Most of us tend to associate a stuffy, runny nose with the common cold or allergy. However, sinus infection or sinusitis may be the reason behind these symptoms, especially if it doesn’t get better in a few days. Inflammation or swelling of the tissues that line the sinuses is termed sinusitis. Sinuses are empty spaces in the skull and the facial bones around the nose, connected by narrow channels. There are 4 pairs of sinuses in the head:

• Maxillary sinuses, one on each side of the nose, near the cheekbones
• Frontal sinuses, located above the eyes
• Ethmoid sinuses, present on each side of the bridge of the nose, near the eyes
• Sphenoid sinuses, present behind the eyes

Sinuses make thin mucus that keeps the nose clean and free of microorganisms. Sometimes, these sinuses get filled with fluid, allowing microorganisms to grow, resulting in sinusitis. Though most sinus infections clear on their own within 2 to 3 weeks, medical attention could be required in some cases. 

Types of sinus infections

• Acute sinusitis: Sudden onset of cold-like symptoms such as runny nose, headache, and facial pain that stays for more than 10 days, is referred to as acute sinusitis. It is a temporary inflammation of the sinuses as the infection can be cleared effectively with the help of decongestants.
• Chronic sinusitis: Chronic sinusitis is the term used when the sinus inflammation is aggressive and stays for more than 12 weeks or recurs more than three times a year. 

What are the signs of a sinus infection?

Some of the common symptoms of sinusitis include:

• Persistent pain around the cheeks, eyes or forehead
• Headache
• Fever 
• Blocked or runny nose
• Breathing from the mouth
• Reduced sense of smell
• Cough 
• Discharge of yellow or green coloured mucus from the nose
• Mucus dripping down from the nasal passage to the throat (post-nasal drip)
• Toothache 
• Bad breath
• Irritability and difficulty feeding (observed in infants and young children).

What causes sinus infections?

Sinus infections occur when fluid builds up in the air sacs in the skull and on either side of the nasal cavity, allowing microorganisms such as bacteria, viruses or fungi to grow and block the sinuses. The reasons for fluid build-up in the sinuses include:

• Common cold
• Seasonal allergies such as allergies to mould or pollen
• Nasal polyps (growths inside the nose)
• Deviated nasal septum (cartilage that divides the nose) causing a blockage
• Weak immune system (either due to illness or medications) 
• Smoking.

How to prevent sinus infections?

Measures that may help prevent sinusitis include:  

• Maintaining hand hygiene by washing hands frequently with soap and water.
• Drink enough water to ensure the sinuses are draining well.
• Get flu and pneumococcal vaccines every year.
• Avoid close contact with people suffering from colds or other upper respiratory infections.
• Avoid smoking or second-hand smoke.
• Use a humidifier to moisten the air at home.
• Practice steam inhalation and nasal irrigation with salt water frequently. 

Can sinus infections be treated?

In most cases, the sinus infection gets better without requiring medical care. However, in some cases, medications would be required to prevent the spread of the infection. The treatment of sinusitis include:

• Getting proper rest.
• Drinking enough water to stay hydrated.
• Avoiding allergens such as pollens, dust mites or particulate matter in the air, that may trigger inflammation.
• Taking over-the-counter available painkillers such as paracetamol or ibuprofen.
• Using a decongestant or saline nasal spray to clean the nasal congestion.
• Applying warm compresses over the nose and forehead to relieve sinus pressure.
• If the infection is on both sides of the face, sleeping with the head elevated is recommended. If the pain is unilateral, one must try sleeping on the pain-free side of the face. 

Sometimes medications such as antibiotics, antihistamines, and steroid decongestants may be prescribed to reduce the swelling and treat the infection. A surgical procedure called functional endoscopic sinus surgery (FESS) may need to be performed to treat chronic sinusitis. The procedure involves opening the blocked sinuses by removing the clogging tissue or by inflating a tiny balloon in the sinus.

When to contact the doctor?

Sinuses are surrounded by several vital organs such as the brain and the eyes. Thus, it is important to ensure that the infection from the sinuses does not spread to these areas.

Signs that indicate the need to contact a doctor include:

• Severe headache
• Persistent high fever
• Swelling of the cheek, forehead or roof of the mouth
• Mental confusion 
• Stiffness in the neck
• Swelling, redness, and pain in one or both the eyes 
• Impaired vision
• Difficulty in breathing, swallowing or speaking.

Conclusion

Anyone can be affected by sinusitis but smokers and those diagnosed with seasonal allergies, nasal polyps, asthma, and abnormal nasal anatomy are at increased risk of developing the infection. Though sinusitis is not contagious, one can spread the virus that may lead to the infection. Hence, it is important to wash hands properly and cover the nose and mouth while sneezing or coughing to prevent the spread of the microorganisms. A doctor must be consulted if the symptoms of sinusitis exacerbate.

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