Chronic sinusitis

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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.

Sinusitis is a inflammation of the sinus lining.

Types of sinuses

We have 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).
Acute sinusitis

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. Because the sinus is too full, you may feel pressure or pain.

See the patient guides acute frontal sinusitis and acute maxillary sinusitis.

Chronic sinusitis

When sinus inflammation lasts more than 3 monthswe are talking about chronic sinusitis.

No one knows why acute sinusitis becomes chronic. But people who have a weakened immune system are at greater risk. Many people with chronic sinusitis also suffer fromasthma.

How to recognize it?

Characteristic symptoms

If you have chronic sinusitis, you have the following symptoms:

Other symptoms
  • Depending on the location of the inflamed sinus, you may develop headache.
  • The pain can last.
  • Acute infections can be added to sinusitis.

How is the diagnosis made?

Usually, the doctor makes the diagnosis on the basis of symptoms and a physical examination.

Imaging exams

In case of doubt, the doctor will ask for additional technical examinations. A x-ray may rule out the presence of fluid or mucus in the sinuses. However, the presence of fluid or phlegm does not always mean that you have sinusitis.

The doctor will preferably choose a CT scan to determine the extent of the condition and further treatment. However, the radiation dose required for a CT scan is considerably higher than for a regular x-ray.

What can you do ?

  • 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 serum. This can alleviate the symptoms.
  • Optionally use a nasal spray (see below). Consult your pharmacist.
  • You can optionally take a Pain killer, such as paracetamol. Do not take this medicine for too long: prolonged use may trigger headaches. Always discuss this with the doctor.

What can your pharmacist do?

The pharmacist can advise you on saline solution (physiological serum), a pain reliever, and a nasal spray to relieve your symptoms.

Saline solution

The symptoms in the nose can be mitigated by a rinse with saline solution.

Pain killer

the paracetamol must be privileged. You will find here different brands of paracetamol.

Nasal spray with cortisone

A cortisone nasal spray can also be helpful in reducing inflammation and in allergy or nasal polyposis. He relieves the 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 Side effects Possible options of a cortisone nasal spray are:

  • 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

a nasal spray containing a decongestant or cortisone (see above) may be helpful.

The antibiotics are rarely needed in sinusitis. They have no influence on the symptoms, nor on the cure of ordinary sinusitis. On the other hand, the antibiotics often cause side effects, such as gastrointestinal problems and vaginal problems.

Specialist orientation

If the drugs do not have the desired effect, the general practitioner will refer you to a otolaryngologist (ENT or nose-throat-ear) for appropriate treatment. The doctor may consider clearing the sinus ducts or removing the nasal polyps. To do this, a surgical intervention is necessary.

Want to know more?

Sources

  • Zelfzorgadvies in de apotheek, Praktijkgids 2. S. Cornwell, V. Foulon. Publisher Acco. 2018 edition.