Chronic sinusitis is an illness that can make you feel symptomatically miserable. It is often under-diagnosed or misdiagnosed. No one wishes to have disrupted sleep at night; getting-up multiple times to sneeze or to clear a blocked nose. Chronic sinusitis is best treated by an ENT doctor who can help address this recurring malady. If you are in Singapore, the ENT Clinic serves you with excellent care for chronic sinusitis and other nasal conditions.
What is Chronic Sinusitis?
Chronic sinusitis which is sometimes referred to as chronic rhinosinusitis is an inflammatory condition that causes the sinuses – the spaces inside your nose and head – to swell and remain inflamed for over three months. Unlike acute sinusitis which is controlled quite well through standard antibiotics, chronic sinusitis persists even with treatment. It interferes with the way mucous normally drains, leading to a nose stuffy. The area under the eyes could also feel stuffy and tender.
What Causes Chronic Sinusitis?
There could be many reasons behind your chronic sinusitis. Some of the most common factors include:
- Blockage in the sinuses: Nasal polyps are a common cause associated with about 20% of the chronic sinusitis cases. In addition, facial and nasal damage, tumors can also harbor chronic infection. Individuals who have a deviated septum have a higher tendency to develop chronic sinusitis.
- Unconventional fungal infections: Standard antibiotics are able to clear-up acute sinusitis, however, sinusitis caused by fungal infections and antibiotic-resistant infections, take time to leave the body.
- Exposure to Allergens and Irritants: Individuals who have allergies and asthma, have a higher chance to develop chronic sinusitis due to the build-up of pressure and the irritation caused due to the presence of irritants in the nasal passages. Nasal allergens like dust particles, pollen, and chemicals cause the nasal lining to inflame due to irritation.
- Formation of Biofilms: Colonies of bacteria bind together to create a thick film. These are highly resistant and difficult to remove. A nasal douche or surgery might be needed to treat the condition.
- Reduced Immunity: Patients with a weakened immune system find it hard to fight infections making them more vulnerable to chronic sinusitis.
What are the symptoms associated with Chronic Sinusitis?
Victims of chronic sinusitis can face multiple symptoms together, which makes it a very troublesome ailment affecting daily life. Common symptoms associated are:
- Inflammation in the nasal cavity
- Thick yellow colored nasal discharge
- Postnasal drip
- Nasal congestion and obstruction
- Difficulty in breathing
- Discomfort in the facial area due to pressure or pain
- Tenderness around eyes, cheeks, and forehead
- Ear pain
- Cough and Sore-throat
- Being tired
The symptoms of acute and chronic sinusitis are similar, but chronic sinusitis has symptoms lasting more than 12 weeks.
When should you schedule an appointment with an ENT Specialist?
- If you are a victim of recurrent sinusitis and your symptoms are not improving with treatment
- Prolonged sinusitis for over 10 days
- Continued symptoms which don’t improve with treatment
However urgent attention is needed if you have:
- An increased body temperature
- Swelling in the forehead
- Severe headaches
- Blurred vision
- Redness around eyes
How is chronic sinusitis diagnosed?
Your sinus specialist will conduct a physical examination in your nasal cavity to check for inflammation, redness, and tenderness. In addition, some of the common diagnostic techniques are:
- Nasal Endoscopy: Your ENT doctor will examine your nasal and sinus passages using an endoscope. It is a thin, flexible tube with a lighting element and a camera attached to the end. This helps with a thorough examination of your nasal cavity.
- Nasal Scans: Imaging done through CT and MRI scans can reveal the deep structures in your sinuses, helping to pinpoint any physical obstruction or inflammation which might not be easy to view with an endoscope.
- Patch Testing: A simple skin test that is done to reveal your allergy status. This rapid test allows your specialist to identify which irritants cause your allergy. This is recommended, as patients with allergies have a higher chance of chronic sinusitis.
- Nasal Cultures: A nasal swab, cultured in a laboratory will help to identify if the patient has a resistance to the standard treatment of antibiotics. This will help the ENT doctor to prescribe the most suitable medications to manage the condition.
What complications can occur due to Chronic Sinusitis?
- Infections: Although rare, patients may sometimes develop meningitis which is an inflammatory condition in tissues, surrounding the brain and spinal cord. It can also lead to skin and bone infections.
- Blurred Vision: If the infection spreads through the eye socket, it can reduce vision causing permanent blindness in rare cases.
What are the treatment options for chronic sinusitis?
There are a number of treatment options that your ENT doctor will discuss with you. These options will depend on the severity of the symptoms and the extent of the condition. Some of the common methods include:
- Nasal Rinse with Saline: Flushing the nasal cavity with nasal sprays and saline is the preferred first line of treatment, which helps to reduce drainage rinsing off any persisting allergens and irritants.
- Medication to improve nasal inflammation: Nasal sprays with corticosteroids help to relieve inflammation and irritation. Some of the commonly used products include fluticasone, triamcinolone, and beclomethasone
- Oral or injected inflammation reducing agents: In cases of severe chronic sinusitis, especially when nasal polyps are present, it is a common practice to use oral corticosteroids, although long-term use is not advised.
- Antibiotics: Sinusitis caused by a bacterial infection is treated with antibiotics. The causative agent is determined through a nasal swab culture and treatment given accordingly if the patient is not responding to the standard antibiotics.
- Hyposensitisation therapy: Patients with severe allergies receive immunotherapy through allergy shots to improve the existing allergy condition.
- Surgery: If the above conservative treatments are not working, the patient would be recommended for surgery. The common procedure is endoscopic sinus surgery, which involves the removal of small bony partitions, between the sinuses in the nasal passage which facilitates draining. It is a safe operation that can be done within two to four hours. Post-surgery, one needs to rest for a couple of days and take the prescribed medication on schedule, avoiding any strenuous activities. The patient will be called for follow-up care which is necessary for recovery.
What steps can you take to prevent chronic sinusitis?
- Allergy Management: Speak to your ENT doctor on how well you can manage your allergies. Avoid exposure to allergens you are aware of or get a skin test done to identify your allergens.
- Keeping away from cigarette smoke and polluted air: Cigarette smoke carries contaminants which cause the nasal passage to have irritation.
- Avoiding chemical irritants: Chemical irritants too can harm the nasal passage causing irritation and inflammation.
- Good hand hygiene: Keeping your hands clean and avoiding touching your face will help in minimizing your chances of upper respiratory tract infections.
- Using a humidifier: By using a humidifier you help to reduce the dry air circulating in your house. Frequent cleaning of the humidifier is important though.
Following the guidance of an ENT specialist is vital to gaining recovery. The ENT Clinic Singapore offers modern diagnostic techniques and treatment options for your chronic sinusitis. This is among the leading choices for ENT patients to consider when seeking personalized care in a modern and comfortable setting with highly trained and experienced otolaryngologists.