Sinusitis is commonly referred to as rhinosinusitis, and it can occur as acute or chronic; it is caused by bacteria. Acute sinusitis is an inflammation of the paranasal sinuses that is typically short-lived, lasting for four weeks to eight weeks (Braun & Anderson, n.d.). It is often caused by a viral infection and less frequently. It often starts as a cold, which then progresses to include symptoms such as facial pain and pressure, nasal discharge, and a reduced sense of smell. In many cases, people with acute sinusitis similarly have a fever. Contrarily, an infection of the paranasal sinuses that persists for more than 12 weeks is considered chronic sinusitis (Almutairi et al., 2017). Although multiple factors can contribute to the development of chronic sinusitis, it is mostly due to chronic bacterial infections or allergies.
Different factors may lead to sinusitis, including both infrequent and frequent. Viral infections, such as the common cold, are the most frequent cause of sinusitis. Allergic and non-allergic rhinitis, which is inflammation of the nose due to irritants in the air or a sensitivity to certain substances, is another frequent cause. Cigarette smoking can similarly contribute to sinusitis by irritating the lining of the air passages and increasing the risk of infection. Some of the less common causes of sinusitis include cystic fibrosis, immune deficiency, sinus surgery, and neoplasia (Almutairi et al., 2017). Cystic fibrosis is a genetic disorder that causes the production of thick mucus that can clog the airways and sinuses. Immune deficiency can leave people susceptible to infection, which can lead to sinusitis. Sinus surgery can disrupt the normal drainage patterns of the sinuses and lead to inflammation. And neoplasia is a term for tumors or cancers of the head and neck region.
Acute sinusitis’s most common symptoms include fever, cough, hyposmia or anosmia (decreased sense of smell), nasal congestion, facial pain, and ear fullness. In some cases, acute sinusitis can additionally lead to complications like brain abscesses or meningitis. It is similarly symptomized by maxillary dental pain, fatigue, and nasal drainage (Braun & Anderson, n.d.). On the other hand, chronic sinusitis symptoms are sneezing, sore throat, malaise, stuffy ears, unpleasant taste, nasal discharge, postnasal drip, fetid breath, and dental pain (upper teeth).
Pathophysiology is the medical science that deals with the alternations in normal bodily functions due to disease or injury. It investigates how these changes come about at both the cellular and organ levels and aims to identify stakeholders for therapeutic interventions. Rhinosinusitis is the inflammation of the mucous membranes that line the nasal cavity and sinuses. The most common symptoms are a stuffy nose, headache, fatigue, and facial pain (Braun & Anderson, n.d.). The pathophysiology of rhinosinusitis is not completely understood, but it is thought to involve an interaction between the immune system, the nervous system, and the airways. The inflammatory response is thought to be triggered by allergens, viruses, or bacteria. This results in swelling and congestion of the nasal passages and obstruction of the sinuses. This can lead to difficulty breathing through the nose and pressure on the face.
Clinical manifestations are the observable symptoms that result from a disease or condition. Sinusitis is a medical disorder caused by an infection or inflammation of the sinuses. The inflammation may be caused by a bacterial or fungal infection, environmental allergies, or by other factors (Almutairi et al., 2017). The most common clinical manifestation of sinusitis is inflammation of the lining of the sinuses, which can cause pain, pressure, and congestion in the facial area. Other symptoms may include a runny nose, fever, and fatigue. In some cases, sinusitis can, in addition, lead to infections of the middle ear or the eye.
Most cases of sinusitis are diagnosed based on symptom observation, medical history, and physical exam. The symptoms are facial pain or pressure, which is worse when leaning forward, headache, fever, fatigue, and a reduced sense of smell or taste. If symptoms are severe or last more than 10 days, imaging tests such as magnetic resonance imaging (MRI) may be ordered to confirm the diagnosis (Mustafa et al., 2015). These tests can likewise help exclude other conditions that may cause similar symptoms, such as a brain tumor or teeth infection. A general laboratory inflammation such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell count (WBC) may identify other causes of the symptoms (Braun & Anderson, n.d.). Radiologic imaging, such as a computed tomography (CT) scan, may likewise be used to aid in diagnosing sinusitis.
Concerning chronic sinusitis, a nasal endoscopy can be advised; it is a procedure where a doctor looks inside the patient’s nose and sinuses using a thin, flexible tube with a light and camera on end. This allows the doctor to see inflammation, obstruction, or other problems in the nose and sinuses (Mustafa et al., 2015). The nasal endoscopy is usually done as an outpatient procedure. If there is any inflammation or obstruction, the doctor may take a sample of tissue (biopsy) for further examination.
There are three main treatment approaches for sinusitis: antimicrobial treatment, surgical treatment, and symptomatic treatment. Antimicrobial treatment involves taking antibiotics to kill the bacteria or virus that is causing the infection (Hansen et al., 2018). Surgical treatment involves surgically removing the infected tissue from the sinuses. Symptomatic treatment involves relieving the symptoms of sinusitis with medications such as pain relievers or decongestants. It is important to treat sinusitis in order to avoid serious complications, such as meningitis.
Treatment for sinusitis often includes antibiotics, decongestants, and pain relievers. Penicillins are a group of antibiotics that are commonly used to treat sinus infections. They work by killing the bacteria that cause the infection (Almutairi et al., 2017). Moreover, cephalosporins are a broad-spectrum class of antibiotics that are effective against both gram-positive and gram-negative bacteria. These drugs work by inhibiting cell wall synthesis, which eventually leads to the death of the bacteria (Hansen et al., 2018). Furthermore, Macrolides are a class of antibiotics that work by stopping the growth of bacteria. They are effective against a wide range of bacteria, including those that cause sinusitis. Macrolides can be taken as a pill or an inhaler, depending on the form of macrolide prescribed.
The surgical treatment of sinusitis is called Functional Endoscopic Sinus Surgery (FESS). The goal of this surgery is to improve drainage from the sinuses and to remove any obstacles that are blocking that drainage. FESS involves going through the nasal passages with a small camera called an endoscope and using special instruments to remove the obstructions. In some cases, the surgeon may similarly need to enlarge one or more of the openings between the sinuses and the nasal passages. FESS is generally considered to be safe and effective, and it has a high success rate in treating chronic sinusitis (Almutairi et al., 2017). Conversely, symptomatic therapy treatment for sinusitis may include balanced nutrition, smoking cessation, adequate hydration, and nonnarcotic analgesia.
Almutairi, A. F. N., Shafi, R. W., Albalawi, S. A., Basyuni, M. A., Alzahrnai, A. A., Alghamdi, A. S., Alshehri A. A., & Al-Gadouri, M. A. (2017). Acute and chronic sinusitis causes and management. The Egyptian Journal of Hospital Medicine, 68(3), 1513-1519.
Braun, C. A., & Anderson, C. M. (n.d.). Applied Pathophysiology. Web.
Hansen, M. J., Carson, P. J., Leedahl, D. D., & Leedahl, N. D. (2018). Failure of a best practice alert to reduce antibiotic prescribing rates for acute sinusitis across an integrated health system in the Midwest. Journal of Managed Care & Specialty Pharmacy, 24(2), 154-159.
Mustafa, M., Patawari, P., Iftikhar, H. M., Shimmi, S. C., Hussain, S. S., & Sien, M. M. (2015). Acute and chronic rhinosinusitis, pathophysiology and treatment. International Journal of Pharmaceutical Science Invention, 4(2), 30-36.