The sinuses are involved in a high proportion of upper respiratory tract infections.
When the openings to the nasal passages are clear, the infections inside them recover promptly, but if the drainage is obstructed by a deflected septum, hypertrophied turbinates, spurs or polyps, the sinusitis may persist as a secondary infection or it may flare up into an acute supportive process.
Acute sinusitis may be restricted to one sinus or may involve several.
If all the sinuses are involved, then the condition is known as pansinusitis.
The most important symptom of acute sinusitis is pain.
In frontal sinusitis, the individual complains of frontal headache, in ethmoidal sinusitis, the pain is usually in or around the eyes, in maxillary sinusitis, the pain is lateral to the nose and is sometimes accompanied by aching of the upper teeth of the affected side, and in sphenoidal sinusitis, occipital headache may occur.
Nasal congestion and discharge are usually but not always present.
The individual feels generally miserable, apart from the pain.
If fever is at all present, is usually mild.
The most dangerous variety of sinusitis is symptoms of a frontal sinus, because it may rupture posteriorly, producing a brain damage.
The treatment of acute sinusitis is bed rest and the establishment of free drainage of the sinuses involved.
This is usually accomplished by nasal sprays of Neo-Synephrine, installations or some other type of vasoconstrictor drug.
Depending on the extent of the infection and the type of infecting organism, the individual may need to apply local therapy of this sort every one to four hours until drainage is established.
The use of penicillin usually speeds up the recovery process and definitely diminishes the chance of complications that follow the extension of a bacterial sinusitis.
Chronic sinusitis usually usually manifests itself by persistent nasal obstruction, due to discharge and edema of the nasal mucous membrane.
Due to the constant dripping of the discharge backward into the nasopharynx, the individual usually experiences a cough, and headaches which are most pronounced on awakening in the morning.
Chronic sinusitis is usually treated with nasal sprays or nose drops, in an effort to establish proper drainage.
The overuse of nasal decongestant for any prolonged time may aggravate rhinitis and sinusitis by causing rebound congestion, thus leading to further overuse.
Oily nose drops are to be avoided.
Structural deformities that obstruct the ostia of the sinus may require surgical attention; polyps may require excision or cauterization, a deflected septum may have to be removed or a narrow ostium widened.
Sterile Ringer's solution used with a nasal douche, can be obtained at any drug store, is a soothing method of cleansing the nose.
For drainage of the maxillary sinus, the incision is made along the upper gum line above the canine teeth.
To drain the frontal sinus an incision is made through the inner third of the eyebrow.