What is sinusitis?

Sinusitis affects over 39 million Americans each year, which makes it one of the most common health conditions in America.

Sinusitis is caused by an inflammation or infection of one or all of your para-nasal sinuses (hollow cavities of the bones of the skull around the nose and behind the eyes).

Three types of sinusitis

Sinusitis is categorized into three types based on the duration of the inflammation/infection -

1. Acute Sinusitis

Acute sinusitis is a sinus infection that usually lasts for no more than 3 weeks. It is usually triggered by a preceding flu or head cold. The original infection (e.g. flu or cold virus) attacks the lining of your sinuses causing them to swell and become narrow. Your body responds to this virus by producing more mucus. Then the sinuses become filled with mucus causing the opening to narrow or to become closed from the inflammation. As a result one or more of your sinus cavities may become blocked causing a build-up of mucus. This build-up of mucus makes a good place for bacteria to grow as they are no longer being “flushed out” by normal mucus flow.

Acute sinusitis symptoms are normally like a typical "cold". If the cold symptoms last longer than one week, then the cold may have advanced into a sinus infection. If acute sinusitis recurs more frequently or if your symptoms never completely go away, it may develop into chronic sinusitis.

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2. Chronic Sinusitis

To most Americans under the age of 45, chronic sinusitis is one of the most common chronic illnesses.

Chronic sinusitis usually lasts for more than 3 weeks and can continue for months or even years. It is commonly caused by allergies or bacterial infections.

The overuse of antibiotics and cortisone sprays have lead to more infectious forms of bacteria forming as well as new fungal infections of the sinus cavities.

Asthma and allergic disorders often cause chronic inflammation to the nasal mucosa. This inflammation causes chronic sinusitis.

About 20% of patients with chronic sinusitis may develop nasal polyps. Nasal polyps are cyst-like growths that develop from sinus tissue. The resulting growth can cause the sinus cavities to become blocked, which causes even more problems.

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3. Recurrent Sinusitis

This type of sinusitis occurs when one has several separate attacks during the year. The attacks are usually caused by an allergic reaction to varying weather conditions, animal hair, dust mites, mold, pollen etc.

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Sinusitis can further be classified according to which pair of sinus cavities are infected:

• Antritis – This type of sinusitis occurs when only the maxillary sinus cavities are inflamed. It is also known as maxillary sinusitis. It can either be chronic, acute or sub acute sinusitis.
• Ethmoiditis – This occurs when the ethmoid sinus cavities are infected. It also occurs chronically or on an acute basis. It is also known as ethmoid sinusitis.
• Sphenoiditis - This type of sinusitis, also known as sphenoid sinusitis can present as chronic sinusitis but more often than not, it is an acute infection.
• Frontal sinusitis – This type of sinusitis occurs when your frontal sinus cavities become infected. These infections can be acute or chronic.

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What causes sinusitis?

Sinusitis is caused by the swellings in your sinus cavities.

Swelling in your sinus cavities causes the mucus membranes to thicken and leads to increased mucus production.
The sinuses drain through tiny openings called ostia. This inflammation causes these small openings to become blocked causing the mucus to accumulate and build up pressure. This results in tremendous pressure, pain and headaches. Blocked mucus becomes an ideal area for trapped bacteria to multiply and cause an infection.

When your sinuses get inflamed and infected they also cause systemic symptoms like fever and fatigue.

Very rarely sinus infections spread backwards which infects the brain and becomes a life threatening disease.

The following can increase your risk of getting sinusitis:

• Constant use of decongestant nasal sprays.
• Smoking
• Swimming
• Diving
• Alcohol
• Pets
• Recurrent flu and colds symptoms.
• Allergies
• Stress