What Is Acute Sinusitis

Overview

Acute sinusitis (or rhino sinusitis) is short-term inflammation of the tissue lining the sinuses. With this condition, you typically experience swelling and a throbbing sensation around the nasal cavity due to a pressure build-up in the sinuses. 

Your sinuses are an essential element of the respiratory system. They produce mucus drained through the nose, thus expelling inhaled substances like pollutants, allergens and pathogens. They also optimise breathing by humidifying and warming air which is beneficial for our respiratory health.^{1, 2} Additionally, the sinuses protect your facial features in the event of trauma and improve speech resonance.¹ Usually, the sinuses are filled with air because produced mucus is drained through the nose. If there is a blockage in the channels connecting the sinus cavities to the nose, you experience the fluid build-up characteristic of acute sinusitis.

Sinusitis is a common condition induced by various causes, which will be explored in this article. Typically, it clears up within 2 to 3 weeks without treatment. Still, if symptoms last over 12 weeks, the condition is said to have advanced to a chronic sinus infection. In that case, you should seek medical attention because the effects are more severe.

This article will answer all your questions about acute sinusitis by delving into its causes, signs and symptoms and effective treatment options to help you manage the condition.

Causes of acute sinusitis

1. Common cold

There are many possible ways you may end up with acute sinusitis, and the most common of these is through a cold. Colds are infections induced by viruses or bacteria. These pathogens infect the cells lining the sinus membrane resulting in inflammation. At this point, the inflamed sinuses become swollen, inhibiting mucus drainage and resulting in acute sinusitis.³ Depending on the cause, you may either have viral or bacterial sinusitis. While viral sinusitis can clear up without medication, a bacterial infection will likely progress to chronic rhinosinusitis without antibiotic therapy.

2. Dental infection

In rare cases, a dental infection could cause acute sinusitis. This is because your upper teeth are in close proximity to the maxillary sinuses, which are situated in the space between the cheekbones and the nose. If severely infected, bacterial species like S. pneumoniae can infiltrate the maxillary sinus, thereby affecting and inflaming it and causing acute sinusitis.⁴

3. Allergic Rhinitis

Allergic rhinitis is a cold-like nasal inflammation caused by exposure to allergens like dust, pollen (hay fever), mould, and dust mites. Inhaling allergens like these could inflame the sinus lining resulting in acute sinusitis.

4. Cystic Fibrosis

 Cystic fibrosis is a rare genetic condition that can cause acute sinusitis. People with cystic fibrosis produce thick and sticky mucus, which can block the sinuses and cause an infection.⁵

5. Nasal polyps

Nasal polyps are noncancerous growths that line the paranasal sinus. They can arise from recurring infections, conditions like cancer or drug sensitivity. Though nasal polyps are non-problematic, they can obstruct the sinuses, which can cause fluid and pressure accumulation in the cavities.

Signs and symptoms of acute sinusitis

Below are a few indications that you may have acute sinusitis.

• Nasal congestion 
• Difficulty breathing
• Sore throat
• Thick mucus
• Cough 
• Altered sense of taste and smell
• Ear pressure
• Bad breath
• Snoring
• Swelling and tenderness around the nose, eyes and forehead
• Headache
• Toothache
• Mucus drainage at the back of the throat
• Fatigue

Management and treatment for acute sinusitis

Typically, acute sinusitis clears up without treatment within a few weeks. You can manage the symptoms with the following approaches:

Nasal corticosteroids: these are anti-inflammatory medications which can effectively reduce sinusitis-induced swelling. This improves nasal drainage, thereby speeding up recovery from acute sinusitis. Nasal decongestants may also have this beneficial anti-inflammatory effect, so they can be used in place of contortionists. However, you should seek medical advice before taking decongestants for sinusitis because certain groups of people may experience adverse effects. These individuals include: 

Saline nasal spray: A nasal spray involves flushing your nose with salt water. When done correctly, saline irrigation loosens thick mucus in the nasal cavity, promoting proper drainage.

Antihistamines: If the cause of your sinusitis is exposure to allergens, antihistamines would be highly effective in managing your symptoms. They reduce inflammation which reduces swelling in the sinus and promotes recovery. Allergen-induced sinusitis can also be treated with immunotherapy.⁶ This approach boosts the body’s ability to react to allergen exposure, thereby reducing the severity of sinusiti.

Painkillers: Sinusitis can be uncomfortable and even painful. This is because the fluid build-up increases the pressure in your sinuses. The NHS recommends using paracetamol or ibuprofen to address this discomfort. You can also address the discomfort with a warm compress over your sinuses to relieve pressure.

Antibiotics: Antibiotic therapy is rarely the first course of action to treat acute sinusitis. This is because the infection typically clears up without intervention. But if the infection persists, your GP may prescribe a course of antibiotics to target the causative pathogens. This can effectively treat the condition.

Endoscopic sinus surgery: In severe cases like chronic sinusitis or recurrent infections, medical practitioners can treat sinusitis surgically using endoscopy. They perform surgery using a  specialised camera to identify the cause of sinus blockage like a nasal polyp, scar tissue or a swollen mucosal membrane. In some cases, sinusitis occurs due to septum deviation, which can be detected using this approach. In the first case, treatment will involve surgically removing the blockages. Septum deviation can also be corrected surgically. Ultimately, endoscopic sinus surgery is an excellent alternative for treating severe sinusitis.⁷

In addition to applying the relevant approaches, the best way to treat acute sinusitis is by getting adequate rest and hydrating. This will promote the body’s immune response against the sinus inflammation, relieving your symptoms. It would be best to avoid allergens like dust and pollen or habits like smoking while recovering from a sinus infection.

FAQs

How is acute sinusitis diagnosed?

To confirm an acute sinusitis diagnosis, your GP will discuss your medical history to identify the expected symptoms outlined above and highlight possible allergen exposure. They may also conduct a physical exam to feel for sinus swelling.

Alternative sinusitis diagnosis could involve allergy testing. A skin allergy test can identify allergens responsible for your flare-ups. As explored above, endoscopy is an excellent approach for visualising blockages and diagnosing sinusitis. Your doctor may also apply imaging techniques like a CT scan to study your sinus cavity. Like with endoscopy, imaging helps to identify abnormalities like septum deviation predisposing you to sinusitis.

A rare diagnostic approach would involve tissue culturing. This method tests a nasal tissue sample in the lab to determine the cause of prolonged sinusitis. This approach is especially beneficial for detecting bacterial sinusitis because there are lab techniques to type pathogenic species, allowing for a more specialised treatment approach.

How can I prevent acute sinusitis?

The best way to prevent acute sinusitis is to limit your exposure to nasal irritants that can inflame the lining of your sinuses. Avoid smoking tobacco and inhaling chemical fumes, and limit exposure to allergens and dust. 

Secondly, since the common cold is a leading cause of acute sinusitis, practising good hygiene can prevent a sinus infection. Simple approaches like washing your hands and brushing your teeth daily can control infection and sinusitis.

Using a humidifier prevents sinusitis by optimising mucus drainage. By moistening the mucus, your body can flush out pathogens that can cause an infection. Regularly using nasal rinses also do the same, making them an effective prevention strategy.

What are the risk factors for acute sinusitis?

There are a few risk factors that increase the likelihood of facing an acute sinus infection. As we have established, the common cold, dental conditions, allergies like hay fever and exposure to irritants like dust and tobacco can induce sinusitis. Secondly, nasal abnormalities like nasal polyps and septum deviation could predispose you to sinus infections. Finally, conditions like cystic fibrosis, respiratory infections and diseases affecting your immune system increase your chances of getting a sinus infection.

How common is acute sinusitis?

Acute rhinosinusitis is common, especially during flu season. Studies have approximated its prevalence to be 25% in some communities in the UK.⁸ This sinusitis is not as common in children because their sinuses are not fully developed.⁸

When should I see a doctor?

The CDC recommends seeking medical attention if you observe the following:

• Severe symptoms like excruciating headaches or a persistent fever for more than four days
• If you experience sinusitis symptoms for over two weeks
• If you have experienced recurrent sinus infections

Summary

All in all, acute sinusitis is a common infection resulting in paranasal sinus swelling. You may experience discomfort due to the symptoms, but this condition is manageable, and treatment is not required. If you have sinusitis, you should manage the symptoms with the above strategies and avoid risk factors where possible.