Service Introduction

Endoscopic Sinus + Septoplasty

Dr. Farhad Farahani - Endoscopic Sinus Fellowship from Austria

Endoscopic Nose and Sinus Surgery

Sinus Infection

Introduction:

Sinus infection or sinusitis is actually a sinus inflammation with an infectious cause that manifests itself with headache, pressure on the eyes, nose, cheek area or on either side of the head. A patient with a sinus infection may present with cough, fever and bad breath. Nasal congestion in the back of the throat is among other symptoms.

1f Sinus infections are classified into two major categories: acute (less than a few weeks) and chronic (more than three months).

Anatomy of the Sinus

The human body has 4 pairs of respiratory sinuses that have the role of warming and humidifying respiratory air along with lightening the weight of the skull. In addition, it also acts as a shock absorber against blows. Another function of the sinuses is to influence the quality of sound.

2f- Frontal sinus (in front of the forehead)

Maxillary sinus (behind the upper jaw)

Ethmoid sinus (between the eyes)

Sphenoid sinus (behind the eyes)

The sinuses normally have a natural defense against infections, but anything that happens in the cellular defense makes them susceptible to infection. And in the continuation of this infection, tissue destruction and inflammation and bacteria can adhere to the mucosa and the infection becomes chronic.

Acute sinus infection is an infection that in most cases lasts less than 4-6 weeks. Treatment is mainly antibiotics. And effective treatment, while eradicating the infection, causes the reconstruction of the mucosa and local defense. Chronic sinusitis lasts more than three months. And its symptoms are more severe than acute sinusitis.

Causes of Sinusitis

The underlying factor of acute sinusitis in most cases is a viral infection. However, air pollution and allergic rhinitis may also cause acute sinusitis. All of the above factors cause the sinus opening in the OMC (osteomeatal complex) area to close. Obstruction and destruction of the mucosa provide the basis for bacterial colonization, leading to a condition called sinusitis. The bacteria that cause the above infection are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. In addition to the above bacteria, anaerobes and Staphylococcus aureus also play a role in chronic sinusitis. The role of fungi has also received much attention in recent studies, especially in people with immunodeficiencies such as diabetes, AIDS, and malignancies.

Symptoms of a sinus infection

Symptoms of a sinus infection depend on whether it is acute or chronic and the sinus involved:

Acute sinusitis:

Ethmoid sinusitis

The pain is usually felt behind the eyes. Nasal congestion and discharge from the back of the throat along with pain in the inner part of the eye and nose are other symptoms. Headache and pressure caused by sinusitis are worse with coughing and bending the head forward.

Maxillary sinusitis

The pain is usually felt behind the cheek over the upper teeth but may extend towards the eyes. Other symptoms are similar to ethmoid sinusitis, but fever is more common.

Frontal sinusitis

The pain is located behind the forehead and other symptoms are the same as other sinusitis.

Sphenoid sinusitis

The pain of this sinusitis is felt in the back and top of the head, extending to the forehead and eyes. Its complications include visual impairment and double vision.

Chronic sinusitis:

Ethmoid sinusitis

Chronic nasal discharge, feeling of congestion and pain that worsens in the mornings, especially with the use of glasses, and chronic sore throat.

Maxillary sinusitis

Pain is below the eye, the pain worsens with colds and flu.

Frontal sinusitis

Mild headache is felt behind the forehead. A history of trauma to the frontal sinus can usually be found.

Sphenoid sinusitis

Mild headache at the back of the head is usually the only symptom.

Diagnosis

The basis of diagnosis is based on history and examination. In most cases, there is a history of respiratory infection before sinusitis develops.

In most cases, the diagnosis can be made based on the above findings, but when another diagnostic method is needed, a CT scan is selected. This imaging method may reveal that one or more sinuses are involved. Involvement may be in the form of air-fluid levels, complete obstruction, and complete sinus involvement, or mucosal thickening of the sinus walls.

Mucosal thickening may also occur in patients without sinusitis, so it is essential to pay attention to concomitant symptoms. Before the use of CT SCAN in the diagnosis of sinusitis, plain nasal X-ray WATER and CAD WEL were used, which have now been shown to be non-diagnostic in more than half of cases.

7 If symptoms persist or if CT shows refractory disease, the patient needs to be referred to an otolaryngologist.

8 In the evaluation of a patient with sinusitis by an otolaryngologist, in addition to a thorough history and examination, an endoscopic examination of the nose and sinuses is performed, which may confirm the symptoms of sinusitis, including a deviated septum, polyps, OMC obstruction, or adenoids.

In special cases, a culture is also taken from the affected sinus, and effective antibiotics can be prescribed based on the results.

When is it necessary to see a doctor for treatment?

Patients should see a doctor when they have a headache in the upper part of the face, accompanied by nasal congestion, phlegm at the base of the throat, and bad breath. Fever is not a symptom of acute sinusitis, but if a patient with a cold suddenly develops fever and headache at the end of the recovery period, it is necessary to examine the sinuses.

Swelling in the forehead, severe pain, and redness or swelling of the eyes are other symptoms that may indicate complications of sinusitis.