Chronic sinusitis: what it is, symptoms and treatment

Chronic sinusitis, which is the inflammation of the sinus mucosa, is characterized by the permanence of sinus symptoms, such as pain in the face, headache and cough for at least 12 consecutive weeks. It is usually caused by resistant bacteria, previous use of antibiotics in excess, or incorrect treatment of sinusitis, as well as poorly controlled allergic rhinitis, changes in the airways, such as deviated septum, or weakened immunity.

Its treatment includes nasal flushing with saline and the use of medications such as antibiotics, anti-allergy agents or corticosteroids, prescribed by the ENT, according to the cause of the inflammation. In some cases, surgery to drain the accumulated mucus and or to correct changes in the nasal septum or removal of nodules may be recommended to allow the disease to cure.

It is very important that sinusitis is treated properly, as there is a risk of complications such as asthma attacks, pneumonia, meningitis, eye infection or even brain abscesses.

Main symptoms

The symptoms of chronic sinusitis last for more than 12 weeks, and can occur after 1 or several episodes of acute sinusitis, in which there is fever, body pain and intense nasal discharge. In the chronic phase, the main symptoms are:

• Pain in the face or headache that gets worse when lowering the head or lying down; Persistent pain located in the cheekbones, around the nose and around the eyes; Secretion through the nose, yellowish or greenish color; Bleeding from the nose; Sensation of pressure inside the head, obstruction of the nose and ear and dizziness; Chronic cough, which worsens at bedtime; Constant bad breath.

In addition, when sinusitis has an allergic cause or occurs in people with a history of allergy or rhinitis, there may be asthma attacks, itchy nose and throat, in addition to worsening symptoms when in contact with substances such as dust.

How the treatment is done

To treat chronic sinusitis, the otorhino may indicate the use of remedies such as:

• Antibiotics, such as Amoxicillin / Clavulonate, Azithromycin or Levofloxacin, for example, are only used for cases of bacterial infection. Usually, they are done for 2 to 4 weeks, because, in chronic sinusitis, the infection is usually resistant; Mucolytics and decongestants, such as Ambroxol, to decrease the viscosity of secretions; Anti-inflammatories or corticosteroids, such as Nimesulide or Prednisone, help to reduce inflammation and local swelling; Antiallergic agents, such as Loratadine, more indicated for cases of sinusitis in people with allergies; Nasal corticosteroids, such as Budesonide, Fluticasone and Mometasone, help fight inflammation and allergies in the airways; Nasal wash with saline or water and salt preparations. Check out the recipe to prepare a homemade saline solution for sinusitis; Nebulization with water vapor or saline to fluidize secretions;

The use of nasal decongestants containing Nafazoline, Oxymetazoline or Tetrahydrozoline, such as Sorine, for example, should be done with caution, for less than 3 weeks, as they cause a rebound effect and dependence.

During the treatment of chronic sinusitis, it is recommended to follow up with the ENT to investigate the cause of the inflammation. Thus, although the diagnosis of acute sinusitis is made through the clinical evaluation of the doctor and does not require tests, in chronic sinusitis tests such as computed tomography of the face, nasal endoscopy and collection of nasal secretion samples may be necessary to identify the microorganism and the exact cause of the problem.

Home remedies options

A great way to help eliminate nasal secretions, as a complement to treatment guided by the doctor, in addition to nasal washing with saline solution, is the inhalation of steam from plants such as eucalyptus or chamomile, for example. Learn how to do these home treatments in the following video:

When surgery is indicated

The objective of the surgery is to enlarge or unblock the natural drainage channels of the sinuses, which may be closed and preventing the drainage of the secretion, which is accumulated and stimulates the proliferation of fungi and bacteria.

In addition, the procedure can also be combined with the correction of some defect in the anatomy of the nose, which may also be making it difficult to cure the infection, such as correction of the septum, removal of the adenoids or reduction in the size of the turbinates, which are the spongy tissues inside the nose.

Learn more about how it is done, risks and recovery from sinus surgery.

Possible complications

Chronic sinusitis, when not properly treated and controlled, can worsen over time and cause an accumulation of secretion, forming an abscess, and inflammation and infection can reach organs close to the nasal cavities, such as the eyes or the brain.

The infection can also trigger asthma attacks, especially in children, and pneumonia or even reach the bloodstream and cause a generalized infection.

Main causes

Chronic sinusitis is more common in people who:

• They did incorrect treatment of other acute sinusitis; They used antibiotics wrongly or unnecessarily, repeatedly; Have severe or poorly controlled asthma or allergic rhinitis; Have gastroesophageal reflux; They have weakened immunity, like HIV carriers, use corticosteroids in a chronic way or uncontrolled diabetics; Had a hospital stay or had recent surgery; They suffered a blow to the face; They have changes in the airways, such as deviated septum, nasal polyps or hypertrophy of the nasal turbinates.

Thus, in order to avoid chronic sinusitis or to treat it properly, it is very important to resolve these situations.