Anand recalls one time when she was down with sinusitis when she found it difficult to bend forward or backwards due to the pain and pressure on the forehead. “I would struggle to sleep as my nose would get stuffy and I would feel suffocated all night. By morning, my face would be swollen, I would have a runny nose, headache and pressure around the nasal cavity, eyes, cheeks and forehead. On some days, I have to push myself to work and on other days, I would just rest at home,” she said.
Dr Maryada Sravani, a consultant ENT surgeon at Apollo Clinic, Hyderabad, says that sinuses are air-filled bony cavities present around our nose with small openings into nasal cavities. “When the openings of these sinuses get blocked, they will be filled with secretions and get infected,” she says.
Sinusitis and symptoms
Dr Sravani says that symptoms are headache (mostly in the region above the eyebrows and at the back of the head), a feeling of heaviness on the face, discharge from the nose, nose block, postnasal discharge, (when mucus from nose drips down the back of throat) etc. which are long-standing.
Common symptoms include sneezing, runny nose and headache, says Dr Deepak Murty, consultant ENT surgeon, Manipal Hospitals, Goa. “Sometimes patients may complain of pain between and below the eyes. There are two types of sinusitis – acute sinus attack which happens only occasionally and chronic sinus attacks in which recurrent attacks occur in a short time. Lethargy and fever may accompany acute attacks. In chronic sinus disease especially potentiated by long-standing allergies, fever and pain may not be the symptoms. A blocked nose, sneezing and sometimes a loss of the sense of smell may be the only complaints,” he says.
“Approximately one in 10 people suffer from sinusitis. It can be viral or bacterial, affecting both males and females equally,” says Dr Sravani. Dr Murty says that the diagnosis is based on clinical findings of a discharging nose, flushed face and foul breath. It can be confirmed with a CT scan of the sinuses and a complete blood count.
Common cold or sinusitis?
Most common colds also infect the sinuses and hence are difficult to distinguish from sinusitis, says Dr Murty.
Dr Sravani says that a common cold is mostly viral and subsides within a week while sinusitis lasts for a long time with nose discharge, severe headaches and heaviness.
Anand recalls that the first time she had a sinus attack, she assumed that it was just a common cold; but only after a CT scan did she learn from her doctor that she had sinusitis.
Treating the infection
Dr Sravani says that in the acute stage, the infection lasts anywhere from seven days to three weeks when antibiotics, antihistamines (used to treat allergies or the common cold) and analgesics (painkiller) are prescribed. “If symptoms persist for more than three months, a surgery called FESS (functional endoscopic sinus surgery) is required,” she said.
Sinusitis among children is common and they do not require any medication, says Dr Murty. “For adults, any antihistamines, fever-reducing medicines and steam inhalation for three days is enough to bring it under control. However, in some instances the sinuses can get infected by bacteria which requires antibiotic treatment right away,” he explains.
For people with diabetes or those who are immunocompromised, the infection could spread inside the eyes and even the brain. “Some of the major complications are meningitis and eye infection,” he says.