Sinusitis Causes, Symptoms, Treatment and ENT Care Guide

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What starts as a common cold can develop into sinusitis. When secretions can no longer drain through swollen nasal passages, they become trapped. The mucus collects in the sinuses and clogs them, allowing viruses and bacteria to easily accumulate and trigger inflammation. Sinusitis usually occurs in conjunction with rhinitis (rhinosinusitis). In persistent or severe cases that do not respond to medical treatment, consultation with a Sinus surgery specialist may be recommended to evaluate advanced treatment options.

Typical symptoms of sinusitis

Sinusitis is often accompanied by a runny nose with nasal congestion and headaches . Signs of the condition include a distinct feeling of pressure in the head , especially when bending forward or applying pressure to the affected areas.

Possible main symptoms:

  • Pressure and pain in the head

  • Facial pain

  • blocked nose

  • purulent nasal discharge

  • Fever (only in cases of acute sinusitis)

  • Impairment or loss of the sense of smell

  • Toothache

  • Possible side effects:

  • Headache

  • Earache

  • Toothache

  • Cough

  • Exhaustion

When should you see a doctor for sinusitis?

If you suspect you have sinusitis, you should definitely seek medical advice. 

In rare complications, sinusitis can also spread to the eye sockets, bones, or skull cavities. Consult an ear, nose, and throat (ENT) specialist immediately if you experience the following symptoms: 

  • severe facial and headaches

  • Visual disturbances

  • persistent high fever

  • Swelling and/or redness around the eyes

  • Confusion

  • Light sensitivity

Causes of sinusitis

Sinusitis can occur when the mucous membranes in the sinuses are inflamed, preventing proper ventilation of the nose and sinuses.

Triggers of acute sinusitis

Sinusitis is often a consequence of a common cold with a runny nose, which is caused by cold viruses (rhinoviruses): During a cold (rhinitis), the nasal mucous membranes swell and produce more mucus. This thick mucus, which normally flushes pathogens out of the nose, can no longer drain. It blocks the openings (ostia) that connect the sinuses to the nasal passages and accumulates in the sinuses along with the pathogens. Without adequate ventilation, the pathogens can then multiply rapidly in the warm, humid environment. The result is inflammation of the sinuses (sinusitis).

Duration: An acute sinusitis should heal within 12 weeks 2 .

The sinuses 

Frontal sinus (Sinus frontalis): located in the frontal bone on the right and left above the root of the nose, above the eyebrows. 

Sphenoid sinus: behind the ethmoid cells, in the so-called sphenoid bone.

Ethmoid labyrinth (ethmoid sinus): Consists of many small cavities, the ethmoid cells. They are located in the ethmoid bone between the nose and the inner corner of the eye. 

Maxillary sinuses (Sinus maxillaris): in the upper jawbone on both sides of the nose, near the palate and upper jaw.

Sinusitis without a runny nose

Sinusitis can also develop without a cold. For example, allergies such as hay fever can cause inflammation of the mucous membranes in the nose and sinuses. If the mucous membranes are severely swollen and irritated, they may no longer be able to drain the mucus. As a result, the sinuses are poorly ventilated. Similarly, anatomical abnormalities can cause a buildup of secretions and thus trigger sinusitis, including a deviated septum or disease-related changes (nasal polyps). When inflammation of the tooth root spreads into the maxillary sinus, it is called odontogenic sinusitis.

Triggers of chronic sinusitis

If symptoms persist for more than 12 weeks, we refer to it as chronic sinusitis . It can develop from an incompletely healed acute sinusitis. However, the causes often remain unclear.

Commonly, the following are among the possible triggers: 

  • Allergies

  • asthma

  • Anatomical peculiarities, such as a deviated nasal septum  

  • Intolerance to acetylsalicylic acid (ASA)

Chronic sinusitis usually affects the maxillary sinuses and ethmoid sinuses, less often the frontal sinus and the sphenoid sinus. 

Types of sinusitis

If only individual sinuses are inflamed, the pain occurs in specific locations. For example, with frontal sinusitis, the forehead area is particularly painful, while patients with maxillary sinusitis feel the discomfort in the area below the eyes. If several sinuses are inflamed simultaneously, doctors refer to this as polysinusitis. When all sinuses are affected at the same time, it is called pansinusitis. In rhinosinusitis , both the sinuses and the nasal mucosa are inflamed.

If only individual sinuses are inflamed, the pain occurs in specific locations.

  • First aid: What to do in case of sinusitis?

This helps with acute sinusitis.

If the sinuses are already inflamed, it is important to quickly improve their ventilation and keep the nasal mucosa moist. Decongestant nasal sprays with the long-established active ingredient xylometazoline help to clear a blocked nose. The active ingredient dexpanthenol additionally supports the healing of the irritated nasal mucosa. Decongestant nasal sprays help to clear a blocked nose.

  • Red light therapy can also help: The warm light stimulates local blood circulation and thus increases the metabolic activity of the inflamed tissue 3 .

  • Proper nose blowing: Hold one nostril closed at a time and gently blow into a tissue. This effectively removes the mucus from the nose. A loud "whistling" sound, however, indicates that you are applying too much pressure. This risks forcing the mucus, along with any germs, not only into the tissue but also into the sinuses and potentially even the middle ear.

Treatment for chronic sinusitis

In severe cases with bacterial infections, doctors may prescribe antibiotics and painkillers. Other treatment options range from cortisone preparations and nasal irrigation to surgical procedures, such as straightening the nasal septum or removing nasal polyps. The home remedies mentioned above can also be helpful in treating chronic sinusitis.

Is sinusitis contagious?

Whether sinusitis is contagious depends on its cause. Acute sinusitis is contagious when caused by cold viruses. As with a common cold, these pathogens can then spread through droplet and contact infection. You can learn more about the risk and duration of infection in our article about the common cold. If symptoms persist or worsen, it is advisable to search for an ENT specialist near me to receive a proper diagnosis and appropriate treatment.

Frequently Asked Questions

  1. Sinusitis – when to see a doctor?

If you suspect you have sinusitis, you should always seek medical advice. It is particularly important to see your doctor immediately if you experience severe facial and headaches, visual disturbances, persistent high fever, swelling or redness around the eyes, confusion, or sensitivity to light.

  1. Sinusitis – how long is it contagious?

The risk of contagion associated with sinusitis depends on the cause. For example, if viruses have caused the inflammation, there is a risk of infection as long as symptoms are present. Avoid close contact with others to reduce the risk of droplet or contact infection.

  1. What helps with sinusitis?

The treatment for sinusitis aims to clear the nasal passages, reduce inflammation, and thus alleviate symptoms. Decongestant nasal sprays can help clear the nose and facilitate mucus drainage. Additionally, red light therapy can stimulate local blood circulation. Antibiotics may be necessary in cases of bacterial infection. It is important to discuss treatment with a doctor. 

  1. What is sinusitis?

Sinusitis, also known as inflammation of the sinuses, is an inflammation of the mucous membrane lining the sinuses. It often occurs as a result of a common cold, during which the nasal mucosa swells due to inflammation and produces more mucus. This thick mucus can block the connections between the nasal passages and the sinuses, causing the mucus, along with any pathogens, to remain in the sinuses and potentially lead to inflammation. 

  1. How long does sinusitis last?

Acute sinusitis should heal completely within 12 weeks. If symptoms persist longer, it could be chronic sinusitis, which requires further medical evaluation and treatment.

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