you which nasal spray to use. He will explain to you how to use it correctly.
Decongestant nasal drops or sprays (vasoconstrictors)
These drugs to put in the nose cause the lining of your nose to deflate. They do not change the duration of the illness, nor the healing process. They just decrease your symptoms temporarily.
If you are using these medicines, use them as short as possible: maximum 5 days and preferably only at night. If you use them for longer, they often cause what is called a rebound effect. This means that when the medicine stops working, the lining swells even more than before. You therefore continue to use the nasal drops or spray and find it even more difficult to do without them.
Nasal spray with cortisone
A cortisone nasal spray can also help. It relieves a stuffy nose and improves your sense of smell. You can use it longer. Ask the doctor for advice first. If you have a doctor’s prescription, your cortisone nasal spray will also be reimbursed.
This product only works after a maximum of 3 to 10 days. We must therefore hold on and continue the treatment.
The possible side effects of a cortisone nasal spray are as follows:
- Irritation of the nose;
- Sneezing attacks after administration;
- Occasionally, nose bleeds (some time after the start of treatment).
If you are suffering from the above side effects, it is recommended to stop the spray for a few days. Side effects are often due to improper use of the nasal spray. Make sure to spray the product without touching the nasal septum.
What can your doctor do?
Medications
As a first step, your doctor may prescribe pain relievers to relieve the symptoms. A nasal medication containing a decongestant or cortisone (see above) may also be helpful.
If your complaints persist and you continue to have a high fever, your doctor may decide to give you an antibiotic. In this case, amoxicillin is the first choice. But it is seldom necessary. The antibiotics have no influence on the symptoms, nor on the cure of ordinary sinusitis. On the other hand, they often cause side effects, such as gastrointestinal and vaginal problems.
Specialist orientation
Complications tend to occur more in frontal sinusitis than in other types of sinusitis. If the doctor notices any of the following signs, he will immediately refer you to an ENT specialist (otolaryngologist, nose, throat and ear doctor):
- Palpable swelling on the forehead;
- Swollen eyelid;
- Double vision;
- Pain during eye movements;
- Signs of spread of infection to the nervous system, such as:
- Confusion ;
- Decreased state of consciousness;
- Irritation of the nerves in the back of the neck.
- Severe feeling of discomfort and intense pain.
Want to know more?
- Paracetamol – CBIP – Belgian Center for Pharmacotherapeutic Information
- Nasal vasoconstrictors (decongestants) – CBIP – Belgian Center for Pharmacotherapeutic Information
- Nasal corticosteroids – CBIP – Belgian Center for Pharmacotherapeutic Information
Sources
- Foreign clinical practice guide ‘Acute frontal sinusitis’ (2000), updated on 25.08.2016 and adapted to the Belgian context on 18.09.2017 – ebpracticenet
- Intego database
- Zelfzorgadvies in de apotheek, Praktijkgids 2. S. Cornwell, V. Foulon. Publisher Acco. 2018 edition.
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