Sinuses are air cavities located in the facial bones, consisting of 4 pairs: the 1st pair is in the cheekbones, the 2nd pair is between the eye sockets and the sides of the nose, the 3rd pair is in the frontal skull between the two eyebrows, and the 4th pair is in the base of the skull. Inside each sinus cavity, there is a sinus membrane that produces mucus to trap dust and pathogens.
Why do sinuses become inflamed?
Sinusitis is a condition where the lining of the air cavities beside the nose becomes inflamed and swollen due to infection. This causes symptoms such as nasal congestion, nasal pain, thick mucus, eye pain, cheekbone pain, forehead pain, or toothache, along with coughing. If observed closely, the breath may also have a foul odor.
Viruses and bacteria are the culprits
About 90% of sinusitis cases are caused by viral infections. Most patients without complications or severe disease progression will recover on their own within 10 days after taking symptomatic treatment.
Sinusitis caused by bacterial infection accounts for about 5-10% of cases and requires treatment with antibiotics because symptoms do not resolve on their own like viral infections. Symptoms often worsen on the 5th day of inflammation, requiring prolonged treatment and medication for more than 10 days.
Factors that cause frequent or chronic sinusitis?
The causes of frequent or chronic sinusitis often include:
- Having allergies, especially allergic rhinitis and asthma
- Having nasal tumors or a deviated nasal septum
- Having a weakened immune system
- Smoking or being in environments with polluted air, dust, smoke, or chemicals
How to confirm if it is sinusitis?
Because sinusitis symptoms are similar to those of a common cold, besides having nasal congestion that makes breathing difficult and thick mucus in or dripping down the throat, sinusitis will also cause pain in areas corresponding to the sinus locations. If symptoms are more severe than a common cold, such as severe headache, high fever, double vision, swelling and pain around the eyes, nose, forehead, or cheeks, or if cold medicine does not improve symptoms or the illness lasts more than 10 days, especially for those with a history of sinusitis, it is advisable to see a doctor promptly.
How do doctors diagnose sinusitis?
When a patient visits a doctor, the doctor will take a history and ask about symptoms along with a physical examination to check if the nasal mucosa is inflamed, swollen, red, or has pus. The doctor will also check for pus in the throat and press on various facial points to locate sinus inflammation.
Additionally, the doctor may use a method called Nasal Endoscopy, which involves inserting an endoscope through the nose to check for inflammation or pus in the sinuses.
Special diagnostic tools can also clearly confirm whether it is sinusitis or not. These tests include a CT scan (Computed Tomography Scan) and MRI (Magnetic Resonance Imaging) to create images of internal organs. The doctor will diagnose based on these images whether there is fluid in the sinus areas and which sinuses are affected.
Treatment of sinusitis
Generally, initial self-care involves symptomatic treatment such as taking fever reducers and pain relievers, decongestants, and nasal saline irrigation. These measures usually relieve acute sinusitis symptoms and lead to recovery within 2-4 weeks. However, if symptoms do not improve or worsen after about 1 week, it is better to see a doctor who will provide the following treatments.
Medical treatment for sinusitis
Doctors may prescribe steroid nasal sprays to reduce inflammation and swelling of the nasal mucosa or steroid drops mixed in saline for nasal irrigation. For severe cases, oral steroids may be considered. All steroids must be used under medical supervision. Other treatments include medications to relieve nasal congestion. Antibiotics are only used for bacterial sinusitis.
Treatment of sinusitis with surgery
If medication treatment is ineffective, doctors may recommend Functional Endoscopic Sinus Surgery (FESS), which uses special instruments to perform surgery through an endoscope. Patients will receive local or general anesthesia depending on the severity of the condition.
Currently, there is a surgical method called Innovative Full House FESS, where the surgeon opens the sinus cavities widely to connect all 4 pairs of sinuses. This allows the removal of thick mucus and pus trapped inside the sinuses, directly reducing inflammation, improving airflow in the sinuses, and enabling more effective delivery of sinus medications compared to older surgical methods. The Full House FESS uses a high-resolution endoscope, minimizing injury and preventing nasal mucosa wounds. Computerized tomography imaging guides the surgery, ensuring precise treatment and reducing the risk of complications. After surgery, patients do not have to endure the discomfort of nasal packing or pain when removing packing materials as in traditional surgeries.
Sinusitis is a condition that often recurs if not properly treated. Therefore, if patients have tried various treatments but still experience recurrent sinusitis, they may consider undergoing Full House FESS surgery, which is an innovative procedure that reduces recurrence and increases the chance of complete recovery.
