Sinusitis is also referred to in the trade as "sinusitis". Affected are the mucous membranes of the antrum, frontal sinus or ethmoidal cells ( see also: inflammation of the ethmoidal cells), more rarely other sinuses. Sinusitis is usually associated with a cold and can have various causes. Inflammation may be acute or chronic for months, as in most cases, depending on the extent of inflammation and therapy.
Contagion is possible through small droplets that are excreted when coughing or sneezing. Important for the risk of infection is how long the disease already prevails; if the person has recently been infected, the likelihood is greater that he will pass the disease on. So, the longer it has been that the disease has broken out, the less likely it is for another person to be infected.
There is a risk of infection if the viral load, ie the number of pathogens, is particularly high. Even before the first symptoms appear you are contagious for about 1-2 days.
With the onset of symptoms, the immune system reacts noticeably to the pathogen and tries to excrete and eliminate it.
In the first 2-3 days of the symptoms, the risk of infection is greatest, because in addition to sneezing and coughing the viruses are distributed over droplets. After about 3 days, the majority of the viral load is eliminated, infection by droplets is then unlikely for a healthy immune system.
The duration of sinusitis may, in some cases, vary from a few days to several months.
A typical viral infection resulting from a runny nose can be cured by itself or with treatment in under a week.
For bacterial pathogens, the healing may be delayed for another week.
Only with very stubborn pathogens and severe runoff disturbances in the nose can sinusitis become chronic. This may require long antibiotics or even surgical measures.
The duration of the sick leave depends on the work, the desire and the clinical picture of the patient. The most common form of sinusitis, caused by viral pathogens, will self-terminate within about 4-5 days. Since the infection of other people and most of the symptoms are largely overcome after about 3 days, the doctor usually writes for 2-3 days sick. In physically demanding occupations or in the health service, a sick leave can also take about a week.
If there is a suspicion of bacterially induced sinusitis, antibiotics may be given. Typically, an agent such as "amoxicillin" is taken for about 5-7 days. Even if the symptoms become significantly better, the antibiotic must not be stopped prematurely on its own. Non-eliminated bacteria can spread quickly and cause re-inflammation. In case of chronic inflammation, antibiotics can also be administered over several weeks together with other therapeutic procedures.
The majority of sinusitis is not bacterially induced. Thus, antibiotic administration only accelerates healing in a few cases.
In bacterial infections that are not treated with antibiotics, there is a risk that the inflammation does not heal by itself.
If sinusitis is ignored for weeks on end, despite sinus pains in the nose and tough yellow runny nose, the infection can become chronic. In this case, healing may be delayed for months. Under certain circumstances, the infection can only heal completely after weeks of therapy.
Sudden toothache can indicate a sinusitis. The antrum is also one of the sinuses and can cause supposed toothache. Loosening by treating the mucus drainage, the pain and pressure of the sinuses should also subside after a few days. In some cases, the inflammation can also settle there and become chronic with long-lasting pain on the tooth.
If the frontal sinus is affected it can also lead to uncomfortable pain in the head, which is accompanied by a feeling of pressure on the forehead and temples. Together with cold and mucous secretions, the headache should go back within a few days. If not, persistent infection may require further treatment.
The causes of sinusitis are, in most cases, infectious agents. Viruses make up the majority of potential pathogens, but bacteria can also cause colds. The viruses, which are mainly responsible for colds with inflammation, are called "rhinoviruses". Bacteria that cause sinusitis are mainly streptococci and staphylococci. They are attributed to less than 20% of the colds.
Important concomitant factors that promote sinusitis are cold, smoking, allergies, polyps, a crooked nasal septum, large turbinates and a pre-existing cold. In the latter problems of the nose there is a general outflow obstruction of mucous secretions. As a result, the mucus gets stuck with the pathogen in the nose and can spread to the paranasal sinuses in the episode. In an allergy, for example against house dust or pollen, there is an increased mucus formation in the nose, which also favors the establishment of a pathogen.
Symptoms of sinusitis include colds, viscous secretions, nasal pressure, forehead and cheeks, nasal pressure, headache, and a stuffy nose. In addition, a major inflammation may cause fever, fatigue, limb pain, cough, swelling, and other symptoms of infection. The pressure sensation above the affected paranasal sinuses is particularly typical, which gets even worse if you lean forward or hang your head down. It is an important indicator in the history of suppurative, tough mucus filling of the sinuses.
The type of cold and mucus in some cases allow a conclusion on the cause of the inflammation. In case of unilateral obstruction of the nose bacterial inflammation is more likely, in both cases a viral. Similarly, with a disease duration of more than a week with a particularly yellowish viscous nasal secretion a bacterial pathogen can be suspected.
Since the cause of the sinusitis is that the secretion drain is obstructed, this passage must be made possible by the therapy again. By opening the drainage channels, the mucus can dissolve by itself and less secretion is produced. Since the nasal mucous membranes are sometimes swollen due to the common cold, decongestant nasal sprays can be used. However, these must never be used for too long a period, as otherwise the independent regulation of the mucosal cells is permanently damaged. Nasal rinsing with sea salt water can stimulate secretion drainage.
If a bacterial pathogen is present, it is often necessary to prescribe an antibiotic for a few days so that the inflammation is suppressed. A long symptom duration with yellow mucus speaks for a bacterial sinusitis.
In case of chronic sinusitis, the causes have to be determined accurately and possible risk factors have to be eliminated. Operatively, in case of emergency, polyps can be removed and the nasal turbinates and nasal septum can be treated, so that the runoff is improved in the long term.