Sinusitis Health Article

Definition

Sinusitis is an inflammation of the sinuses, which are airspaces within the bones of the face. Sinusitis is most often due to an infection within these spaces.

Description

The sinuses are paired air pockets located within the bones of the face. There are:

• the frontal sinuses, located above the eyes, in the center region of each eyebrow
• the maxillary sinuses, located within the cheekbones, just to either side of the nose
• the ethmoid sinuses, located between the eyes, just behind the bridge of the nose
• the sphenoid sinuses, located just behind the ethmoid sinuses, and behind the eyes.

The sinuses are connected with the nose. They are lined with the same kind of skin found elsewhere within the respiratory tract. This skin has tiny little hairs projecting from it called cilia. The cilia beat constantly to help move the mucus produced in the sinuses into the respiratory tract. The beating cilia sweeping the mucus along the respiratory tract helps to clear the respiratory tract of any debris or of any organisms that may be present. When the lining of the sinuses is at all swollen, the swelling interferes with the normal flow of mucus. Trapped mucus can then fill the sinuses, causing an uncomfortable sensation of pressure and providing an excellent environment for the growth of infection-causing bacteria.

Demographics

It is estimated that about 37 million Americans are affected by sinusitis each year. Having a cold increases the chance of getting sinusitis. Immune system disorders also increase this likelihood. Children with asthma are also considered more likely to be affected by sinusitis.

Causes and symptoms

Sinusitis is usually due to an infection, although swelling from allergies can mimic the symptoms of pressure, pain, and congestion, and allergies can set the stage for a bacterial infection. Bacteria are the most common cause of sinus infection. Streptococcus pneumoniae causes about 33 percent of all cases, while Haemophilus influenzae causes about 25 percent of all cases. Sinusitis in children may be caused by Moraxella catarrhalis (20%). In people with weakened immune systems (including patients with diabetes, acquired immunodeficiency syndrome or AIDS, and patients who are taking medications that lower their immune resistance, such as cancer and transplant patients), sinusitis may be caused by fungi such as Aspergillus, Candida, or Mucorales.

Acute sinusitis usually follows some type of upper respiratory tract infection or cold. Instead of ending, the cold seems to linger on, with constant or even worsening congestion. Drainage from the nose often changes from a clear color to a thicker, yellowish-green. The individual may develop a fever. Headache and pain over the affected sinuses may occur, as well as a feeling of pressure that may worsen when the patient bends over. There may be pain in the jaw or teeth. Some children, in particular, get upset stomachs from the infected drainage going down the back of their throats and being swallowed. Some patients develop a cough.

Chronic sinusitis occurs when the problem has existed for at least three months. There is rarely a fever with chronic sinusitis. Sinus pain and pressure are frequent, as is nasal congestion. Because of the swelling in the sinuses, they may not be able to drain out the nose. Drainage, therefore, drips constantly down the back of the throat, resulting in a continuously sore throat and bad breath.

When to call the doctor

If the child is displaying the signs of sinusitis for more than a few days, the doctor should be contacted. If a cold seems to be getting better and then gets worse again, it may have developed into sinusitis. Likewise, colds that linger beyond a week may indicate sinusitis, and the doctor should be called.