Paranasal sinusitis is a condition that can affect people of all ages and frequently develops as a complication of upper respiratory tract infections. The paranasal sinuses are responsible for, among other things, warming and humidifying inhaled air and contributing to voice resonance. When secretion drainage from the sinuses is impaired, inflammation develops, which can cause troublesome symptoms and significantly reduce quality of daily life. Depending on the duration and severity of symptoms, sinusitis is classified as either acute or chronic.
Paranasal sinusitis is an inflammatory condition of the mucous membrane lining the sinuses. Acute sinusitis most commonly develops as a result of a viral infection, which can progress to bacterial sinusitis. A genetic predisposition to allergic or other inflammatory diseases plays an important role in the development of chronic sinusitis. Fungal sinusitis is encountered less frequently.
Sinusitis symptoms can vary in severity and character depending on the type of infection and its duration. They often initially resemble a common cold, but become more troublesome over time.
The most common symptoms include:
- a blocked, congested nose
- pain or pressure around the forehead, cheeks or bridge of the nose
- headache that worsens when bending forward
- thick nasal discharge or post-nasal drip
- reduced or lost sense of smell
- cough, particularly worse at night
- fatigue and a general sense of feeling unwell
A medical consultation is recommended when symptoms persist for more than a few days, worsen over time, or are accompanied by a high fever, severe facial pain or swelling around the eyes.
ACUTE SINUSITIS
Typically lasts up to 10 days and is most commonly viral in origin. In many cases it resolves spontaneously or with symptomatic treatment. If symptoms persist or a bacterial superinfection occurs, extended pharmacological treatment may be required.
CHRONIC SINUSITIS
Diagnosed when symptoms persist for more than 12 weeks. In these cases, symptoms may be less severe but are recurrent or persistent in character. Anatomical changes in the nose and sinuses are often present, making conservative treatment less effective.
The differences between acute and chronic sinusitis relate to:
- duration of symptoms
- underlying cause
- severity of symptoms
- diagnostic and therapeutic approach
Diagnosis of sinusitis begins with a detailed medical history and an ENT examination. The physician assesses nasal patency, the appearance of the mucous membrane and the presence of secretions. In cases of recurrent or chronic symptoms, further investigations are necessary.
Depending on the clinical picture, these may include:
- nasal and sinus endoscopy
- CT scan of the paranasal sinuses
- laboratory tests if bacterial infection is suspected
- allergy testing if an allergic cause is suspected
At LUX MED Carolina Hospital, investigations are selected individually based on the clinical picture and duration of symptoms.
Treatment of paranasal sinusitis depends on the cause and nature of the condition. In acute sinusitis, conservative treatment forms the basis of management, aiming to reduce mucosal swelling and facilitate secretion drainage.
Pharmacotherapy may include:
- intranasal corticosteroid therapy
- anti-inflammatory and analgesic medication
- nasal decongestants
- mucolytic agents
- antibiotics when a bacterial infection has been confirmed
- anti-allergic treatment
If pharmacological treatment fails to produce improvement, or if sinusitis is chronic in nature, surgical options are considered. The aim is to restore sinus patency and improve ventilation. The scope of surgical treatment depends on the underlying cause and the anatomical condition of the nose and sinuses.
The most advanced and effective approach for chronic sinusitis is biological treatment. This method is used when surgical treatment has not proved effective and the inflammatory process is at an advanced stage — particularly in cases of recurrent nasal and sinus polyps.
