Sinusitis: Find a doctor and more information about sinusitis

07.11.2023
Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Sinusitis is an inflammatory reaction of the mucous membrane of the paranasal sinuses, usually caused by viruses or bacteria, rarely also by fungi. A distinction is made between acute sinusitis, which persists for up to 12 weeks, and chronic sinusitis, which persists for 12 weeks or more.

Here you can find additional information and selected doctors for the treatment of sinusitis.

ICD codes for this diseases: J01, J32

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Brief overview:

  • What is sinusitis? An inflammation of the sinus mucosa. It can be acute or chronic (longer than 12 weeks).
  • Causes: Most often, viruses, bacteria, or fungi cause the inflammatory reaction in the passageways to the sinuses.
  • Symptoms: Depending on the sinus affected, different headaches occur. They may be localized behind the eyes, on the forehead, or the back of the head.
  • Diagnosis: The medical history and a physical exam are sufficient for diagnosis; if chronic inflammation is suspected, a CT scan is often consulted.
  • Treatment: The acute form is usually treated conservatively, such as with nasal drops and directly applying the drops to the nasal passage via cotton swabs. The chronic form requires further medication and possibly also surgical intervention to widen the passageways.

Article overview

Definition: Sinusitis (inflammation of the sinuses)

A distinction is made between acute and chronic sinusitis. The only decisive factor here is the duration of the disease’s progression. Acute sinusitis is diagnosed when a purulent secretion of the nose persists for up to 12 weeks. If the symptoms persist for at least 12 weeks and beyond, it is called chronic sinusitis. By definition, it is an independent inflammatory reaction of the sinus mucosa or one that accompanies the common cold.

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Causes of sinusitis

Acute sinusitis is caused by the passageways, called ostia, to the sinuses. This can be triggered by swelling of the excretory ducts or a mucosal disposition. The chronic course of sinusitis is more characterized by a gradually increasing obstruction of the ostiomeatal unit.

The most common pathogens are viruses, bacteria of the nasal flora or, more rarely, fungi. The following are being discussed as predisposing factors for sinusitis: allergies, analgesic intolerance, asthma, and natural constrictions.

What are the symptoms of sinusitis?

The symptomatology of sinusitis is closely related to the localization of the affected sinus:

  • If the ethmoid or maxillary sinuses are affected, a severe headache develops that radiates behind the affected eye and creates pressure and percussion tenderness in the anterior wall of the maxillary sinus.
  • If the frontal sinus is affected, there is a frontal headache with an increase in symptoms when bending over.
  • If the sphenoid sinus is involved, the pain is more toward the back of the head.

If all sinuses are affected, it is called pansinusitis.

Diagnosis of sinusitis

The diagnosis of acute sinusitis is based on the medical history and examination alone, whereas a CT scan of the sinuses is indicative if chronic sinusitis is suspected. Ultrasound diagnostics and X-rays are of secondary importance.

How is sinusitis treated?

The treatment procedure depends on whether the sinusitis is acute or chronic.

Treatment of sinusitis

In most cases, treatment for acute sinusitis consists of conservative therapy in the form of decongestant nasal drops, direct application of medicine via cotton swabs, administration of moist and dry heat, and additional consideration of antibiotic therapy to prevent or treat bacterial superinfection. Immediate additional surgical repair only becomes necessary in case of orbital or intracranial complications.

Treating chronic sinusitis

Treatment of chronic sinusitis additionally includes administration of topical and systemic corticosteroids. If this does not bring significant relief, surgical restructuring is recommended as part of the paranasal sinus surgery. The main objective of this intervention is the ventilation of the sinuses after expansion of the ostia. Today, this is mainly done endonasally or, in rare cases, externally, in a manner that is either endoscopically or microscopically supported. At this point, however, it must be acknowledged that recurrences may occur.

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