Chronic sinusitis
Key points
- Chronic sinusitis is a prolonged or recurrent infection and/or inflammation of the sinuses of the head.
- The sinuses are openings in the bones around the nose.
- The goals of treatment are the cure of the infection and the relief of symptoms.
- Chronic sinus infections are usually curable but may require extended treatment.
Alternative names
Chronic sinus infection; Sinusitis - chronic
Definition
Chronic sinusitis is a prolonged or recurrent infection and/or inflammation of the sinuses of the head.
Causes, incidence, and risk factors
The sinuses are openings in the bones around the nose. There are 4 pairs of sinuses connected to the nasal cavity by small openings. Normally, air passes in and out of the sinuses, and mucus and fluid drain from the sinuses into the nose.
Sinusitis occurs when there is infection, or inflammation due to allergies, in one or more of the sinuses. Acute sinusitis is often associated with upper respiratory infections, as inflammation of the nasal passages prevents drainage of fluid from the sinuses, which allows infection of the sinuses to occur.
A deviated nasal septum or other obstruction of the nose may also trap fluid in a sinus, causing chronic sinusitis. Dental infections such as tooth abscess may spread into the sinus and infect it directly.
Chronic sinusitis is much less common than acute sinusitis. When sinusitis recurs frequently, or lasts for a prolonged period of time, it is classified as chronic. While acute sinusitis is usually caused by infection with a single type of bacteria or virus, chronic sinusitis is usually caused either by allergies or by infection with a mixture of different types of bacteria.
Chronic sinusitis may have less severe symptoms than acute sinusitis but can cause damage and destruction to the tissues of the sinuses. It may flare up spontaneously or may follow respiratory infections such as colds.
Allergy to the aspergillus species of fungus appears to cause a particularly difficult to treat form of chronic sinusitis.
Symptoms
Symptoms may persist for 3 months or more.
- headache (in the front of the head or around the eyes)
- facial pain around the eyes or in the forehead or cheeks
- pain in the roof of the mouth or teeth
- nasal drainage (yellow, yellow-green, thick)
- cough
Signs and tests
- Percussion over a sinus shows tenderness.
- Normal sinuses transilluminate (glow when a light is shone directly on the sinuses), but sinuses do not transilluminate when sinusitis is present.
- Sinus X-rays, cranial CT scan, or cranial MRI shows the sinuses to be filled with fluid, or shows thickening of the membranes of the sinus.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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