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Sinusitis: Chronic Sinusitis
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Chronic Sinusitis is Sinusitis lasting as long as 12 weeks. The diagnosis is confirmed by the major and minor clinical factors complex described previsouly with or without findings on the physical examination. A strong history consistent with chronic Sinusitis includes the presence of two or more major factors or one major and two minor factors. A history suggesting that chronic sinusitis should be considered in the differential diagnosis includes two or more minor factors or one major factor. Facial pain does not constitute a strong history in the absence of other nasal factors. Cultures may be of particular value in identifying resistant microbial flora.
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Sinusitis is one of the most common health conditions in the United States. It is estimated that more than 37 million people suffer from sinusitis and sinusitis-related conditions each year and that more than 13 million people visit their physician each year due to chronic sinusitis.
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Sinusitis starts as a result of blockage of the drainage pathway of the sinuses. This blockage can occur as a result of an anatomical obstruction, swelling due to a cold or allergy, or chronic recurrent sinus infections. When this occurs, mucus that normally is expelled from the sinus builds up in the sinus. This can cause pressure or pain. In addition the mucus is an excellent culture medium for bacteria. If the mucus is not cleared immediately, a bacterial infection exists until the blockage is cleared and the sinuses drain nornally again.
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Sinusitis is defined as chronic if it has been ongoing for more than 8 to 12 weeks. Doctors do not understand exactly what causes chronic sinusitis but it may follow a viral infection, a severe allergy, or exposure to an environmental pollutant. Often the person has a family history; a genetic predisposition appears to be a factor. If the person has a bacterial or fungal infection, the inflammation is much worse. Occasionally, chronic sinusitis of the maxillary sinus results when an upper tooth abscess spreads into the sinus above.
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Sinusitis is treated with a decongestant and steam inhalation to open the nasal passages. Applying a warm, moist washcloth to the painful areas and taking a non-prescription pain reliever can help relieve inflammation and pain. If a decongestant does not relieve symptoms within a few days, or if symptoms are severe, your doctor will prescribe an antibiotic. People with chronic sinusitis or sinusitis caused by a fungus may need to have surgery to drain the sinuses, remove nasal polyps, or correct a nasal defect. Frequent sinusitis in children is usually relieved by surgery to remove the adenoids. Sinusitis caused by allergies may be treated with nasal sprays and antihistamines.
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Sinusitis is often confused with rhinitis, a term used for the symptoms that accompany nasal inflammation and irritation. The symptoms of rhinitis and sinusitis can be very similar. Although rhinitis only directly involves the nasal passages, the nasal congestion can cause facial pain and the postnasal drip can cause cough. Underlying conditions like allergies or structural abnormalities can cause chronic sinusitis and/or rhinitis, or can produce symptoms that mimic sinusitis. A computed tomography (CT) scan can determine if the sinuses are actually involved.
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Chronic Sinusitis