Sinusitis

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• Sinusitis is inflammation of the mucous membrane of the paranasal sinuses, most often developing against the background of a runny nose or a cold.
• Main signs: nasal congestion, thick coloured discharge, pressure in the forehead and cheeks, headache, reduced sense of smell.
• With severe headache, facial swelling, high temperature or worsening vision, urgent medical help is needed.
• The diagnosis is made by an ENT doctor on examination; in prolonged cases, computed tomography, radiography, allergy tests, and a nasal swab are prescribed.
• Prevention of exacerbations: treatment of a runny nose and allergies, humidifying the air, giving up smoking, nasal irrigation, protection from getting chilled.

What is sinusitis

Sinusitis is an inflammation of the mucous membrane of the paranasal sinuses, which often occurs against the background of a runny nose or a cold. The sinuses are small cavities in the bones of the face, and when they become inflamed, nasal congestion, pain and pressure in the facial area appear.

What happens in the body

Inflammation of the mucous membrane of the paranasal sinuses begins with swelling, which blocks the narrow outlet openings of these cavities. The mucous membrane swells and stops letting air and contents pass normally, so fluid accumulates inside. The pressure inside the cavity rises, and the person feels heaviness in the facial area and a headache. The nose becomes blocked, the voice becomes nasal, and the sense of smell noticeably weakens for several days. The contents stagnate, and microbes gradually multiply in them if the outflow does not restore itself. Because of this, the condition can drag on, and the unpleasant sensations can intensify towards the evening. If the congestion and pressure persist for a long time, it is worth seeing a doctor so that they can assess the condition of the sinuses.

What causes it to develop

• A recent cold or viral infection: swelling of the mucous membrane disrupts the outflow of contents from the sinuses, and this is the most common trigger for the onset of inflammation.
• Allergic rhinitis: a reaction to pollen, animal fur or dust keeps the mucous membrane swollen, so the outflow is impaired for a long time.
• A deviated nasal septum or polyps: these structural features prevent air and contents from passing freely, creating conditions for stagnation.
• Smoking and polluted air: smoke and suspended particles constantly irritate the mucous membrane, so it swells more often and more severely.
• Exposure to cold: after prolonged time in the cold, the protective forces of the mucous membrane decrease, and it resists microbes less well.
• Reduced immunity: if the body is weakened, even an ordinary runny nose drags on, and inflammation in the sinuses lasts longer.

Who experiences it more often

Inflammation of the paranasal sinuses is more common in people whose runny nose or cold drags on and does not go away within the usual timeframes. Children and adolescents get viral infections more often than adults, so inflammation occurs more regularly in them too. Adults with a deviated septum or polyps report recurring episodes over many years. Smokers and those who work in dusty rooms complain of congestion and pressure in the facial area noticeably more often than others. People with allergies during the flowering season are also at risk, because their mucous membrane swells constantly. People with weakened immunity endure inflammation more severely and for longer than others. If episodes recur frequently, it is worth discussing the possible causes and suitable examination with a doctor.

What symptoms can there be?

Sinusitis manifests with signs that are easily mistaken for a common cold, but they last noticeably longer. It is important to recognise in time the typical course and the conditions that require urgent medical help.

How it is noticed at the very beginning

At the start, sinusitis often looks like a lingering cold that does not go away within the usual time frame. A person feels nasal congestion and difficulty breathing through the nose, which makes them breathe through the mouth. To this is added pressure in the area of the forehead, cheeks or around the eyes, which intensifies when bending forward. Many put such a condition down to fatigue, lack of sleep or a change in the weather and postpone a visit to the doctor. Nasal discharge becomes thick and coloured, and the sense of smell noticeably decreases. A headache appears, sometimes accompanied by a rise in temperature and general malaise. If such signs persist for more than a few days, it is worth booking an appointment with an ENT doctor rather than waiting for it to pass on its own.

Signs that occur most often

• Nasal congestion: breathing through the nose is difficult, and this interferes with sleep, work and everyday tasks during the day.
• Nasal discharge: it is often thick and coloured, which distinguishes the condition from an ordinary runny nose with a cold.
• Pain or pressure: unpleasant sensations in the area of the forehead, cheeks and around the eyes intensify when moving the head.
• Headache: it becomes more noticeable when bending forward, when the position of the head and body changes.
• Reduced sense of smell: smells are felt more weakly, and sometimes disappear, which affects the taste of food.
• Temperature and malaise: a rise in temperature and general weakness indicate that it is worth seeing a doctor.

When to seek help urgently

Examinations and tests

Examination for sinusitis begins with a conversation and a physical examination, and instrumental methods are added when the clinical picture is insufficient. Below is a breakdown of what exactly is prescribed, what each investigation shows, and which documents are worth bringing to the appointment.

How the examination begins

The examination begins with questions about symptoms and an examination of the nasal cavity, and this gives the doctor most of the information. The ENT doctor clarifies how long the congestion has persisted, whether there is pain in the sinus area and nasal discharge. Then he examines the nasal passages, assesses the swelling of the mucosa and the nature of the discharge. This examination is called rhinoscopy and is performed right in the office without preparation. Based on the clinical picture, the diagnosis is usually made without additional procedures if the course is typical. In a prolonged course, the examination picture is insufficient, and then there is reason for imaging methods. Computed tomography of the sinuses shows their condition in more detail than a routine examination. Radiography of the paranasal sinuses remains a simpler way to assess their condition. If allergy is suspected, allergy tests are prescribed. A nasal swab helps identify the causative agent when this is important for further management. It is worth writing down in advance when the first signs appeared and how they changed.

What is prescribed and what it shows

What is worth preparing for the appointment

• Discharge summaries: take the records of previous visits to the doctor to show how the condition developed and what has already been done.
• Previous images: bring the results of computed tomography and radiography of the sinuses, if they were done earlier, together with the reports.
• Test results: prepare the available laboratory data, including nasal swabs and allergy tests, so that the doctor sees the full picture.
• Observations: write down when the symptoms appeared, how they changed and what worsens the congestion or pain in the sinus area.
• List of questions: formulate in advance what you want to clarify with the doctor so as not to forget anything important at the end of the appointment.

Which doctor should I see?

With sinusitis, help is provided by an ENT doctor, but the choice of specialist depends on how pronounced the symptoms are and which structures are involved in the process. Below is an explanation of whom to go to, what treatment consists of, and what remains on the patient's side.

Which specialist manages this condition

Sinusitis is managed by an ENT doctor, since it is they who assess the condition of the paranasal sinuses and the nasal cavity. If a specialist of this profile is not available nearby, one can start with a physician or a general practitioner, who will refer further if necessary. During the appointment, the ENT doctor asks about the duration of the congestion, the nature of the discharge, and pain in the facial area. Then they examine the nasal cavity, assess the swelling of the mucosa, and the patency of the sinus ostia. If complications are suspected or the course is prolonged, additional examination may be needed. The doctor also clarifies whether there have been previous nasal injuries, surgeries, or allergic reactions. If symptoms persist for a long time or recur, booking an appointment specifically with an ENT doctor saves time and allows the further approach to be discussed straight away.

What treatment consists of

• Nasal irrigation with saline solutions: helps remove accumulated secretions and reduce irritation of the mucosa, easing nasal breathing.
• Decongestants in a short course: temporarily reduce swelling and restore the patency of the ostia, but are used to a limited extent.
• Anti-inflammatory and analgesic medications: reduce pain and the inflammatory reaction if they are pronounced and interfere with daily activities.
• Antibacterial therapy for bacterial infection: is added only as prescribed by a doctor, when there are signs of a bacterial process.
• Physiotherapy: is used as an adjunct to improve the outflow of contents and reduce inflammation in the sinuses.
• Surgical treatment for anatomical obstacles: is discussed if the structure of the nose interferes with normal drainage and conservative measures do not help.

What depends on the patient themselves

The result largely depends on how regularly the patient follows the doctor's recommendations and monitors their condition. Nasal irrigation and humidifying the air at home are important to carry out constantly, not from time to time. If symptoms worsen or pain appears in the facial area, this should be reported to the doctor rather than changing the approach independently. Notes on when things got better or worse help the doctor more accurately assess the dynamics at a follow-up appointment. Refraining from independently extending the use of decongestants reduces the risk of worsening the condition of the mucosa. If the course is prolonged, it is important to come for a follow-up examination, even if things have become noticeably easier. Regular monitoring and an honest account of symptoms speed up the selection of suitable help.

What helps prevent an exacerbation?

Prevention of sinusitis exacerbations largely depends on a person's own everyday decisions. Below are habits, observations and monitoring intervals that help maintain the health of the upper respiratory tract.

What to change in your habits

Timely treatment of a runny nose and allergies noticeably reduces the risk of repeated inflammation in the paranasal sinuses. An incompletely treated runny nose retains mucus and creates conditions for congestion. Humidifying the air indoors helps the mucosa stay moist and better resist irritation. Giving up smoking reduces the constant exposure of the nasal mucosa to tobacco smoke. Avoiding getting chilled is important in cold weather, when the defences of the respiratory tract are reduced. Regular nasal irrigation during the cold season removes accumulated mucus and dust particles. If the home is too dry, it is worth considering a humidifier and airing the rooms more often.

What should be kept under control

• Runny nose: nasal discharge that drags on longer than usual requires attention, because mucus congestion maintains inflammation.
• Allergy: seasonal reactions should be kept under observation, as swelling of the mucosa prevents the normal outflow of sinus contents.
• Air humidity: dry air in the flat irritates the mucosa, so it is worth monitoring the microclimate in the bedroom and work rooms.
• Smoking: giving up cigarettes reduces constant irritation of the respiratory tract and lowers the frequency of exacerbations during the year.
• Getting chilled: dressing for the weather and protection from draughts help avoid situations after which the first signs of malaise usually appear.
• Nasal irrigation: a regular procedure during the cold season cleans the nasal cavity and serves as a simple habit for maintaining the health of the respiratory tract.

How often to see a doctor

A regular check-up with a doctor is useful even when you feel well and nothing is bothering you. The specialist assesses the condition of the mucosa and notes changes that a person may not notice themselves. If runny noses are frequent, it is worth discussing their causes with the doctor and their connection with allergies or structural features of the nose. If exacerbations recur season after season, a visit helps adjust habits and notice unfavourable shifts in time. Planned consultations are especially important for those who live in a dry climate or spend a lot of time in rooms with air conditioning. The doctor will advise which preventive measures are suitable in a particular case and what to pay attention to at home. Such monitoring does not replace the prescribed treatment, but it helps reduce the frequency of exacerbations and keep breathing free.

What is worth remembering

Sinusitis does not always resolve on its own, and the course of the illness depends on how attentively a person treats their condition. Below are several conclusions that help make a balanced decision.

Key conclusions

Sinusitis requires attention when nasal congestion lasts longer than an ordinary cold. If pain in the facial area intensifies when bending over, and nasal breathing does not recover, it is not worth postponing a visit to the doctor. Sinusitis is often confused with an ordinary runny nose, so people wait for a long time hoping everything will pass on its own. Meanwhile, inflammation of the sinuses can become prolonged and cause complications. A doctor distinguishes sinusitis from other conditions by the nature of the complaints and the results of the examination. Self-diagnosis gets in the way here: a person treats the wrong thing and loses time. At the first suspicious signs, it is more sensible to clarify the cause with a specialist rather than choosing remedies at random. Sinusitis is not a reason for panic, but it is also not something that can be ignored for weeks.