Sinusitis

What is Sinusitis?
Sinusitis is an infection or inflammation of the paranasal sinuses or the hollow spaces within the bones of the head surrounding the nose. It is usually preceded by a cold, allergy attack or irritation by environmental pollutants

How does one know if he has Sinusitis?
The following are the most common complaints of a patient with sinusitis:
• Yellowish, greenish nasal discharge
• Clogged nose
• Facial Pain/Pressure
• Phlegm over the throat
• Loss/Decrease of sense of smell
Other symptoms include:
• Fever
• Cough
• Fatigue
• Dental pain
• Ear pressure/fullness

Who are at risk and what are the risk factors?
• Anyone with viral upper respiratory infection (URI) that have not improved after 10 days or worsen after 5 to 7 days
• People with allergic rhinitis
• Patients with decrease immune system
• With immune deficiencies and HIV infection
• With abnormality of mucus secretion or mucus movement (cystic fibrosis)
• With diseases of abnormal cilia (Kartagener's syndrome)
What happens when you have sinusitis?
• Each sinus has an opening into the nose for the free exchange of air and mucus, and each is joined with the nasal passages by a continuous mucous membrane lining.
• Therefore, anything that causes a swelling in the nose (an infection or an allergic reaction) also can affect the sinuses.
• Intense Pain of a sinus attack is caused by air trapped within an obstructed sinus, along with pus or other secretions which causes pressure on the sinus wall.
• When air is prevented from entering a paranasal sinus by a swollen membrane at the opening, a vacuum can be created that also causes pain.

How is sinusitis diagnosed?
• Diagnosis is clinical or based on signs and symptoms
• Symptoms of a viral URI that have not improved after 10 days, or worsened after 5 to 7 days, up to a maximum of 28 days with the presence of two or more of the following symptoms:
• Clogged nose
• Phlegm over the throat
• Facial pain/pressure/fullness
• Loss/ decrease in sense of smell
• Imaging studies such as CT Scan of the paranasal sinuses
• Nasal endoscopy

When do you consult?
If any of the symptoms mentioned persist, VISIT your ENT – Head and Neck Surgery specialist for consult
How is sinusitis diagnosed?
• Acute sinusitis is treated by
• Re-establishing drainage of the nasal passages
• Controlling or eliminating the source of the inflammation, and relieving the pain.
• Doctors generally recommend
• Decongestants to reduce the congestion
• Antibiotics to control a bacterial infection
• Pain relievers to reduce the pain.
• When medical treatment fails, surgery may be the only alternative for treating chronic sinusitis.
• Functional Endoscopic Sinus Surgery (FESS) – the most common surgery done today.
• The natural openings from the sinuses are enlarged to allow drainage. This type of surgery is less invasive than conventional sinus surgery and serious complications are rare.
• See separate brochure on FESS
What are the possible complications of sinusitis?

If untreated, infection may extend to the eyes causing orbital cellulitis or abscess and the brain causing
Epidural or subdural abscess

HOW CAN THE MEDICAL CITY HELP YOU?
At The Medical City we have a complete roster of competent otolaryngologists /ENT specialists who may assess or treat people with sinusitis.
For further inquiries or if you want to seek consult, please call:

EAR, NOSE &THROAT CENTER
Tel. No. (632) 988-1000 / (632) 988-7000 Ext. 6251

CENTER FOR PATIENT PARTNERSHIP
Tel. No. (632) 988-1000 / (632) 988-7000 Ext. 6444

References:
Clinical Practice Guidelines of Philippine Society of Otolaryngology-Head and Neck Surgery (Acute Bacterial Sinusitis) 2006
ttp://www.webmd.com/cold-and-flu/sinusitis-allergies
Cummings Charles, Otolaryngology Head and Neck Surgery 4th ed vol 2, 2005
American Academy of Otolaryngology-Head and Neck Surgery.www.entorg.net

Note: This information is not intended to be used as a substitute for professional medical advise, diagnosis or treatment. If you or someone you know have any of the symptoms mentioned above, it is advisable to seek professional help.