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Sinusitis

Acute sinusitis is a transient inflammation of the tissues lining the paranasal sinuses. As the mucous membranes of the nasal cavities are most often affected at the same time, it is known as acute rhino-sinusitis.

Acute sinusitis is a very common condition, affecting around one in seven people every year. Although benign in the majority of cases, this condition can sometimes lead to serious complications, particularly when caused by bacteria.

Sinus anatomy

The paranasal sinuses are air-filled cavities located in the facial bones and connected to the nasal cavity by narrow passages. They include the maxillary sinuses, located under the eyes; the frontal sinuses, located above the eyes; the ethmoidal sinuses, located between the eyes; and the sphenoidal sinuses, located deeper behind the nose. While the nasal cavities humidify, warm and filter inhaled air, the exact role of the paranasal sinuses remains controversial. In the event of infection or inflammation, the drainage orifices of the sinuses can become blocked, leading to an accumulation of mucus and unpleasant symptoms.

anatomie sinus

Symptoms of acute sinusitis

Clinical signs of acute sinusitis include persistent nasal congestion accompanied by thick nasal discharge, which is often yellow or green colored. Pain or a feeling of pressure in the face, particularly around the cheeks, forehead or between the eyes, is common. This pain is often intensified when the patient tilts his or her head forward. A reduction or loss of sense of smell is also common. Some patients may also experience moderate fever, general fatigue, a dry or hacking cough, and tooth or ear pain. These symptoms generally appear in the days following a viral infection of the upper respiratory tract and may persist for 1 to 2 weeks before gradually improving.

Causes of sinusitis

Acute sinusitis is often the result of a viral infection, such as the common cold. These viruses irritate and inflame the nasal and sinus mucosa, blocking the drainage channels and creating an environment conducive to the accumulation of mucus. In around 0.5% to 2% of cases, a secondary bacterial infection occurs. The bacteria most often involved are Streptococcus pneumoniae, Haemophilus influenzae and, more rarely, Moraxella catarrhalis. Environmental or physiological factors, such as allergies, a deviated nasal septum or smoking, can also contribute to the development of sinusitis.

Sinusitis risk factors

Several factors increase the predisposition to developing acute sinusitis. Chronic respiratory allergies, such as allergic rhinitis, predispose the nasal mucosa to inflammation. Smoking, whether active or passive, weakens the defence mechanisms of the mucous membranes. Other factors include asthma, immunodeficiency, structural abnormalities such as a deviated septum, or regular exposure to polluted environments.

Diagnosing sinusitis

The diagnosis of acute sinusitis is based primarily on an analysis of the symptoms and a meticulous endoscopic clinical examination. The ENT doctor will assess the presence of purulent nasal discharge, localised facial pain and nasal congestion. Nasal endoscopy often provides information on the condition of the nasal mucosa, the patency of the drainage channels in the various sinuses and the presence of associated pathologies, such as deviated septum, polyps, masses, etc. If there is any doubt, or if complications are suspected, a CT scan may be performed to visualise the state of the sinuses and rule out underlying causes, such as polyps or serious infections. Rarely, a puncture is required to take samples for microbiological analysis.

Treating sinusitis

Most acute sinusitis is caused by viruses and responds well to symptomatic treatment. Nasal cleansing with saline solution is recommended to remove secretions and reduce inflammation. Nasal decongestants can be used for short periods to relieve pressure and make breathing easier. Analgesics and antipyretics, such as paracetamol or ibuprofen, are effective in calming pain and reducing fever. In confirmed cases of bacterial sinusitis, antibiotics may be prescribed, but only if symptoms persist or worsen after 7 days.

In cases of chronic sinusitis or in the presence of structural complications, surgery may be considered. Functional Endoscopic Sinus Surgery (FESS) is a procedure frequently performed to restore normal sinus drainage by removing obstructions, such as polyps or inflamed tissue. This treatment is reserved for patients in whom drug therapies have proved ineffective or unsuitable.

Progression and possible complications

Although acute sinusitis is often self-limiting, serious complications can arise from untreated bacterial infection. The most feared include orbital cellulitis, brain abscess, cavernous sinus thrombosis and meningitis. Although rare, these complications require urgent medical intervention to avoid potentially fatal consequences.

Another potential consequence is the development of chronic sinusitis, defined as symptoms that persist for more than 12 weeks. Chronic sinusitis may be the result of several poorly resolved acute episodes or persistent inflammation due to factors such as nasal polyps or a deviated nasal septum. It manifests as chronic nasal congestion, recurrent facial pain and prolonged loss of smell. This condition often requires specialist management, including prolonged drug treatment or, in some cases, surgery.

Preventing sinusitis

Adopting certain preventive measures can significantly reduce the risk of acute sinusitis. Good hand hygiene is recommended to prevent the spread of respiratory infections. Allergies should be properly managed, and exposure to irritants such as cigarette smoke should be avoided. Using a humidifier in dry environments can also help keep nasal mucous membranes healthy.

When should you contact the Doctor?

Medical attention is advised if symptoms persist for more than 7 days or suddenly worsen. Signs of seriousness, such as fever over 39°C, intense facial pain or swelling around the eyes, warrant urgent attention. Blurred vision, mental confusion or a stiff neck are also alarming symptoms requiring immediate assessment.

Care at Hôpital de La Tour

Hôpital de La Tour has a specialist ear, nose and throat team to diagnose and treat acute sinusitis effectively. With modern equipment and a personalised approach, every patient benefits from care tailored to their clinical situation.

FAQ on acute sinusitis

What are the main causes of acute sinusitis?
The main causes include viral infections, which are the most common, followed by secondary bacterial infections and allergies.

How can you tell the difference between viral and bacterial sinusitis?
Bacterial sinusitis is often characterised by symptoms that persist for more than 10 days, worsen after initial improvement or are markedly intense.

What are the signs of serious sinusitis?
Alarming signs include high fever, intense facial pain, swelling around the eyes and blurred vision.

What treatments can relieve the symptoms?
Saline nasal washes, analgesics and, if necessary, corticosteroid nasal sprays are the most effective treatments.

Should antibiotics always be used for acute sinusitis?
No, antibiotics are only indicated for confirmed bacterial cases or cases of complications.

Is sinusitis contagious?
Sinusitis itself is not contagious, but the viral infections that cause it can be.

What factors increase the risk of sinusitis?
Respiratory allergies, smoking and immunodeficiency are among the main risk factors.

How can recurrent sinusitis be prevented?
Good hand hygiene, treating allergies and avoiding irritants such as tobacco are effective preventive measures

Did you know ?

Contrairement aux idées reçues, les antibiotiques sont rarement nécessaires dans le traitement de la sinusite aiguë. La plupart des cas régressent spontanément en moins de 10 jours.

Who should I see about these symptoms?

We recommend that you see the following health professional(s) :

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