What is sinusitis?

Written by Xu Qing Tian
Otolaryngology
Updated on September 01, 2024
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Sinusitis is a nonspecific inflammation of the sinus mucosa, a common and frequently occurring illness. Its onset is often due to diseases of the nasal cavity such as nasal polyps, allergic rhinitis, deviated nasal septum, hypertrophy of the nasal turbinates, or nasal cavity tumors that block the sinus ostia, all of which can lead to sinusitis. Patients with sinusitis typically experience symptoms such as nasal congestion, purulent nasal discharge, and headaches. Usually, a diagnosis requires sinus CT scans, either plain or enhanced, to confirm the occurrence of sinusitis. Once diagnosed, most cases of sinusitis can be alleviated with oral medication. However, a small number of patients who are difficult to cure may need surgery to open the sinus ostia and maintain drainage, thus curing the sinusitis.

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How to check for sinusitis?

The examination for sinusitis is mainly divided into three major categories. The first category is visual inspection. The second is endoscopic examination, and the third is radiologic examination. Visual inspection mainly involves directly observing with the naked eye the mucosa inside the nasal cavity, the inferior turbinate, and assessing the presence of thick nasal mucus. For some patients, a basic diagnosis can be made through visual inspection alone. However, for other patients whose conditions are not very clear, it becomes necessary to use endoscopic examinations, such as nasal endoscopy or fiberoptic nasopharyngoscopy, to visually inspect the interior of the nasal cavity and the nasopharynx for any abnormalities. If the inflammation is severe and conservative medical treatment is ineffective, it may also be necessary to consider a CT scan of the sinuses to make a clearer and more accurate diagnosis.

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Can sinusitis heal on its own?

Sinusitis may recover on its own. This primarily depends on the extent of the specific inflammatory responses, as well as clinical symptoms and the patient's own immunity. If the sinusitis is very mild, the clinical symptoms are not severe, and the patient's immunity is relatively strong, recovery is indeed possible. Additionally, with acute sinusitis, some patients naturally tend to recover on their own. However, in cases of chronic sinusitis or severe inflammatory responses in acute sinusitis, where symptoms like nasal congestion, purulent nasal discharge, headaches, and dizziness are more pronounced, it is generally advisable to consider timely medical treatment. It may also be beneficial to incorporate saline nasal washes and schedule regular follow-up examinations to observe effects.

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What are the symptoms of sinusitis?

The clinical symptoms of sinusitis vary widely among individuals, and in general, it is considered a common illness. The most frequent clinical manifestations include nasal congestion, purulent nasal discharge, reduced sense of smell, headaches, and dizziness. Some patients may also experience facial pain and numbness; however, specific symptoms vary from person to person. Some may exhibit only one symptom, while others may experience two to three, or even multiple symptoms, with the disease demonstrating recurrent and fluctuating patterns. In terms of treatment, medication remains the primary approach, supplemented by nasal irrigation. Only a small fraction of patients, whose symptoms do not improve with conservative medication treatments or who suffer from particularly severe inflammatory reactions like fungal sinusitis, may consider surgery.

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What medicine is good for sinusitis?

Sinusitis is mainly caused by acute inflammatory infections, such as Staphylococcus aureus or Streptococcus pyogenes. When a patient's immunity and resistance are low, these bacteria can invade the sinuses through the sinus openings, leading to congestion, swelling, proliferation, and exudation of the sinus mucosa. Patients will experience persistent nasal congestion and discharge of yellow purulent secretions from the nasal cavity. Additionally, patients may also experience fever, facial swelling and pain, headaches, dry mouth, coughing, and other related symptoms. Upon examination, bilateral nasal turbinate mucosal congestion and swelling can be found, and yellow secretions may be seen adhering in the middle nasal meatus or common nasal passage. In terms of treatment, as it is a bacterial infection, patients firstly need symptomatic anti-inflammatory treatment. Oral cephalosporin antibiotics are effective. Moreover, using saline to rinse the nasal cavity also provides very good results. If necessary, patients may require endoscopic sinus surgery for recovery. (Please use medication under the guidance of a professional physician.)

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How to treat sinusitis?

The treatment for sinusitis primarily involves conservative medication, as well as surgical procedures. Generally, conservative medical treatment is the standard first-line method. In terms of treatment methods, antibacterial therapy is mainly used, along with the oral administration of traditional Chinese medicine preparations, and mucolytic agents, which help alleviate sinus inflammation and facilitate the discharge of secretions from the nasal and sinus cavities. Additionally, nasal irrigation with saline solution can be considered to further improve the condition. If standardized medical treatment is ineffective, or in cases of fungal sinusitis, we may consider conducting minimally invasive sinus surgery using nasal endoscopy. Overall, the outcomes of surgical treatment are usually quite good, but regular follow-up examinations are needed to check for any recurrence of the condition.